I have believed since my first boyhood visit to Dr. Walter "Chocolate" Chung that our medical community physicians, nurses and hospitals puts patients and their families first. In a world where greed is often regarded as a virtue, I’ve always felt I could rely upon the physicians creed to do no harm.
So it baffles me that the trade association representing Hawaiis acute-care hospitals opposes Senate Bill 2264 (also known as the CARE Act). The bill allows patients of acute-care hospitals to designate a caregiver, requires that the hospital notify the caregiver before the patient is discharged, and also requires that the acute-care hospital demonstrate to the caregiver how to provide the care the patient will need at home.
We all know that not every patient walks out of the hospital completely cured. Patients requiring round-the-clock care may be discharged to nursing or care homes. Others, though still in a recovery mode, may be discharged home. That’s where caregivers, usually a family member, come in.
Several years ago a national organization, AARP, researched this special group of people. They found that on any given day in Hawaii, about 167,000 people or 247,000 people annually spend some unpaid time (or a lot of unpaid time) caring for a sick family member. So we’re not talking about a splinter-group of neighbors. Reliance on family caregivers is a fact of life here.
But as the state’s population turns increasingly grayer, the demands on caregivers will grow. You likely are, or may become, one. If you are, you may be called on to perform nursing care for which you have had little or no training or support. And if you fail to properly dress a wound, administer an injection, or properly deal with a gastric feeding tube, there’s a possibility that the one you care for will end up back in the hospital.
So, why are the hospitals opposed to SB 2264?
They claim the problem is "liability."
The irony is that in recent years, physicians and hospitals have increasingly turned over to nurses many of the clinical duties once reserved only for doctors. No one complained about "liability" while this transition took place.
The hospitals also say this bill would force them to hire more staff. Not so. SB 2264 doesn’t require hospitals to hire more people or go beyond the call of duty. It simply requires them to do their job as a part of the discharge planning process. In most cases, the person best qualified to provide the instruction is an attending nurse who is already familiar with the patient’s needs not some newly hired clinician who has never seen them.
I’ll never forget the situation with my late aunt, whom I hadnt seen in a while. She called me one afternoon from her hospital bed and asked for help. She was old and alone and could not think of anyone else to call. When I got to the hospital I discovered she had already been discharged. They gave me an address where they said I could find her; nothing else. I found her unattended in a bed in the basement of a house in a dilapidated part of town that somehow passed for a residential care facility. She couldnt tell me anything about her condition.
Since then, I have often wondered how many stories like that were floating around town.
Senate Bill 2264 puts patients and family members first and helps our seniors live independently at home. It needs to pass.
