This is the one thing I do NOT like about Hospice. Tonight, had a patient transferred in from an area hospital. The woman has end stage cancer. She is absolutely Hospice appropriate. However, the family is in NO WAY shape or form ready for her to be in hospice. She is still a full code, they want all her meds to stay the same and asked when her AM labs would be drawn. I asked them exactly what it was they wanted. They really would like more treatment, but the doctors told them nothing more could or would be done for her. We discussed hospital and acute care vrs. hospice and comfort care. She was admitted respite care so that the family could have time to decide whether or not to place her or to take her home. They thought she was coming in as an inpatient for symptom management. I reviewed the two types of services with them as well. The decision was made to have her admitted, then discuss all options with the medical director and social worker on Monday. (Did I mention the great planning that had this woman transferred at 6pm on a Friday night? They KNEW this was going to be a problem:banghead:) So in comes patient's sister after I finally got through to the spouse and children. "What do you MEAN she can't stay past 5 days? We cleared all this with "Mrs. Big whig" at your main office. Don't you understand who I am? I have donated a lot of money to this place and I demand that you take care of my sister:rolleyes:" My reply? Ma'am, "Mrs. Big whig" doesn't have the authority to make those kinds of decisions, her title is in marketing. The doctor and social worker will be in Monday to help straighten everything out. Futhermore, while our organization does appreciate all donations that will not encourage us to make fraudulant claims to insurance companies. If we did that then they would shut us down and we could help nobody. ALSO, I have cared for a US Senator's father and I have cared for the homeless, they all get treated with the same respect.
She was not happy with me, her hand was on her hip and she was jabbing her finger in my face. Finally the patient's spouse had to tell her to stop it. She then left the building and promptly called "Mrs. Big Whig" and left a message on her cell phone. I got a call at 11:30 at night. How dare I say she has No Authority, she IS a director. I replied, I wasn't being disrespectful, I was being honest. You do NOT have the authority to decide if someone is admitted GIP or repite care. Further, I hope the money she gave was worth all the energy and time I have spent admitting this patient tonight while the rest of my patients got neglected. I was informed in no uncertain terms it wasn't about the money it was about the patient. Blahhhh, sometimes I just want to tell them all where to go. I just want to take care of my patients and make them as comfortable as I can.
