who will be held responsible?
a question which i hate to answer, and more often than not, i don't have the answer.in our current department, patients often stay quite long (in the range of 1 to 6 weeks) because this is after all, a place for them to rehabilitate, and we know rehabilitation takes time. but unfortunately some patients (or relatives) will make use of the situation and tend to extend their hospitalisation stay. and because this is singapore, healthcare is heavily subsidised by the tax-payers if u stay in class B2 and C wards. we are all pressurized by the management to discharge the patients when they are fit to be discharged. (honestly i feel that we should have more nursing homes and step-down care centres, to be sponsored by some richy rich people so as to minimise this problem)
anyway, this gives us additional burden. besides treating the patients' medical conditions, we have to work beyond that. we have to cover the social aspects - updating relatives, ensuring the needful has a carer, ensuring that the patients will be discharged on the scheduled time, etc. most of the times this can be settled by the medical social worker. but usually i will try to settle first unless it gets way too out of hand, or when the social issue becomes the primary issue.
unfortunately, some relatives will treat the hospitals as a temporary place for respite care. and some dun even have realistic expectations. For the severely stroked-out patients, u don't expect them to be up and walking independently, do u? and for that matter, even for the patient who has residual function, we don't usually wait for them to recover completely (in terms of function). Which is why realistic goals need to be set and inform to the family.
anyway back to the topic.
i called up a relative a few days back to inform her that we will be discharging the patient next week. and the relative, when unable to take patient back, will come up with a lot of excuses or reasoning. Having working in this field for quite a while, i can briefly classify this into 3 main groups.
1) The one who played the doctor.
"i still hear him coughing.. he still complained that he is breathless, and i think he is still not well"
2) The last-minute changes.
"the maid that i have employed has her application rejected..."
"my mother, who is the one taking care of my sick father is also sick now..."
"i lied to u about the maid application. i have never intended to apply for one."
3) the one who played the lawyer.
"what is your name? are you going to be held responsible when something happens to my dad upon discharge?"
"wait.. before u say anything, let me prepare my pen and paper"
I hate to deal with the last group the most, because for the first 2 groups, i still have solutions. For the last group... well unfortunately i am not god and i don't play god. i wouldn't know what will happen to u, me or the patient tomorrow, so i can't be held responsible. and in the first place, should u be held responsible now that your father/mother/child has ended up as a patient cos u didn't take good care of him/her?
sigh. ultimately this is a service industry. we can't be too rude cos singaporeans are so fond of complaining the slightest bit. and i don't see the need of risking a complaint letter when the bulk of the profit is not shared with me.
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