There is lots of medicine to learn on the wards. You’re always busy taking histories, making assessments, writing notes and writing orders for a treatment plan. There are times when you get stuck with scutwork, more often than not paperwork that needs to be filled or things no one else wants to do.
In my case, I’m stuck with a patient.
She’s a homeless lady that bounces in and out of all the hospitals. She has chronic addiction problems and she has been evicted from every possible halfway house, detox program, government assistance, low-income rent in the city due to her continual drinking habits. No one is willing to take her. Her family members are not willing to take care of her and they are refusing to look after her in any of their homes. Most homeless people we can send to a shelter. Yet anytime we suggest sending her to a one of the many shelters in the city, leads to a barrage of phone calls and verbal abuse from family members. They accuse us of killing her and that there will be blood on our hands if we send her outside during the winter.
This patient has poor health but does not have any acute or ongoing medical issues. Her problems are social issues and specifically her drinking problems.
And as a MS3, I’ve spent several hours over the last two days trying to find a solution for her. Each day she stays in the hospital is costing taxpayer’s a few thousand dollars. Each day she’s in here, is another day this bed is occupied and not in use for someone with current medical issues requiring hospitalization. This is a no-win situation. The social worker is frustrated. Our medical team feels she has no reason to be in a hospital. The patient is lying to the nurses, social workers and other health care workers in order to buy a few more days in hospital.
Being in the medical profession can be quite frustrating when you’re stuck with difficult “social” cases. And as a medical student, when you have to take time – out of the little you have – to deal with disposition issues, you can become quite frustated. That is time that could be better spent seeing your other patients, learning at the bedside or catching up on your reading. Instead, you are stuck with bureacracy of paperwork and phone calls.
It’s things like this can drain the energy from your day and depress your mood when you get home.
I think the plan is to discharge her tomorrow (she’s already delayed it by 2 days) back to her family whether they like it or not. Now… the only question is how long will it be before she bounces back. It’s stuff like this that makes me dread going in some mornings.
*Events and identities changed to protect patient confidentiality.