And today, this same patient was admitted AGAIN, for the third time over the past 5 weeks, and with the same presentation – non-infective exacerbation of COPD -_-”
I first saw this patient during the first week of my general medicine rotation. With a background history of schizoaffective disorder, the registrar already foresee this patient returning due to poor compliance and apathy. Hence, the team requested psychiatric review; psychiatric team decided that no further psych review required. COPD nurse and social worker input were requested; patient simply refused social workers assistance. And so patient was discharged, and to be followed-up by local GP.
In about two weeks time, the patient was admitted again. He just came back from having a cigarette when the registrar was about to see him during ward round -_-” Imagine a patient coming in with exacerbation of COPD, and yet still managed to walk down to the yard for a cigarette!? The registrar was a little pissed off, and decided to discharged him on that day itself since he did not appear to be medically sick at all! GP follow-up was arranged in a week time.
Four days later (i.e.today), the patient was re-admitted AGAIN! He reported shortness of breath (again), took TWO PUFFS of ventolin, and decided to call the ambulance! And he was about to go for a cigarette (again), when the medical team was just about to review him. And when asked why didn’t he try taking more ventolin before calling the ambulance, he claimed that too much ventolin is not good for him! -_-” The registrar decided to discharge him today (again)! This time the COPD nurse was to be visit him in a few days time, to make sure he does not come back to the hospital (again)!
Ah, god knows when will he be coming back again. And wasting the hospital resources!
Update: patient was re-admitted again on the night of discharge. This time, he reported having 6 puffs of ventolin before calling the ambulance -_-”
