Patient A.B. has a bed on 5 South, a med floor notorious for NOT taking patients. Patient A.B. is a pleasant — as in nice-as-pie-pleasant — 45 year old woman with a very remote history of substance abuse as well as HIV infection related to, and well-controlled with antiretrovirals. She is here for recurrent fevers and myalgias that may or may not be related to her HIV infection; she is presently well, afebrile and basically waiting to see Infectious Diseases, who ironically has an infectious disease himself and can’t come till the next day. She is easily the best patient — and did I mention nicest? — I have today.
5 South has gotten wind of this patient from Bed Management, and all sorts of alarm bells are going off mostly, I am very sad to report, because of this patient’s HIV and/or substance abuse history. (In 2009!) I spend an hour trying to get this patient up to 5 South and into a decent bed — and just get flak from the floor. She’s too fat, I’m told. Seriously, and not that it should make any difference — but they can’t tell the difference between kilograms and lbs, apparently. She had loose stools five days prior to admission — Sweet Jesus, she has C.diff! She’ll disturb the patient in the next bed, who needs her rest. And so on. Finally they tell the charge to pick another patient, ’cause she ain’t coming, no way no how. A.B., it seems, has “too many issues.”
Is this a hospital, or what? Since when does the floor get to pick and choose patients? Apparently, this is what Acme Regional Health does.
In my exasperation, I call the 5 South charge nurse and suggest to her that she needs to come down and explain to my patient what issue in particular prevents her admission to 5 South.
This goes over, um, poorly.
Meanwhile (and against my better judgment) I complain, loudly, to my manager about the shoddy treatment my patient has received at the hands of the hospital.
Nothing, of course, is done. A small fuss is made. A lot of stonewalling from the 5 South manager, with a dash of equivocation. Accountability counts for squat.
Another day in the emerg.