Sunday, April 12, 2009

An Issue of General Concern

There is something I need to mention which has always been of concern to me and I know will also be of concern to others.

We hear a lot in the media (mostly in relation to the older generation) about patients' daily needs being neglected on hospital wards. We hear about elderly people being offered no help with eating and being left on soiled and/or wet sheets.

There are bound to be times when this is a result of staff shortages or bad organisation but there are other times (probably more often than any of us would like to imagine) when these incidents of neglect are deliberate.

There are times when hospital staff want the patient discharged but would rather that the family took the responsibility of initiating the discharge. That way any later problems can not be blamed on the hospital as 'they' didn't authorise the discharge of the patient.

There is a familiar pattern to this neglect. Previously efficient nurses, who are helpful to family members in the processes involved in daily care needs, suddenly offer no help at all and if the family members are not present at any point ignore the needs of the patient in relation to feeding and hygiene. The intended result is that the family will be so incensed by this neglect that they will take their relative home in order to prevent the situation from deteriorating further.

This is something we have encountered on several occasions in relation to Hari - and on most occasions I could see it coming. It follows general disinterest in Hari's health from the medical team; either they are totally disinterested in the problems that caused the admission or there are further problems that they simply don't want to deal with.

The disinterest of the medical team could be problematic if they just discharge the patient and his/her condition worsens once they are home. There is the possibility of complaints and media coverage resulting from early and inappropriate discharge. So if the family can be deceived into initiating the discharge through this type of neglect there can be no come back on the medical team / hospital.

I should point out that individual nurses should not be blamed when this occurs - they are following orders and dare not disobey.

I should also point out that we have been aware of this nasty little trick from very early on and have been able to predict when it was about to happen - oh and we know who was giving the orders for this when it happened at the end of Hari's last admittance in early 2008!

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