Hospitals fund drunk tanks...

sjoe · Feb 8, 2003

emily responds: "Obviously you don't understand that not ALL homeless people are lazy or "don't wish to take care of their own responsibilities" as you say."

The topic of this thread is NOT homeless people, but drunks who would otherwise be in jails or ERs because of their behavior.

and: "Does that make every over-worked, stressed out RN/LPN a possible criminal? "

Of course every nurse, stressed out or not, is a possible criminal, as is everyone else. And if this theoretical nurse behaves in a criminal manner, and is relatively obvious about it, then he/she can expect to be arrested at some point.

and: "I volunteer at a homeless men's shelter and also for Feed My People foodbank/shelter. What have YOU done to help?"

Good for you, but don't break your arm patting yourself on the back. That is a LOT different from spending several 8-hour shifts/week with them, IMHO.

NMA writes: 'I was referring to why aren't the intoxicated being taken to the local police drunk tank these days to "sober up?" '

Well, in San Francisco the tanks are often filled to overflowing, AND sometimes these people are going through DTs, seizures, etc. Perhaps when and if the City has its next budget surplus (I am not holding my breath), it could put more money into more and larger drunk tanks. (That would be an interesting campaign issue. I can see the placards now.) Certainly would be a more cost-effective measure than the ER (except for the lawsuits that result when inmates later complain that they didn't get the healthcare that the Supreme Court has mandated they are entitled to). Many problems.

colleen writes: "I doubt the hospitals are putting this plan into action out of the goodness of their hearts. This is probably the most cost effective way for them to handle an immense and growing problem."

Hopefully it will work out.

The next major problem of the same kind is the street IV drug users, whose abscesses, when I lived there a couple years ago, were costing upwards of $100,000 to treat. Many of my patients had current I&Ds and scores of old scars from previous infections.

Should the ERs and jails be clogged up with these people? Should taxpayers be shouldering this weight? Should the county hospitals be over-burdened by these costs? Should you or your family members have to wait extra hours in an ER to get treated because of this overload? I haven't seen any effective solutions as yet.

emily_mom · Feb 8, 2003

I'm not breaking my arm patting myself on the back. I'm making a point that maybe if there were more people willing to donate some of their time to others less fortunate we wouldn't have such a problem.

Everyone wants to shove them off on someone else. Somebody needs to step up to the plate as we have done in our city and give them a hand up....not a hand out. We have had a 90% success rate with getting them off the streets and into treatment, job training, etc.... It can be done. It just takes a lot of money and a lot of patience on the part of everyone.

It just pizzes me off that everyone thinks it is the other person's problem. It's a problem for all of us and some solution is better than nothing.

Kristy

sanakruz, ADN · Feb 8, 2003

They did this in CT when I worked at the state psych hosp there.It was a detox ward staffed by nurses where vitals were monitored and intervention given if needed(read:valium). Too many people die in the drunk tank at county lock ups. One would be lucky to get a blanket never mind a bunk.

2ndCareerRN · Feb 8, 2003

In keeping with the why don't the drunks go to jail theme.

There is not enough room for them. Almost every jail in the US is overcrowded. Many to the point that there have been court orders handed down to limit the number of prisoners at one time.

Because of this the decision on who stays, and who goes rests with the arresting agency. For the most part, public drunkeness is a victimless crime. Unless of course the drunk himself gets assaulted or robbed. I would much rather have a sleepy drunk turned loose than someone who just assaulted the little ole lady down the street. Or the perp of some other crime more violent than being drunk.

I applaud the effort of the hospital to try to do something to both help society and to help out the people who really need the ER.

FWIW, we routinely get drunks in to do legal blood draws on, and after it is completed they are turned loose to make their own way home, with their summons in their hand.

bob

NMAguiar · Feb 8, 2003

After reading 2ndCareer_Rn's posting, another issue came to mind. Since police and EMS representatives pick up most drunks, won't liability issues force them to still be delivered to emergency rooms?

Speaking as a former paramedic, most regularly contacted drunks have additional health issues. Many others simply fake symptoms -- some are very proficient at using the S&S's that will assure they end up in a hospital and not a jail.

Isn't it likely that many of these problems will still find themselves in ER rather than the planned shelter? Real or not, I can't imagine any public servant risking a lawsuit by delivering a drunk with other issues -- real or not -- at a shelter.

Emily_mom: I wish I knew you. You are obviously very sensitive and elequent in your passionate descriptions of the problem. I agree 200 percent. We need more like you in nursing.

fiestynurse · Feb 8, 2003

Yup! Huge liability issues associated with "drunk tanks" Even if police bring a highly itoxicated individual to the jail, they still get sent to the ER first to be evaluated, then they are closely monitored in safety cells. There have been many deaths associated with "drunk tanks" and I am surprised that a hospital would want that liability. It really is a community issue that the hospital should not have to deal with on it's own.

