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Message
re: Hospital pushing discharge for my 70 y/o parent who is COVID positive and hasn't improved
Posted on 4/3/20 at 11:30 am to Pandy Fackler
Posted on 4/3/20 at 11:30 am to Pandy Fackler
quote:
Well that's something the OP, his mom and an independent review body decides, not the hospital. They have rights. They should act on them.
Ummm the OP and his mom have zero say in it. It’s up to the doctors treating her. If she doesn’t meet the criteria for hospitalization (which is obviously the case since they are trying to discharge her) then she needs to go home. It’s not like the doctors are just guessing and following a hunch. There is very specific criteria that guides them on when a pneumonia case requires admission. Vital signs (HR, Ox Saturation, respiratory rate, etc) and labs indicate she can be at home for now.
1
Posted on 4/3/20 at 11:33 am to Scruffy
quote:
Scruffy
Lol you said this wasn't any more concerning than the yearly flu.
Posted on 4/3/20 at 11:35 am to Lithium
quote:
as long as she's in the hospital she is contagious to the staff. Huge shortage right now.
This shouldn't even be a remote concern of the OP's. It's not for him to take the weight of the world on his shoulders. It's for him to exercise his rights as he sees fit and to take care of his mom. That's it, that's all.
Posted on 4/3/20 at 11:37 am to JohnnyKilroy
quote:Definitely said that the CFR will be similar in the end.
Lol you said this wasn't any more concerning than the yearly flu.
Guesstimate was 0.1-0.3%, if Scruffy can recall.
Still gonna hold to that one for now.
Definitely is more concerning right now than the yearly flu, especially for the elderly.
Posted on 4/3/20 at 11:39 am to Pandy Fackler
This attitude is going to continue to make this whole bullshite worse. I'm not going to say anything more. If you don't want to hear that, that's fine.
Posted on 4/3/20 at 11:42 am to Scruffy
quote:
Definitely said that the CFR will be similar in the end.
Guesstimate was 0.1-0.3%, if Scruffy can recall.
Well a CFR between .1% and .3% is 5-15x higher than the seasonal flu
Posted on 4/3/20 at 11:43 am to Antonio Moss
quote:
The hospital can discharge. It's the doctor's (the one actually trained in medicine) call.
They can discharge if they win the appeal. I see this shite every single day. Also, physicians are the ones who review the appeal.
quote:
quote:
They have rights. They should act on them.
Sure, and its a waste of resources like I said.
Exercising one's rights is never a waste of resources. You sound fricking stupid and furthermore, if you believed a physician or hospital was making the wrong decision regarding someone you love, you'd goddamn act on your rights for sure.
I watch physicans prematurely discharge patients all the time because the administration wants them out. And because of that, I routinely see appeals won.
You sound like a fricking bureaucrat.
Posted on 4/3/20 at 11:45 am to Scruffy
quote:
Definitely is more concerning right now than the yearly flu, especially for the elderly or OBESE.
FIFY. Seems that my patients have all been large and talking to Docs at other ERs seems to be obesity is just as big a risk factor
Posted on 4/3/20 at 11:47 am to Lithium
Ofc obesity is a factor. Fatasses always have shitty breathing bc their intercostals have to do their regular job AND pull all that fat up
Posted on 4/3/20 at 11:47 am to wope
quote:The insurer is probably the root of the problem. When my Dad was in a coma, they forced the hospital to kick him out.
She is insured so it is not a payment issue.
The next day we were approached by our insurance company's insurer, who reversed that decision. He got 2 more months in a hospital.
This post was edited on 4/3/20 at 11:50 am
Posted on 4/3/20 at 11:48 am to LSUFAITHFUL
quote:
Ummm the OP and his mom have zero say in it.
Ummmm, bullshite.
If they had "zero" say in it, they wouldn't have appeal rights.
quote:
It’s up to the doctors treating her.
Ummmm, bullshite.
If it were up to the "doctors treating her", she wouldn't have appeal rights.
quote:
There is very specific criteria that guides them on when a pneumonia case requires admission. Vital signs (HR, Ox Saturation, respiratory rate, etc) and labs indicate she can be at home for now.
I examine this criteria every single day. Every day.
Posted on 4/3/20 at 11:48 am to Pandy Fackler
quote:
Exercising one's rights is never a waste of resources.
That's just a ridiculous statement
quote:
You sound fricking stupid
Ok, Mr. Exercising rights is never a waste of resources.
quote:
if you believed a physician or hospital was making the wrong decision regarding someone you love, you'd goddamn act on your rights for sure.
Based on the information in OP, there aren't making the wrong decision - hence, if the info is accurate - its a waste of resources all around.
Posted on 4/3/20 at 11:55 am to El Segundo Guy
quote:
This attitude is going to continue to make this whole bullshite worse. I'm not going to say anything more. If you don't want to hear that, that's fine.
You can say anything you want.
I'm a licensed healthcare professional in three states, including Louisiana and I work in a GNO hospital.
I see physicians get discharges wrong often enough to know that not exercising one's rights as an educated and intelligent consumer often results in readmission.
