Drama and Trauma: Unpacking Moral Distress in the Context of Discharge Planning.

Abstract

This series of personal stories about hospital discharge experiences expose how fraught this transition can be. Not only do the authors reveal personal angst, feelings of endangerment, frank safety problems, lack of structural supports, but even more concerning are their perceptions of callous disregard, lack of adequate preparation and education, and unilateral decision-making by the health care teams. The "invisible hand" of our corporate health care system percolates, with some authors questioning whether the health professionals are advocating for their (i.e., the patient's) best interest or the best interest of their institution. There are also some shining examples though-moments when a health care team member takes the time, listens, problem-solves, advocates and expresses concern. In this commentary I will explore common themes in the narratives, and conclude with some suggestions-some simple, others aspirational, for how to make the discharge process more patient-centered and less traumatic for all moving forward.