We had a "drunk tank" here at the local College campus, but it was shut down due to cost. A safe place for the kids to sober up and then they had to go through an educational program before leaving. Further treatment and counselling was offered when appropriate.

NMAguiar · Feb 9, 2003

I thought "College Campus" and "Drunk Tank" were synonimous. :roll

sjoe · Feb 9, 2003

Or "fraternity" and "drunk tank." Good thinking.

Mama Val, ASN, RN · Feb 10, 2003

2ndCareerRN- "Because of this the decision on who stays, and who goes rests with the arresting agency. For the most part, public drunkeness is a victimless crime. Unless of course the drunk himself gets assaulted or robbed. I would much rather have a sleepy drunk turned loose than someone who just assaulted the little ole lady down the street. Or the perp of some other crime more violent than being drunk."

Victimless Crime, I don't think so, the "town drunk" touches a lotta people, they affect businesses with their presence, encourage others to drink along with them leading to fights, vandilism, destroy property and in extreme instances rape or kill. And the cost for the Police man hours to resolve the above problems who pays for that...we do.

I am not saying that you should lock up someone because they are drunk and/or homeless but getting them off the street into a safe environment until they can take care of themselves is the next best thing.

Up here we have the Title 47 Commitment, if a Peace Officer or a doctor declares that you are to intoxicated to care for yourself he can commit you to the jail for a 12 hour sleep-off. You get out if someone who is sober, over 18 y/o will sign for you stating they will monitor you for the 12 hours and be responsible for your welfare, or you are released after 12 hours. The cops run these guys by the hospital for medical clearance before they come to jail, but its a joke. A lot of times they don't get a BAC or a set of vitals and then declare these people ok to come to jail. We get a clearance sheet that tells us just about nothing on this person. When they get to the jail we check on them every 15-30 minutes. I know most of these people and we (the jail) become= their primary care provider. T47 is a non-criminal hold, but I would rather get these guys in a safe environment then out on the street, they do not need to be in the ER unless they are REALLLYYYY injured.

And lets face it some of these people are not gonna change, they either can't or won't and why should they , they get all they need from public or gov assistance anyway. We used to have a transfer station here also, if you were drunk, had no place to go you could come in and get your vitals checked and crash for a few hours on a mattress then leave. It came in handy when it was 20 below outside and it freed up the police who now spend so much wasted time running drunks back and forth.

I only wish our hospital would fork over some of that money for a place like that all. All they do is b!tch at they way we (the jail and the treatment center) are doing our job. I would ask anybody to try my jobs for a month and then give me the answers because I have been doing it for 6 years and I still don't know the answers myself.

Sorry guys just venting, think I will go have a drink now, make it a virgin I am working at Detox right now

sjoe · Feb 10, 2003

Mama writes: "And lets face it some of these people are not gonna change, they either can't or won't and why should they , they get all they need from public or gov assistance anyway."

You got it right.

An additional problem in overly-"helpful" cities like San Francisco is that there are so many of these people that the entire system is completely overloaded and most of them can't be taken off the sidewalk on any given night, much less put through any screenings or into any protective environments (punitive or otherwise). And what is done clogs up the ER (and jails) for other people who have more reason to be there.

At least stopping the city's practice of giving these people weekly cash (!) might encourage some to consider alternative lifestyles, but no solution has yet been found.

Then, of course, is the parallel problem of street junkies.

Mama Val, ASN, RN · Feb 11, 2003

I only wish that the cash these people get would actually pay their bill. We get PFD checks once a year here, $1800 last year, our clients can sign over a percentage of this to pay their bill, HA.

Just take a number and stand in line to get it after :

child support payments are taken out,

any court fees are taken out and

civil action fee's are taken out, and thats if the client wants to give up some of their money to pay their bill...what a concept...personal responsibility, who knew.

Every quarter the native corporations send checks to all their share holders and the money is drunk up as fast as you can cash the check, we can't touch thios money. When I ask my clients how they are gonna pay their bill they just look at me like I am crazy, ANHS (Alaska Native Health Service) will pay, well no they won't can you make payments of $5.00 a month...why should I, you have to take care of me why, I can't afford it and why should I pay anyway (sounds like jail). They have enough cash to get drunk/high but can't spend any on their on health care needs. But we let them get away with it, sometimes I wonder if we are enabling or truely helping?????

Frustrated