<p>Admitted Friday and not discharged until Monday… This means either held in captivity or held for protection, depending on point of view. At times the protective nature of the policy for the student would be clear; at other times the policy would seem only to serve the school and hospital in terms of liabililty. Over the course of years, my bet is that at least one life is saved by the policy, however outrageous it might seem other times. </p>
<p>Yes, it’s clear that it serves the school in terms of liability. I get that and I don’t know why anybody thinks I dont get the concept. As blossom said, it’s likely cheaper to pick up a few hospital tabs here and there than to staff the center on weekends or 24/7, and forestalls the case where the stomachache-sent-home becomes a ruptured appendix with no one around which is both a bad thing AND a lawsuit. I understand WHY they do it, and I can easily imagine that in the past, some incident with a bad / unfortunate outcome prompted the policy. </p>
<p>Though it begs the question - the stomachache-sent-home that becomes a ruptured appendix late Sat night on campus with no one around – well, any student’s appendix could rupture on Saturday night as well without warning. Or a concussion could occur, etc. The real issue is that the only health care coverage on weekends appears to be - talk to someone over the phone, or call campus police and get to an ER. </p>
<p>Deleted.</p>
<p>I do wonder how a hospital justifies admitting someone who does not need to be admitted- how they would even code things from noon Saturday until Monday for insurance purposes. I know you’re frustrated, Pizzagirl. It does sound like a strange system. Glad your daughter’s okay.</p>
<p>Thank you, sevmom and everyone else who has expressed that. Much better she’s fine and temporarily inconvenienced, than needing medical care and not able to get it. </p>
<p>My D’s school has no health service person available after a certain time evenings and nothing on Sunday. They have limited hours on Sat. Other times, you go to the ER. A kid on D’s floor went to the ER on the weekend, and according to her left AMA, and had no trouble getting back into the dorm. This is what is hard to understand about Pizzagirl’s daughter’s experience, that she would be locked out of the dorm. I assume that the kid my D knew about did not go to the health service first because the story seemed to begin on a weekend night to my recollection. Probably if a kid at Pizzagirl’s D’s college went in on Sat night to ER, the kid could leave and student health would be none the wiser.</p>
<p>Years ago, in our day in school, there were infirmaries where you stayed overnight which were run by the college. I think some schools still have them, but fewer do have them. I remember a tour a few years ago of a LAC that said they had one with a NP 24/7. I think at Columbia U, you go to the ER on weekends (although I won’t swear to that). In law school my friend got food poisoning and went to the infirmary. We were at Emory, and this was a little building next to the big hospital. The services were less, but they did check on her and bring her food and I guess run some tests and other treatment. I had to get her keys and go to her apt and get her clothing when she was ready to leave, so I saw the place inside. The beds were not hospital beds, and the room did not look like a hospital room. She was pretty sick for a couple of days, but apparently they did not feel that she had needed the regular hospital room. This was pretty easy to do there, since they had the entire hospital just next door. In my undergrad there was an infirmary as well, but no more. </p>
<p>Our D became ill last year, and it was a bit of a saga because she did not go for treatment right away. It is difficult if they are a distance from home. This is one of the downsides of the independence of being at a school a bit far from home. She called us, but really did not want to hear what we had to say.</p>
<p>PG, I think you are right to pursue this, but I don’t think that this type of non availability of health service is so uncommon on the weekend. I work in healthcare, and I also don’t understand how the bill is justifiable, but I am not in the hospital. I know my FIL had a weekend in the hospital a while back where he was ready to go home but was not to be discharged until monday. The initial diagnosis was not so minor so perhaps this justified it. This was on medicare, so i assume the hospital knows what is legit. Another time he was in ER for observation for many hours, and then discharged. The medical issues were different. But to keep someone for two days with a minor issue would seem to be excessive.</p>
<p>It sounds like your beef should be with the school, not the hospital. The school will not allow a campus resident to return after being hospitalized until cleared by the health center personnel. The school apparently refuses to make such personnel available over the weekend. So she’s barred from campus until Monday.</p>
