Can only afford to hire caregivers? Multiple hospitals in Beijing have different opinions, why not allow family members to accompany the patient's family members | Hospital | Statement

Recently, Ms. Wang from Yunnan reported to reporters that in mid April this year, her family was hospitalized for 11 days in a hospital in Beijing due to a neurotumor. The hospital did not allow family members to accompany her, so she could only wait outside the ward every day. "At that time, the cost of nursing staff was over 2000 yuan, but now she still has to bear the high cost of accommodation, which puts a lot of economic pressure," Ms. Wang said.

Ms. Chen's family also encountered similar situations while hospitalized in Beijing. She said that she complained to the relevant departments before the hospital agreed to accompany her. "The hospital does not allow accompanying, and can only pay for caregivers. In fact, many patients hope that their families can accompany them."

Is it an isolated case or a common phenomenon in the industry that hospitals do not allow family members to accompany them? Does the relevant department have clear regulations on this? Recently, reporters visited multiple hospitals in Beijing and found that hospitals, patients, and patient families have different opinions on accompanying care issues.

Multiple hospitals do not allow patient family members to accompany them

Ms. Liu, who works in Beijing, told reporters that in March this year, she underwent laparoscopic surgery at a hospital in Tongzhou and stayed there for 7 days. After the surgery, Ms. Liu was unable to get out of bed due to the insertion of a catheter, but according to hospital regulations, family members are not allowed to enter the ward to accompany her.

In response, the hospital explained that this is in accordance with the regulations of the hospital during the epidemic, which have been used to this day. It also stated that for patients who cannot take care of themselves and elderly patients, a family member is allowed to accompany them.

"I suffered a lot of pain after the surgery and needed the help of my family to pick up food, help me with my body, go to the bathroom, and change my urine bag. My mother is outside the ward but she doesn't allow me in." Ms. Liu believes that the hospital's definition of "not being able to take care of oneself" is vague, and unfortunately, she can only hire a caregiver to take care of her, which costs 260 yuan per day.

Nursing Commission Agreement for a Hospital in Beijing

At another hospital in Beijing, a family member of a patient presented a caregiver commission agreement to the reporter, which showed a fee of 200 yuan per day. "It's not the patient's the final say whether to hire a nurse or not. If the doctor thinks you need to hire a nurse, he will give you a bill," said the nurse in the inpatient department of a Beijing hospital. Another hospital nurse said, "I don't know the reason, the whole hospital hires caregivers like this."

Some hospitals still use ward management regulations during the epidemic period

Why does the hospital not allow family members to accompany? The reporter visited multiple hospital departments and received different explanations.

The ward of a certain hospital in Beijing is still under closed management, and family members cannot accompany them

Several nurses in the inpatient department of Beijing Wangjing Hospital have stated that according to the epidemic control measures three years ago, the ward is under closed management and family members are generally not allowed to accompany. If accompanying is required, it needs to be decided by the resident doctor, but only one family member can accompany and cannot go out after entering the ward until discharge.

For the reason of not being able to accompany, the respiratory nurse in the inpatient department of the hospital stated that the hospital has such requirements. Previously, it was the epidemic, but now it is H1N1, in order to prevent cross infection.

At another hospital, a nursing staff member from the inpatient department explained that the department does not allow family members to accompany them, and even major surgeries are not possible. "The whole hospital is like this, and we are still following the rules of the previous epidemic."

Multiple departments of Beijing Children's Hospital claim that accompanying is not allowed

The reporter visited multiple departments of Beijing Children's Hospital, and many patient families and medical staff told the reporter that young children in cardiac surgery can be accompanied during surgery, while most other departments cannot be accompanied due to "limited ward space", "this has been the case since the establishment of the hospital", and "epidemic reasons".

So, do hospitals in other cities in China allow family members to accompany them? The reporter inquired about multiple hospitals in Henan, Hebei and other places. The head nurse of a hospital in Shijiazhuang, Hebei Province, stated that she has never heard of similar regulations that prohibit family accompaniment. To some extent, family accompaniment can alleviate the pressure on the hospital to care for patients.

When hiring a caregiver, we need to calculate the economic account and also consider the effectiveness

Some family members expressed that they do not understand the regulations in some hospitals in Beijing that do not allow family members to accompany them. They believe that hiring caregivers is a significant expense, and if family members take care of patients, it can be more considerate and reduce their financial burden. Moreover, for pediatric patients, the companionship of family members is most needed when they are sick, and even the most meticulous caregivers are not as caring as family members.

