After 60 days in an acute inpatient hospital (nearly half of them critical care) my sister was discharged to a subacute facility. I cannot tell you the relief it is for my whole family to see her graduate to a subacute status and to a facility closer to home. The problem, however, was that the discharge took place on a Friday which shouldn’t be a big deal considering the human body functions 24/7 and so do care facilities.
Anyone who works in healthcare has heard the adage that every hospital really operates as four unique entities. There’s the daytime hospital, the evening and night hospital, the weekend hospital and the holiday hospital. Administrators like to think that what they see in the daytime is consistent 24/7. Not even close.
It didn’t occur to me that we’d have to orchestrate my sister’s transfer and new admission to avoid getting swallowed up in the evening and weekend abyss. She arrived at the new facility on Friday at 4:30 pm after a four hour transport. After being in her room for four hours she called the nurses to ask when they would be doing her dressing change and other cares needed before bed. She was exhausted from the trip and wanted to go to sleep but knew that she could not until certain things were performed by the nurses. The aid said, “The nurse doesn’t know how to do any of your procedures. She’s never seen this before.” That comment is a classic example of how to destroy patient and family trust in under five seconds. It left my sister in a panic and my other family members who were with her questioning if we had chosen the wrong facility.
I really had to ask, where was the director of nursing and admission coordinator in this? Hadn’t they prepared the staff for the admission? They had known for days what to expect in terms of her care and yet, left an inexperienced nurse in charge. Now I’m questioning everything on both ends of the transfer. Had the referring hospital really done their job? Is the receiving facility capable?
It’s clear we got the weekend hospital and staff members who not only felt insecure in their clinical abilities, but unfiltered in what they share with patients and families. Telling Elizabeth and my family what they did immediately eroded trust. Good thing I’m not shy about calling the DON on weekends, but honestly, what about all the other consumers who don’t know the system and how to advocate for themselves or family members? I shudder to think how often it happens.