#hosptials

The reason hospitals exist is because there are many situations in which a person doesn't have the skill, equipment, and/or ability to take care of themself at home.

Maybe the person can't keep anything down and needs IV fluid to stay hydrated. Maybe they have altered mental status for some reason and can't keep themself safe. Maybe they need assessments for changes to their status around the clock. Maybe they need a medication that is dosed based on an assessment that they can't do themself. Maybe they need a treatment or medication that is too dangerous or side effect prone to give outpatient.

Any of these, among many others, are reasons people might have to stay in a hospital.

For surgery/trauma specifically, a pretty standard checklist has to be met for someone to go home. They have to:

Be able to hold down fluids (with oral anti-nausea medication if necessary)

Have tolerable pain with oral pain medication

Be back to (or very close to) their baseline mental status

Be able to pass gas

Be able to urinate

Finish their course of IV antibiotics (in the case of trauma or an intestinal surgery)

Be able to understand and follow their care plan at home (when to take meds, how to change dressings, when to come back for follow ups, when/how they can bathe, etc...)

Once these are all met, the person can generally go home safely. For some people and surgeries, this takes a few hours, for others this takes weeks or even months. Some people may even need to go to a rehab center or a skilled nursing facility before they can go home safely (especially if they can do everything but the last one).

Someone who is shot in the side and needs surgery likely had the bullet penetrate their peritoneum- the sac that holds their abdominal organs. This probably injured some intestine, which means she will need IV antibiotics and runs the risk of part of the bowel dying or failing to work as it should after the surgery.

If she was really proactive and there were no complications*, she could probably meet everything but the antibiotic requirement within 24 hours.

Now, after 24 hours, even if she'd met all the requirements except the IV antibiotics, she'd still have to leave against medical advice, or "AMA". This means that the best course of treatment, the IV antibiotics, has to take place in the hospital, and she would run the risk of complications (peritonitis) by skipping out before they were done. If she could convince the doctors to give her oral antibiotics**, she might even be able to leave without the high risk of peritonitis that comes with bowel surgery.

Speaking of complications, the main complications would be dead bowel (which would cause a lack of bowel movement/passing of gas, and vomiting), and peritonitis. For either of these, she would have to come back to the hospital and spend possibly a week or more with an NG tube or more IV antibiotics.

*This is something that would require her to start working on her checklist the second she got up to the floor. Trying to pee, being really aware of when she passed gas, drinking clear liquids like it was her job the second she was allowed, refusing IV meds if there was any other option, etc... It would not be fun or comfortable, and this assumes of course there are no complications.

wc: 1.2k

Also on archive

Dean found himself drifting off to the sweet litany of beeping monitors. The sound was like a lullaby in his head, the slow beep beep beep beep nothing more than a whisper, telling him to sleep. It rocked him on gentle waves and coaxed him closer to unconsciousness, although, a Dean that wasn’t pumped full of pain medication would understand that the beeping had nothing to do with his drooping eyelids and everything to do with said pain medication. 

Sleep was welcome to his aching body. He knew it was bad, it had to be if he was in the hospital and not some rundown motel, but his mind was foggy enough not to worry about just how bad. 

He came and went from consciousness, only waking when a nurse came to check on him or the drugs wore off and the pain started to creep in. His head hurt like a motherfucker and there was a throbbing ache in his leg and ribs that caused his breath to stutter every time he inhaled. 

“How are we doing?” a nurse asked, she was blond, petite, and was exactly Dean’s type, but unfortunately, being bedridden and out of it meant that he couldn’t exactly turn the charm on easily. Not to mention, he was already taken, he had no reason to flirt.

“‘M’kay,” Dean slurred in response.

New Post has been published on https://freenews.today/2020/12/18/italian-nurse-couple-brings-family-love-to-icu-burdened-by-covid-19/

Italian nurse couple brings family love to ICU burdened by COVID-19

ROME — The pandemic has posed unprecedented challenges for families around the world managing work and home life.

For the Di Giacobbe family, the juggling is even trickier since mom and dad are intensive care nurses in the same COVID-19 hospital. They spend their days trying to provide their patients the type of personal care and attention they give their children.

The family will celebrate Christmas together this year — parents Maurizio Di Giacobbe and Glenda Grossi managed to both get Dec. 25 off. But they won’t have grandparents, aunts and uncles around their holiday table. They want to protect them.

“So we will be with our three children, the dog and the two cats,” Grossi said on a rare Saturday when both parents were home at the same time, decorating the Christmas tree with Tiziano, 4, Arianna, 9, and Flavio, 10.

When the pandemic first erupted in Italy last spring, and no one knew how to mitigate its spread, the parents wore surgical masks around the children and developed a “virtual hug” to express their love. For the children, it was a game. But their parents knew first-hand just how deadly COVID-19 was.

“I don’t want to say we got used to seeing people die, but we were going to work with a kind of feeling of resignation” that at most they could provide their patients with dignity in their final moments, Di Giacobbe said.

Over time, doctors figured out which therapies worked better. “Now, instead, we are fighting,” he said.

Still, Italy now leads Europe with the most COVID-19 deaths — more than 65,000.

In many ways, the couple bring the love of a family into the COVID-19 ward, knowing well the importance of touches, caresses and video calls with their patients’ loved ones outside, who are otherwise barred from visiting.

Grossi tears up when she remembers one of her first patients at Rome’s Tor Vergata COVID hospital, Fabio, a 43-year-old father of three who married his partner in March while he was hospitalized with COVID-19.

“I remember that day when Fabio made the video call to his wife and children, he touched his chest with his hand and said: ‘They need to intubate me, I’ll see you soon.’” As Di Giaccobe sits by her side, Grossi’s voice cracks.

“’See you soon’ never came true unfortunately, because Fabio didn’t make it.”

Larger, modern emergency room on tap for NCH Downtown Baker Hospital in Naples. We are fortunate to have excellent healthcare including 4 hospitals in Collier County!Another great reason to retire or relocate to Naples Florida!