Discharging a patient...to the streets

TheCommuter, BSN, RN · Jul 11, 2008

In my area, when homeless patients stay at the hospital, the social workers gives them several options to keep them from going back to the street corner. Social work can either send them to a nursing home or extended care facility to live, they can be discharged to a shelter, or the ones who have willing relatives can be discharged home with family.

It is typically the homeless person who consciously chooses to end back up on the streets. They cannot deal with rules or authority figures in institutions such as nursing homes and shelters, and the ones who have family cannot abide by the household rules of their loved ones.

Although it is hard to believe that someone would choose to live like that, I am assured your former patient was given other options which he likely refused.

FireStarterRN, BSN, RN · Jul 11, 2008

Our jobs is to care for our patients, compassionately and competently while they are actively our patient. We cannot (and should not) live their lives for them.

TheCommuter, BSN, RN · Jul 11, 2008

I didn't even stop to offer him a few dollars.

This might sound cold-hearted, but I wouldn't offer money to a homeless person. Many spend the proceeds on alcohol or illegal drugs, and that's definitely not where I'd want my hard-earned dollars to go.

Giving them money will only make things easier in regards to scoring dope or buying the next bottle of whiskey. Giving the person a food item would be a better idea.

ChocoholicRN · Jul 11, 2008

I feel the same way about giving a homeless person money, in the past I have tried to give some sort of food or drink item. I actually had some of my lunch left (since I never got to take a lunch break) and was thinking of offering it to him. I've seen too many homeless people spend the money they get on alcohol. Also, given his admitting diagnosis (ETOH) I definately would not have given him money. I just wish I had given him something, even to hold him over for a little while.

bscn2013 · Jul 11, 2008

I heard one story where somebody gave a homeless person a gift card to a restaurant or fast food place. I thought that was a great idea!

leslie :-D · Jul 11, 2008

hubby gives me a hard time whenver i give money to the homeless people.

so now, for those who stand outside walgreen's, begging, i come out of the store w/oj's and candy bars.:chuckle

not a whole lot of choices in walgreens.

leslie

morte, LPN, LVN · Jul 11, 2008

i had a friend who worked as a discharge planner, she told me they had a patient who was given food, he sold it on the street for the money to buy what ever his drug of choice was....ETOH, i think.....so, unless you are going to "treat" them to a meal, eaten in front of you, even this is supporting or potentially supporting their habit.

Rabid Response · Jul 11, 2008

When I was youngster and new to San Francisco, I saw a man panhandling for change outside of a fast food restaurant that I was entering. He was asking everyone for "money for food." I felt so guilty while I was inside ordering my food that I just got myself a small bag of fries and spent the rest of my limited funds to buy the homeless guy a complete meal. When I handed the food to the man on the way out, he called me all kinds of names because he had wanted cash. He even threw the bag of food in the street. Talk about wake-up calls! I have since learned that there are plenty of places in SF for people to get free food. When they want money it is usually for drugs or alcohol.

I have volunteered at various organizations around town and with my church, which has a big homeless outreach program. I have grown to care a lot about some of the people I've worked with, but I now realize that addiction is an incurable disease that some people just cannot muster the strength (even with outside resources) to manage. Hospitals should do everything they can to discharge patients to safe places, but, without violating patients' civil rights, they can't control where many of those patients choose to end up.

allnurses Guide · Jul 11, 2008

Near me there are lots of disabled and older people living in vans,, SUVs, and motor homes.

They are very glad when I take him left over food from nurse meetings. Thay can buy the gas they need to move every night to a parking lot and then back to the street where there is no parking from 2:00 am until 6:00 am.

Some get free senior parking at the beach on week days.

I do keep some food in the trunk to offer people who ask for food money.

Some are glad to get bread, peanut butter, canned juice and soup.

One young man claimed he was allergic to everything I offerred so I said, "I'm sorry."

The worst was a guy smoking a cigarette who tried to sell me $50.00 in food stamps for $20.00. He said he needed toothpaste and tampons for his wife. But refused my offer to go buy him those items.

Someone probably did that for thirty dollars worth of food. Now I think there is a card they must show ID or have a PIN to use.

DanFNP · Jul 11, 2008

I often see homeless people. Social services and psych try to find safe places for these people. However, after I'm done treating them I have to move on. I honestly can't ensure that everyone who comes in the ED has a warm bed to go to. Overall, the hospital does its best.

allnurses Guide · Jul 11, 2008

A young homeless man spent all his waking hours walking around a pole. He would eat or dring what was handed to him but keep walking. I once saw him sleeping under a bench. When I checked to se if he was breathing he got up without looking or listening and began walking around the pole. He was incontinent and wore the same clothes every day.

After nearly three weeks he collapsed and was taken to a hospital.

Nearly a year later he wrote a letter to the editor thanking the people who fed him and tried to help him.

He had a family hundreds of miles away. After mental health treatment he was working and going to school.

Sure wish all coould recover like that.