the homeless that wander in...

eyesopen_mouthshut, CNA · May 27, 2013

But that is just one experience. There are also amazing success stories! It's just learning to not be jaded from multiple bad experiences, because no one is exactly the same, and one experience cannot equal or justify all others.

Sassy5d · May 28, 2013

I'm not sure if it's so much the humanity and compassion of the community as it is homeless population of the community.... You can offer help and money and shelter and food to someone without those things, but if they have it in their minds that they only want alcohol or drugs, what are you supposed to do?
In my community there is a real problem with the homeless. Not in the sense that they are a nuisance or a problem, but in the sense that they rob, steal, and kill others for drugs and alcohol. It's also not that we don't have enough community support for them, we have a lot of shelters, food services, free health services, and transportation services for those who have jobs... It's just what they decided to do with all of the help we provide them.
Example would be I volunteer with a "soup kitchen" and we go out to these communities, and one night we had run out of bread to go with the vegetables, chicken, water, rice, and desserts we were serving, and about 15 people started screaming and throwing rocks and lit cigarettes at the staff saying "how in the f### do you expect us to eat without bread?! You dumb c####!!" now, unfortunately, we cannot go back to that part of town without added (and paid for) security.

Sadly, I've seen this myself. Handing out bag lunches. Sandwiches, drinks, side, ect and many complaining.. 1 guy said 'my Gf pregnant, htf is she supposed to eat this s@$&?'.... In the same thought, I think it might be 1 of those things where they have no control in their life and this behavior is some control. I see that a lot with quadriplegic pt's.

KelRN215, BSN, RN · May 28, 2013

We never discharge unless they have some where to go, especially when the weather is bad.

Therein lies the difference between the US and Canada.

Do-over, ASN, RN · May 28, 2013

Therein lies the difference between the US and Canada.

I don't know, I've not known my place to discharge people to the streets... Now, I don't know about ER, but not from the floor.

morte, LPN, LVN · May 28, 2013

If they are refusing placement, what are you supposed to do with them? take them home?

anotherone, BSN, RN · May 28, 2013

In some places there are thousands of ho

eless people. There simply isn't any where to place them and should that be yet another acute care hospital responsibility?

tewdles, RN · May 29, 2013

It is NOT the hospitals' responsibility solely, it is the responsibility of the community to address their civic issues, such as homelessness.

morte, LPN, LVN · May 29, 2013

yup, we don't want the patients to think of acute care as a hotel, so don't "rent" these folks a room. Which is what is happening.

It is NOT the hospitals' responsibility solely, it is the responsibility of the community to address their civic issues, such as homelessness.

Esme12, ASN, BSN, RN · May 29, 2013

It depends......there are the homeless and there are "the homeless". There are patients that do blatantly abuse the system......but.in most cases.....that is not for me to judge. IN the cold northeast......I don't turn out the homeless in a blizzard. I just don't especially at night. The is always a corner that can be found for a cup of coffee and a sandwich. Grant it this was a few years ago. We would collect all the held trays that were untouched to feed those who were needy. Key word needy .......not entitled and abusive.

There are those who look for the free meal and want that cab ride home and that needs to be handled differently. But if they are found dead in the parking lot on a cold winters night huddled next to a car by the door ...it will not be my conscience that will be haunted.

ChristineN, BSN, RN · May 29, 2013

We see a large number of homeless in the inner city ER I work in. The majority come in intoxicated or with psychiatric symptoms. It is very difficult to help these people, mainly we just give them a meal and a clean pair of clothes if they need it and send them back when they are stable. We seldom admit them but will if there is some medical reason besides intoxication (and I can say from working med-surg that once admitted they will not d/c them to the street, they will find a group home or something).

I did have a homeless guy the other day that was the exception. Polite, respectful, and very appreciated of our help. I don't know what lead to him being down on his luck but I did go out of my way to make sure he got a meal while in ER, would be able to afford his meds, etc.

tewdles, RN · May 30, 2013

Again, IMHO, the community owns the responsibility for their homeless, the hospital as a member of the community shares in that...but it is the communities issue.

Do the homeless suffer in your area? Are they treated with compassion or with disdain. What has the community done to try to improve the problem they have with homelessness?

allnurses Guide · May 30, 2013

When the homeless person (4-5 to 1 male to female) has so abused the system that even the shelters refuse to let them come back, it is hard to continue feeling compassion for long. When the abuse (while under the influence) is then turned towards staff, sedation is in their future. Which then gives a reason for keeping in the ER, have to monitor the effects.

We let people sleep it off overnight, and discharge in the morning (even have an acronym on the board for it "MTF" metabolize to freedom). Sometimes when we're flooded with people, they get DC'd, but finish out the night in the waiting room. Large amounts of community help/resources available. But that individual has to want it and work toward it. Those that just demand sandwiches, return abuse and have to be escorted out by security after discharge tends to demolish how eager anyone is to help the next one.