The patient had to go back to the
hospital for almost a month when
staph and e coli infections arose at
home after her discharge following
quadruple bypass surgery.
When leaving the hospital this time
she enrolled with a visiting-nurse association
for in-home care, to be paid for
by her health insurance.
The care plan was for the nurses to
treat her wounds and flush her peripherally
inserted central catheter.
The care plan also called for the
nurses to teach the patient how to care
for her wounds herself, how to maintain
her diet, how to care for her diabetes
and how to keep her home safe.
From the start the patient objected
to her nurse’s “overly polite” attitude
and complained that her nurse was talking
down to her during patient-teaching
sessions.
Over the course of the first week
the nurse repeatedly insisted the patient
needed to start participating in her own
wound care and learn to flush her own
PICC line or she might possibly forfeit
her insurance coverage for skilled nursing
care. The patient became upset at
the prospect of losing her insurance
coverage for home care, as she might
die if the nurses stopped coming and
caring for he