“Bed 10 is medically cleared but not going home today because he still got social issues we need to sort out. And there’s no one to pick him up because, for some important reason, his son who looks after him is in South Island. Besides, he is still waiting for his walking frame that the physiotherapist will bring in tomorrow morning.”
Perhaps for my colleagues, that nursing handover was totally uninteresting. But for me, during my first few weeks of working as a nurse in New Zealand, it sounded amazing.Back home, working as a staff nurse in a private hospital, our priority during discharge is to ensure that patients (or patient’s family) show us the receipt as proof that they have paid the hospital bills – and we do not care enough how they are going to get home or whether they can cope when they get home. It’s not that we do not really care. It’s just because there is no system in place to provide support for our patients – and yes it’s a very sad reality. When doctors decide that patients are good to go, that’s it! They need to go home.
I was overwhelmed by the adjustments that I have to go through particularly in this area where I am expected to be thoroughly involved with the MDT (Multidisciplinary Team – OT, PT, Dietician, Social Worker). I had all sorts of questions that may sound silly for some: How do we know that the patient has to be seen by the social worker? How do we write the referrals? Do we need a social work referral for everyone who lives alone? What can we do if the patient is unable to cook his meals after discharge? What do I do if the patient wants to see the social worker but the family says they’re happy and do not need the social worker? Do we really need to know how they are going to do their groceries when they are discharged? When do we decide NOT to refer a patient to PT? What kind of answer do they expect from me when they ask me how the patient is doing? Questions unending.
That time I wished I could get into that stage when a patient arrives for admission and I just know instantly who needs to be involved to discharge the patient safely. Things started to make real sense after a few months and I found the answers to my own questions.
After two years, I was already working in a busy Medical Assessment and Planning Unit and it was so refreshing to realize how much I’ve learned about MDT referrals. I couldn’t believe I could lead MDT meeting covering all 24 patients admitted in the unit with only 30 minutes to prepare – most of time I haven’t even met all 24 of them. It’s indeed amazing how I was able to find out their living situations, previous and current mobility and functional ability, social issues and other things they need like community support and dietician input. And I thank the Lord for the people he used to teach me well.
This photo (taken the other day at our backyard) reminds me of those moments of naivety. It reminds me of my desire to be better, to bloom in awesome colors from being a green bud. It reflects how I draw inspiration when I’m learning something and the proficiency I wanted is yet a wish. It is a lasting reminder that something bright and beautiful awaits and we need to be patient. It teaches us to hope and see the wonders beyond the present moment.