<p>So what’s the hospital supposed to do in that situation? It sounds like they would have released her if she had someplace else to go – you said they would have released her if the parents had flown to the hospital. It sounds like the agreement with the school allows the hospital to AVOID having to kick students out onto the street before they are allowed to return to their home on campus. The hospital is being accommodating here.</p>
<p>We don’t know enough about OP’s daughter’s condition to speculate, but there are certainly times that patients will be held in the hospital unless and until they have adequate care arranged at home. That’s happened to me because I live alone. </p>
<p>I wonder if the hospital would have released her if (a) you had arranged for her to stay in a hotel until she was allowed back on campus; or (b) you had arranged for her to stay in a hotel WITH a non-professional caregiver? </p>
<p>In any event, some might be grateful that the hospital didn’t require her to leave during a time she wasn’t permitted to return to campus.</p>
<p>
</p>
<p>It seems like this could have been handled over the phone by someone on Saturday, although I’m not sure that anything more than a doctor’s statement that the student is cleared to return to campus is the school’s business. An exception may be if the school was somehow contributing to the illness or injury or the student needed new accommodations.</p>
<p>The policy was likely not designed for the exact medical issue PG’s D had. (policies never are). It was likely designed for an ER visit which upon follow up, labs, and the medical judgment of the attending, is deemed non-emergent yet requiring monitoring, further labs, observation, etc. And this is probably 75% of cases this college/hospital combo has seen- suspected food poisoning/pathogen; other acute gastro symptoms, headache/sore throat/acute neck pain (is it a bad cold or mono?) maybe early symptoms which could be an ectopic pregnancy (but that’s quickly ruled out) and then a wide range of other gyno/gastro conditions need to be considered.</p>
<p>The easy college health issues are breaks and sprains, dislocated shoulder playing lacrosse, etc. Nobody has to build a college health care ecosystem to take care of those. Find an ER or an acute care clinic with an Xray machine, give the kid a 2 day supply of painkillers and recommend follow up with an ortho on Monday.</p>
<p>The ones that require some diagnostic subtlety end up catching someone’s kid in a twilight zone- which is PG’s kid. In this case, no further labs were required. But SOMEONE (and it wasn’t going to be the Friday night attending at the ER) needed to determine that PG’s daughter was in no danger of readmission, relapse, needing any medical or pharma intervention, etc. And since that someone wasn’t an on-call doc from the college… kid is stuck at the hospital.</p>
<p>The policy was designed to catch mono, meningitis, etc. And if your kid is PG’s roommate, you’d be grateful that the policy required that someone be deemed “no threat” before coming out of the ER and moving back into the dorm.</p>
<p>Problem is that PG’s D was fine, nobody willing to bend the policy to sign her back in. So the policy is too rigid. But I still think the college likes the current system despite the once every two years it messes up.</p>
<p>“Problem is that PG’s D was fine, nobody willing to bend the policy to sign her back in. So the policy is too rigid. But I still think the college likes the current system despite the once every two years it messes up.”</p>
<p>Right. And I understand that once it was deemed a for-everyone-in-every-situation policy, that’s what it became. It’s a combination of liking their current policy, having it be cheaper than staffing a health center over the weekend, and certainly liability avoidance. I understand how they got to the place they are. </p>
<p>It would have been nice to at least known that at the time of admissions, though – rather than be told “you’re medically cleared for discharge, start packing” and then “surprise! you’re staying here til Monday.” </p>
<p>I think it’s interested that whomever does “intake” at the college trumps a physician. Let us hope the “intake clearer” at the college is equally trained or more trained than the physicians at the hospital who make the decision when typically discharge occurs. I still find the policy puzzling and procedurally flawed. </p>
<p>Pizzagirl, I admire your perspective (post #124) now that your daughter is back in school. I hope she is feeling better.</p>
<p>ER’s stabilize. They discharge people all the time who end up back there again within hours or days, and some don’t make it. I think it makes sense for the college to want to clear people themselves. The rigidity of the policy may just signify how hard it is to draw a line, and they are probably legally safer not drawing lines but making it absolute.</p>
