Tuesday, January 21, 2014

I need your help in evaluating this story.  Is this what I should hope for when I advocate for patient-driven care, or is this an example of over-use in a hospital?  I'm really not sure, and I'd welcome your thoughts.

The story is of a 10-year-old boy who has a fever.  He is taken to the local urgent care center at 9:00am.  The family is told that the center cannot disburse medication and that, in any event, since the child's temperature is 102 degrees, he should be taken to the emergency room of a hospital in the neighboring community.

The family arrives at the ED in the late morning.  During the many hours of diagnosis and waiting, a "child life specialist" appears.  These caregivers are apparently common in pediatric centers.  I read from the hospital's website later that these staff members:

[P]rovide emotional support for children and families. They cover the inpatient service, operating room and Pediatric Emergency Department. Child Life is active in preparation and procedural support for children undergoing testing and procedures as well as providing support to children and their families. 

At some point, the specialist asks the child if he would like to watch a movie. He says yes and is presented with a five-page listing of videos from which he can pick.  He chooses one to watch on the television screen.

Meanwhile, he is also loaned an iPad, on which he can play games.

When it comes time for a nurse to insert an IV port, the child life specialist shields the child's eyes from the procedure with a book, while he continues to watch the movie and the iPad.  Here's the scene.

Eventually, at 3:00pm, the boy is discharged with a diagnosis of a fever of unknown origin and instructions to take medication to reduce the fever.

The parents, while greatly appreciative of the demeanor and expertise of the staff, were stunned at level of costs that would be required to deliver this kind of care.  They were perplexed as to why their son needed it.

What do you think?


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