3. Case Managers (CM) and Social Workers (SW): Most hospitals have designated people to help with social aspects, insurance problems, and setting up good follow-up/care once patients are discharged from the hospital. Case Managers and Social Workers help set up all these things, you just need to let them know. In which situations will you need their help? DISPOSITION: This is BIG in the US. Patients CANNOT be discharged from the hospital if they don’t have a SAFE place to go back to. I stress the word SAFE because patients can have a home, but going back there might not be the best thing for them. Example: A 90-year-old man, who lives with an 85-year-old wife, underwent a R hip replacement due to a R hip fracture. This patient won’t be able to get the level of care he needs at home, so even though he has a house with a relative living with him, it’s not safe to discharge him home. He’ll need a Skilled Nursing Facility (SNF or “SNIF”) temporarily while he recovers. Case managers make the arrangements to get them a bed in a SNF, transport from the hospital, and insurance details you don’t need to worry about! Social workers can also help with housing situations, like shelters for unhoused patients. They also help set up Home Health, which is a service that requires a nurse to visit the patient daily in their home. For example, daily IV antibiotic infusion (patients with osteomyelitis), wound care (sacral wounds), physical therapy, etc. Patient might need to be discharged to a rehab facility, CMs can help set it up. Patient was found unconscious and alone, they can do a due diligence search to look for relatives. Some states provide a lot of social help so patients can get food stamps/vouchers. Sometimes they just need a ride to their houses, they can also get that arranged for patients. 2. Interpreter services: The US is very diverse regarding its population, and even though you might be proficient in many languages other than English, at some point, you’ll need to use the interpreter services to communicate with your patient and their relatives. Hospitals usually have iPads/tablets on mobile stands that you can grab to contact the interpreter. How does it work? Get the iPad inside the room, select the language you need, and wait for the interpreter to be connected. Most services will ask for some kind of patient identification information. Don’t forget to have it ready to speed up the process. Once the interpreter is ready, don’t forget to introduce yourself and the interpreter. Extra tips: Make sure it has a decent amount of battery because you don’t want the iPad to die in the middle of your history taking. Even if the patient has a relative who speaks English fluently, use the interpreter services for history taking as well as serious conversations. In most states, relatives are not allowed to translate for doctors. Legally, you need to have a certified translator to ensure that the patient is getting the best possible care in a language they can understand. Using an interpreter might be awkward and feel uncomfortable at the beginning, but it gets better with time.
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