What are social problems?

[alberrito]

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Hi

Can someone give examples of social problems in the wards? I have heard of it but am not sure what they are specifically. Thanks!

 

[FutureInternist]

Need for f/u appts
Old lady who lives alone but can't be safely d/c'd home & you are waiting for placement
No money for Rxs & you have to get Case Management to help out
Pt in hospital & you need to get a way to get their electricity bill paid so they don't turn it off.
etc
etc
etc

 

[alberrito]

thx! That's kinda awful how residents spend a lot of their time dealing with such issues...

 

[cassrae]

thx! That's kinda awful how residents spend a lot of their time dealing with such issues...

Well... it's the way of the world... do I wish there were less social issues to deal with? yes. Am I glad I got exposure to lots of social issues during residency so I know what I'm doing out of residency? yes.

 

[IMreshopeful]

This is why when looking for a job it's crucial to go to a place which has good case management. Otherwise you're screwed.

 

[Siggy]

thx! That's kinda awful how residents spend a lot of their time dealing with such issues...

Not nearly as awful as not being exposed to them until an attending, even if it's simple to reduce the sudden feeling that the job of an attending isn't something you signed up for.

Also, there's two different type of social problems. The medically related one (i.e. I once admitted a patient discharged home from a sub-acute with a trach and vent where home health didn't feel that they needed an RT available... that patient spent almost an entire hour at home before the family freaked and called 911) is one thing. The "the patient is homeless and drunk and needs someplace to sober up that isn't the street... and the police don't want to take him to jail," is a completely different social issue.

 

[FutureInternist]

thx! That's kinda awful how residents spend a lot of their time dealing with such issues...

You will have to do this as an attending as well although not to the same degree since Case Management @ private practice seems to be better
But knowing about it ahead of time will save you a ton load of time, re-writes of Rxs etc

Eg - For someone going home on O2 (new issue) & having MediCare you have to document
a) Room air O2 sats @ rest/ambulation (On the day of d/c)
b) Document a "face-to-face" in one of your notes (I told pt how to use O2 & what the benefits are etc)
c) If you sign your d/c summary then go back to addend anything in it, you have to print it out & sign it
d) The components of an O2 Rx -
"Room air O2 sats < 89% on 10/29/15
Dx - Hypoxia 2/2 CAP
Dose - 2 LPM via NC 24/7
Duration - 3 months"

You mess up any one of these & the pt can end up staying an extra day which is just more work for you the next day