Only the stench of a stage IV decubitus would be worse that what has been written here.
While I am no apologist for the “modern nursing home” Dr. Grumet clearly doesn’t know anything about them, or the many hardworking dedicated people who staff them. It is too easy to cast brickbats from the top of the hill where the hospital emergency room is located, but has the doctor tried to enlighten the nursing staff at the local SNF about the clinical protocols of managing a febrile, uncommunicative, 90 year old woman? I doubt it; it’s too easy to just throw stones, and roll your eyes when the patient appears at your door.
The societal metaphor for “nursing home” is negative, certainly. They exist NOT because there’s no place else as Dr. Grumet suggests, but because it is necessary to have 24 hour supervised nursing care for many patients at a price to society that’s acceptable. SNFs are NOT necessary evils as they were portrayed, but valuable centers of caring and support for patients, families and communities, including, I would insist, your local hospital. I know, because I’ve been inside thousands of both hospitals and nursing centers.
Most professionals in the sector know that dis-coordination between and among care platforms (i.e., hospital, SNF, HHAs, etc.) is a major fault line in the US healthcare system. Addressing these requires communication and earnest effort; patronizing stereotypes do not serve.
Really, doctor, if you’re driven to poetics, write an ode about the cold coffee in the doctors’ lounge, or a sonnet about the curve of the stethoscope. Please write about something of which you have some knowledge.