Advertisement
Special Feature| Volume 355, ISSUE 1, P99-100, January 2018

When Patient/Family Expectations and Hospital Protocol Conflict

  • Orel Shuker
    Affiliations
    Internal Medicine Department, Institute of Endocrinology, Diabetes & Metabolism, Rambam Health Care Campus, Haifa, Israel

    Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
    Search for articles by this author
  • Mogher Khamaisi
    Correspondence
    Correspondence: Mogher Khamaisi, MD, PhD, Internal Medicine D, Institute of Endocrinology, Diabetes & Metabolism, Rambam Health Care Campus, POB 9602, Haifa 31096, Israel.
    Affiliations
    Internal Medicine Department, Institute of Endocrinology, Diabetes & Metabolism, Rambam Health Care Campus, Haifa, Israel

    Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
    Search for articles by this author
Published:February 16, 2017DOI:https://doi.org/10.1016/j.amjms.2017.01.012
      We recently cared for a 57-year-old female admitted to the internal medicine ward at our hospital with shortness of breath, worsening dysphagia and increasing peripheral edema for 3 weeks. Past medical history was significant for polymyositis, treated previously with corticosteroids and intravenous immunoglobulin. When her symptoms worsened progressively, she was admitted to the intensive care unit of the internal medicine department (ICU-IM). After 1 week, we performed endotracheal intubation and 2 weeks later tracheostomy. In the ICU-IM, our patient suffered several episodes of ventilator-associated pneumonia and septic shock, leading to organ damage (renal, gastrointestinal and endocrine). Recovery occurred gradually in the ICU-IM over 3 months, such that she regained the ability to breathe and feed on her own. As highly qualified personnel in our small (6 bed) ICU-IM deliver expert healthcare to the most critically ill patients, plans were made per standard hospital protocol to transfer this improving patient from the ICU-IM to a general internal medicine ward and later to an intensive rehabilitation center. During the patient׳s recovery period, we provided the patient and family with projected dates and specific goals for transfer.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to The American Journal of the Medical Sciences
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect