M3. Teams & Teamwork: Scene 3C

Summary

The transcript details a team meeting discussing the care options for Mrs. Garcia, a patient facing a complex decision about going home or staying in rehab. Various healthcare professionals, including nurses, social workers, physical therapists, and administrators, debate the risks and benefits of each choice. The family is determined to take her home, considering cultural factors and support from extended family. Despite concerns about safety, financial implications, and the patient's readiness, the team remains divided, with a final discussion scheduled to reassess the situation.

Takeaways

• 😀 Rose, RN expresses disappointment that the meeting ended on a negative note, and highlights past conflicts in recommendations.
• 😀 Phyllis, SW points out that she was not given the chance to report, indicating communication issues within the team.
• 😀 JP, PT is concerned about Mrs. Garcia's readiness to go home and believes she needs rehab, emphasizing the need for the family to be comfortable with the decision.
• 😀 Marilyn, ADM raises the financial burden on the family if Mrs. Garcia goes home, with insurance coverage potentially limiting physical therapy to three visits a week.
• 😀 Phyllis, SW defends the family's wishes to take Mrs. Garcia home, explaining that they have support from extended family and friends and cultural reasons that influence their decision.
• 😀 Jane, SLT is willing to adjust the speech therapy approach, acknowledging that Mrs. Garcia can express her needs and the family can understand her well.
• 😀 JP, PT raises concerns about the safety of the home environment, citing stairs, the second-floor bedroom, and potential hazards like toys around the house.
• 😀 Phyllis, SW counters JP's concerns by explaining the family's efforts to make the home safer, including building a ramp and a bedroom on the first floor for Mrs. Garcia.
• 😀 Rose, RN acknowledges that some team members are uncertain about allowing Mrs. Garcia to go home and proposes reconvening at 2:00 pm to update Dr. Osgood and make a final decision.
• 😀 The conversation reveals the team's struggle to balance medical recommendations with the family's wishes and financial limitations, highlighting the complexity of caregiving decisions.

Q & A

What is the main concern that Rose, RN, expresses in the transcript?

Rose, RN, is concerned that the situation did not end on a positive note and feels uncomfortable witnessing the conflicting recommendations among the team. She also expresses uncertainty about the decisions being made, particularly regarding Mrs. Garcia’s discharge.

What conflicting recommendations are discussed in the transcript?

The main conflict in the discussion revolves around whether Mrs. Garcia should be discharged home or sent to a rehabilitation facility. Various team members have different perspectives on her readiness and the implications for her care.

What is Phyllis, SW's, argument regarding the family’s wishes for Mrs. Garcia?

Phyllis, SW, argues that the family has made it clear from the beginning that they want to take Mrs. Garcia home. She emphasizes that the family and extended circle of support are committed to ensuring her care at home, and that in their culture, placing her in a facility is considered taboo.

What financial concerns are raised in the discussion?

Marilyn, ADM, raises the concern that sending Mrs. Garcia home might be financially burdensome. Specifically, the family might only be able to secure approval for a limited number of physical therapy visits per week, which could impact the long-term financial viability of the decision.

How does Jane, SLT, adjust her stance on speech therapy for Mrs. Garcia?

Jane, SLT, acknowledges Phyllis’ point about the family's commitment and adjusts her stance on speech therapy. She becomes more flexible, recognizing that Mrs. Garcia is able to express her needs, and the family understands her well.

What is JP, PT's, concern regarding Mrs. Garcia’s safety at home?

JP, PT, is concerned that Mrs. Garcia's home is not safe due to factors like stairs, her bedroom being on the second floor, and the presence of children leaving toys around the house. These hazards make JP uncertain about whether home care is a viable option.

What solutions does Phyllis, SW, suggest to address the safety concerns?

Phyllis, SW, points out that the family has already considered these safety concerns. She mentions that Miguel’s brother is building a ramp for the entryway and converting a first-floor bedroom for Mrs. Garcia, showing their commitment to making the home safe for her.

What is Rose, RN's, stance on the discharge decision?

Rose, RN, expresses that she and some others are still unsure about allowing Mrs. Garcia to go home. She suggests the need to carefully consider the decision and update Dr. Osgood, who had recommended transferring Mrs. Garcia to rehab.

What is the overall tone of the conversation among the healthcare team?

The tone of the conversation is tense and somewhat divided. There are differing opinions on what is best for Mrs. Garcia, with some team members prioritizing the family’s wishes and others focusing on medical safety and financial concerns.

What is the significance of the family's cultural considerations in the discussion?

The family’s cultural considerations play a crucial role in the decision-making process. Phyllis, SW, highlights that in the family’s culture, placing Mrs. Garcia in a facility is considered taboo, which makes them even more determined to care for her at home despite the risks.