<p>Speaking of civil rights, one of my kids was recently restrained in bed for some weeks so the hospital would not be sued for a fall. Net result is extreme muscle atrophy, and, frankly, soiling oneself. (Staffing levels are too low to get there in time)</p>
<p>Institutions have their own agendas, usually self-protective. Then again, that same hospital saved my daughter’s life.</p>
<p>So if PG’s daughter demanded that she be allowed to leave the hospital, they would have had to let her go, right? And if the hospital then called the college to let someone there know that daughter had been released, would that have been a violation of patient confidentiality? And if the college had disabled daughter’s card for door swipes after learning that she was on her way back to campus, what’s to prevent daughter from calling a school friend to let her into the dorm? Daughter is an upperclasswoman, so assuming she has a single, the only potential hurdle to getting in to her dorm room is whether or not the room lock is an old fashioned key (which daughter likely has in her possession) or a card-activated lock, which the school could render inoperable by disabling the card. What’s the school going to do, post a campus security person to be on the look out for daughter and physically restrain her from entering the dorm or room?</p>
<p>PG, have you asked to be provided with a written copy of this policy? If so, has the school complied with your request? It just seems to me that there are too many potential problems with such a policy, as I understand it from PG’s posts, to be legal or practical in a situation where a student asserts her rights. The convenience or CYA factor for the college does not trump a student’s rights.</p>
<p>@sevmom
I think that PIzzagirl’s daughter was admitted, for legit reasons – she wrote something about being held for 24 hours’ observation – it’s that they didn’t discharge her on Saturday. That is due apparently to the fact that the D. was received as a patient from the college (rather than arriving on her own to the ER, without having first gone to the student health services) – so it has something to do with the agreement between the two medical facilities as well. </p>
<p>Although Pizzagirl was told that the policy applies to “any” ER treatment, it might be more nuanced - it’s possible that there is a more detailed and nuanced list of conditions under which the policy applies, but the medical director didn’t want to get into a long conversation over the details. I’m not saying that the medical director lied - just that maybe there are some exceptions to the policy that weren’t applicable in her daughter’s case. </p>
<p>@middkid86 –
Patient confidentiality isn’t implicated because the campus health center was initial treatment provider. If a patient goes to Medical Facility A, and Facility A decides to transfer the patient to Facility B – Facility B is under an obligation to report back to Facility A what happened to that patient It would have been a different matter if the daughter had bypassed the student health center and gone to an outside emergency room on her own. Essentially, under these circumstances, the ER operates as an extension of the student health facility. </p>
<p>^Right, but the student health facility isn’t the one saying they’ll freeze the dorm-card. That’s non-medical personnel.</p>
<p>When the hospital doc has cleared her to leave the hospital and go back into the community, and yet the college threatens to bar her from her housing until she jumps through their administrative hoops, I wonder if it’s a fair housing act violation.</p>
<p>I imagine this is all legal. I think Pizzagirl is wise to move on, and appreciate that her daughter is, at least for now, well. We think long and hard before entering an ER, even without the added factor of a college health service sending us.</p>
<p>Kidnapping is legal? Seems like in loco parentis taken way too far.</p>
<p>Ask the ACLU. This poor thing was quarantined for no medical reason.</p>
<p>Glad your D is safe and sound; that is the most important thing. Working as a nurse in the hospital in the past I have seen some bizarre admission and discharge practices. I was curious as to if they offered her a choice; (I’m assuming she is 18 or older) Leave AMA and not got the clearance paperwork you need to go back on campus, thus endangering your status as a student; or just wait til Monday and get the proper paperwork. That’s frequently hospitals justify things; they give you a choice but not really a feasible one.</p>
<p>@calmom (#133) I guess I thought the observation from Friday (which was justified) would have been considered different for insurance purposes from an admission that would have taken place on Saturday but perhaps I’m mistaken. I am not a medical person .</p>