The Public System

I am on prac at a hospital that is divided into a public sector and a private sector. At first look there is really no difference with the facilities provided and when talking to the physios, there is no difference in the time spent with patients or the amount of care patient receives. This got me tinking about why then would people pay all this money to be in the private sector of the hospital when they could have the same treatment in the public for free!

For three weeks now I have been treating patient on the public ward, who is a very dense right hemiplegic and still remains non responsive to verbal commands. Treatment so far has included positioning, passive movements of UL and LL and mm stretches of tight muscles esp Pect mj, lat dorsi, wrist and long finger flexors, hip adductors and IR. With the assistance of another physio we hve been moving him from supine to SOEOB (max 2xA) and working on some sitting balance (and also beneficial for his lungs) and we have also slide sheeted him onto a tilt table which he tolerated well. For three weeks he has not made any progress. He still remains non responsive (GCS 9/15) and he is max assist of 2 people for bed mobility and supine to SOEOB, and requires a hoist transfer.

His prognosis is poor and is very much likely to be transfered to a nursing home instead of rehabilitation. I do understand that it is very hard to rehab someone who is non responsive but my impression from being on the ward is that this patient is too expensive to keep in hospital. I am having a lot of difficulty accepting that in the public sector it is mainly about how much the bed is costing the government each day then what is best for the patient. I have not a lot of experience and I dont know what will be best for this patient in the long term but should it really come down to money? Its a persons life we are dealing with here...not a bed number.

I have talked to the physio about this briefly and really thats the way it is...unfortunately. I know as I enter the work ofrce I will encounter many frustrating things and maybe with some I might beable to change somethings for the better of the patient. Right now tho as a student I do believe somethings are just out of our reach.