Cooler weather and homeless "patients" - Page 3

Well, if a pt is that booze soaked it needs an admission, sorry but etoh does kill. There are many out of the way places in the hospital at night, not just the waiting room...although its not my responsibility to find it...nor to pass judgement on a homeless seeking shelter, nor to worry about offending the rest of the 'clients' getting a glimpse of societies real problems. This is a management problem, not a nursing issue, but if you are willing to try to step outside your roll as homeless police and do securities job for them...well, I say your in for early burnout. Sorry, but, I have compassion for them, even if they don't seem human, they still are. Like I said before...when did it become the nurses job to boot people into the street? Discharge them, and your role is over....let admin come up with a solution so I don't have to be the bad cop. Not my job.

I came back to this thread to respond specifically to you. I was thinking of your post yesterday when we began a spontaneous discussion about our regulars early yesterday morning. A couple of thoughts for you: 1) you only "need a bed upstairs," if you are so intoxicated you cant ambulate without falling over or worse; 2) if I am in triage, it is my responsibility to care for the people in the waiting room. I assure you the manager will not care that they weren't in the system when they collapse; 3) they are discharged or...checked in but not willing to go see the doctor when their turn comes; 4) it is my job to provide for the safety and well being for the people in the waiting room. One day, two discharged homeless patients got into a fight about a half cigarette and a dollar bill in our waiting. We had to clear the waiting room and get security to resolve it. They broke several chairs and finally...as we talked, I wondered how well you know the homeless patients you pity? Most of these folks have places they could stay but choose not to. I know this because I know them and their story. I do pity them but I also respect them as human beings enough that I refuse to act as though their hard existences are a reason to indulge inappropriate behavior. They are grown ups, they are endangering their well being and bankrupting the hospital!

I think for those frequent flyers who don't pay for their own care there should be some kind of limit. For instance, if you show up in the ER more than X number of times for non-emergent situations, we won't pay for it, and you will have to. I guess then it becomes a problem of collecting on the debts though...

I don't know about most other EDs but we contract our ED docs. They don't get paid unless they see patients. None of ours would let someone like this just hang out *unless* it isn't taking up resources. Those resources include the nurses and techs, since we need to get our work done on the other pts so they can be discharged.

DC