During my most recent clinical rotation, I was assigned to a middle-aged man who was admitted for cellulitis and had a PICC line for antibiotic administration. I met him during his second hospitalization related to this diagnosis, as it was discovered that he was not self-administering his antibiotics at home.
This client did not have a stable job or a steady source of income, while also having three kids at home, of whom he is the primary caretaker. One of his children is severely autistic and requires constant care. He is HIV+, and has been diagnosed with T2DM, ADHD, anxiety, hypertension, and asthma. He is a current smoker and has a history of substance abuse.
I can imagine that this client is always stressed. He is a single parent with multiple health problems, poor economic stability, a high school education, and now must remain hospitalized due to an acute condition. While he was able to find transportation to and from the hospital, it sems that he’s lacking support medically, socially and emotionally at home. I think the staff at the hospital should have paid more attention to his home life and taken that into consideration before he was discharged with a PICC line and IV antibiotics. Maybe he couldn’t continue his treatment due to caretaker overload, or because he didn’t receive thorough and comprehensive education about how to administer the medications. Social work or home health could have followed up with him to make sure that he was comfortable with the regimen and staying on track with his scheduled antibiotics.
I also wish that the system had provided him with resources for his family and daughter. Clearly this patient was not going to be able to balance taking care of his medical conditions and his kids, let alone afford the treatments that he needs to stay alive on top of feeding three other people. I wish that there was a more rigid policy within hospital systems that required staff members to evaluate a patient’s home life and be able to designate resources and additional support as needed.
On a personal note, I definitely could have done more investigative work regarding the client’s mental health status, support systems and access to resources. I often feel that as a student nurse, I don’t have as much of a voice, but I know that I probably could have at least advocated for this man.