Appeal rights are in place because in healthcare, everyone knows doctors are only a part of the decision making process when it comes to discharge. And because of this very salient truth, appeal processes are in place because hospitals and physicians cannot be trusted to do the right thing on their own. Now that's a fact.
Posted on 4/3/20 at 12:00 pm to Pandy Fackler
And I’m a civil litigation lawyer. People exercising their rights, 99% of the time, is a complete waste of everyones’s time, including mine. But, I’m paid to defend against stupid bullshite, so fine.
If she doesn’t meet the criteria to be in the hospital, what makes you think the appeal board of other doctors are going to do? They aren’t going to change the criteria.
Appeal boards are there to deal with close calls. This doesn’t sound like a close call. She’s not even having respiratory problems. He wants her admitted because she generally doesn’t feel well.
Also, you said that it’s not his responsibility to take this on. It absolutely is. Hospitals are there to treat the critically ill. She’s not there (at least yet). He needs to bring her home, take care of her, and watch her for signs of improvement or digression.
If she doesn’t meet the criteria to be in the hospital, what makes you think the appeal board of other doctors are going to do? They aren’t going to change the criteria.
Appeal boards are there to deal with close calls. This doesn’t sound like a close call. She’s not even having respiratory problems. He wants her admitted because she generally doesn’t feel well.
Also, you said that it’s not his responsibility to take this on. It absolutely is. Hospitals are there to treat the critically ill. She’s not there (at least yet). He needs to bring her home, take care of her, and watch her for signs of improvement or digression.
This post was edited on 4/3/20 at 12:03 pm
Posted on 4/3/20 at 12:03 pm to Pandy Fackler
Are you doing direct patient care for hospitalized confirmed coronavirus patients?
Posted on 4/3/20 at 12:04 pm to Antonio Moss
quote:
quote:
if you believed a physician or hospital was making the wrong decision regarding someone you love, you'd goddamn act on your rights for sure.
Based on the information in OP, there aren't making the wrong decision - hence, if the info is accurate - its a waste of resources all around.
The OP's not a clinician dumdum. He wouldn't fricking know if it's a waste of resources or not. Right now, he knows only what he's told. He doesn't have access to the EMR. An independent third party physician however will have access to the EMR. That's why he has appeal rights.
Hear me now and believe me later. If you ever had concerns a doctor or hospital was making wrong decision about someone you love, you would be morally remiss to not exercise every right you had to protect your loved one.
I see people appeal all the time. They're intelligent, tenacious and pro-active when it comes to their loved ones.
If you had doubts, you'd be a fool to just blindly listen to a doctor.
This post was edited on 4/3/20 at 12:05 pm
Posted on 4/3/20 at 12:11 pm to LSUFAITHFUL
quote:
Appeal boards are there to deal with close calls. This doesn’t sound like a close call.
How the frick would know? You're a goddamn lawyer.
quote:
Also, you said that it’s not his responsibility to take this on. It absolutely is. Hospitals are there to treat the critically ill. She’s not there (at least yet). He needs to bring her home, take care of her, and watch her for signs of improvement or digression.
Hey OP on second thought, the lawyer convinced me. Listen to the lawyer. He speaks very intelligently to what you need to do regarding the clinical care of your Mom.
I mean he is a lawyer and all.
I take it all back OP. the lawyer says "exercising your rights is a complete waste of everyone's time".
The lawyer has spoken. End thread.
This post was edited on 4/3/20 at 12:12 pm
Posted on 4/3/20 at 12:12 pm to Lithium
quote:
But as long as she's in the hospital she is contagious to the staff. Huge shortage right now.
Although it's obviously true about resource shortages (staff, beds and machines), the next person in that same room will probably be another Co-vid+ person due to everything that is going on right now.
The truth is that under normal situations, doctor's are fairly accurate with knowing who to discharge and who not to discharge, but they are currently dealing with something that is more unpredictable just because it's a new version of this virus and they don't have years of studies/practice on how to handle clients dealing with it. And it sounds like there isn't a lot of support in place for this lady other than her son, so I can understand his concern since simce she may not be able to fully advocate for herself at this time.
This post was edited on 4/3/20 at 12:16 pm
Posted on 4/3/20 at 12:12 pm to El Segundo Guy
quote:
Are you doing direct patient care for hospitalized confirmed coronavirus patients?
Yeas and I wear a number of different hats.
Posted on 4/3/20 at 12:14 pm to Pandy Fackler
quote:
Hear me now and believe me later. If you ever had concerns a doctor or hospital was making wrong decision about someone you love, you would be morally remiss to not exercise every right you had to protect your loved one.
If it were actual concerns based on evidence, sure. Not, "she is running a temperature and feels bad" emotion "so the doctors must be wrong."
I can spend 30 minutes to look up COVID guidelines for discharge and view it against the vital statistics and know whether the discharge order is legitimate.
I dealt with this kind of thing for seven weeks with a premature child. Listen to the doctors, research independently to verify.
And, as an attorney, I see wasted resources all the time when people, without any background knowledge, challenge those in-the-know based on nothing but emotion. They are passionate enough to get worked up but not passionate enough to do a little of reading on their own.
It's lazy, selfish, and ultimately harmful to others.
This post was edited on 4/3/20 at 12:16 pm
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