However, some family members believe that not allowing caregivers is also beneficial, as it can not only reduce the number of left behind personnel in the ward, but also provide patients with a relatively quiet environment.

Reporters visited multiple hospitals in Beijing and all stated that family members are not allowed to accompany them

A medical expert stated that the advantage of family companionship is that it does not require payment of caregiver fees. For some economically disadvantaged patients, it can reduce their financial burden. In some cases, family companionship can have a positive impact on the patient's treatment and recovery.

The admission reminder shows "Pay 1000 yuan for nursing workers"

Professor Wang Yue from the Department of Medical Ethics and Law at Peking University School of Medical Humanities stated that the ward should be the quietest and most suitable place for rest and recuperation. From the perspective of high-quality nursing, it is not advisable to encourage the patient's family to accompany the patient in the ward, as the professionalism of accompanying patients is relatively strong. If the patient's family members do not receive systematic and professional training, it may lead to improper nursing and cause new harm to the patient. In addition, accompanying family members can also cause inconvenience and disturbance to other patients, which is not conducive to their recovery.

Please ask the caregiver to open the blind box. How far is the "unaccompanied" ward?

According to media reports, as early as 2010, the former Ministry of Health issued a notice requiring the gradual resolution of the problem of relying on patients' family members or self hired caregivers to undertake patient care, and reducing the burden on patients' families.

In August 2020, the National Health Commission issued a notice on further strengthening the nursing work of medical institutions, which also proposed that when nursing resources are insufficient, medical institutions can hire a certain number of trained and qualified medical nurses according to actual needs.

In April 2022, the National Health Commission issued the "National Development Plan for Nursing", which proposed to "establish a management system for medical nursing staff" and "explore the establishment and development of a professional team of medical nursing staff" in filling the gaps and weaknesses in nursing.

However, to this day, many families of patients still face the dilemma of higher caregiver fees than self paid medical expenses; Even if you pay a high fee, you may not necessarily receive the corresponding service. Regarding this, Deng Yong, a professor at the Law Department of Beijing University of Traditional Chinese Medicine, stated that in reality, except for a few places, the medical nursing staff system has not been established for a long time and only stays at the theoretical level. It is still nursing staff who fill the gap in nursing resources.

Many patients and family members have a deep understanding that hiring a caregiver is like opening a blind box: encountering a good caregiver brings joy to everyone; Otherwise, not only will patients not receive good care, but disputes will also arise. In addition, caregiver fees have become a heavy burden for some families, and the combination of high caregiver fees and poor professional competence of some caregivers has become a major pain point in the caregiver industry.

The importance of nursing work for patient rehabilitation is self-evident. After entering an aging society, the care of patients with diseases such as cancer, cardiovascular disease, stroke, physical disabilities, and Alzheimer's disease all involves enormous energy. Children have to take care of their families while also working, which is truly unbearable. However, there are widespread problems in the nursing industry, such as insufficient nursing abilities and poor professional competence, which expose loopholes such as low entry and exit barriers, non-standard training, and even suspected abuse.

Promoting "unaccompanied" wards is not about having no caregivers, but about having standardized trained medical caregivers replace family members to take care of patients during hospitalization. In July 2019, the National Health Commission and other departments jointly issued a notice clarifying that medical caregivers are one of the medical auxiliary service personnel, and medical institutions have the responsibility to train medical caregivers. It can be seen from this that replacing ordinary caregivers with professional medical caregivers is the trend, the expectation of the people, and the practical task that medical institutions should take the lead in achieving.

The nursing industry cannot always be in a state of wild growth. Experts suggest establishing a graded nurse system, allowing registered nurses to engage in more professional medical related work, while caregivers are responsible for the patient's daily care; At the same time, strengthen the assessment of the bed to nurse ratio in public hospitals and form rigid constraints. Accelerating the implementation of the medical nursing staff system and promoting "unaccompanied" wards requires not only medical institutions to take the lead, but also medical insurance policies and financial investment support. This complex system project is a long and arduous task, but it must be pushed forward.

Comprehensive Beijing Evening News, CCTV, and Legal Daily