Homeless working the system, multiple admissions

Specialties Psychiatric

Published

What do you do with people that keep coming back every 2 weeks or some that think they are smarter by getting discharged from 1 hospital then going to another and saying the magic words.

As a society, what do we do with these people?

Specializes in Hospice.

For every crack addict gamer there are more than one who are not ... Who's more important?

All the resentment I read here is perfectly valid and I'm not about to minimize it. Many years in public hospitals have made sure of that.

But if the gamers are the only ones you pay attention to or remember, then the gamers are running running the show.

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If assuring they have a safe place to be discharged to means 'finding them a home'- then I guess that is exactly what I am suggesting.

In an ideal world, I agree, that should be the case. However, that would essentially make hospitals responsible for finding housing for every homeless person in the country. If we had to keep each and every healthy person until the hospital found a place for them to live, there wouldn't be any room for people who are actually sick.

I think that healthcare systems should be responsible for helping people get healthy and stay healthy...and that is a big enough responsibility.

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I can certainly understand how hard it is to ask for public assistance. I was once one of the people processing disability claims for SSI and SSDI for my state. I made it 11months out of the 12month probationary period then got fired. I went from processing claims to being on it due to treatment resistant depression. At least now I can use that experience to help my close friends with SSA paperwork.

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It is more than just "I don't like homeless" people for a lot of these people complaining. People do game the system because they don't like other available options, but there are limited resources for psych. I work in a decent sized city and we get admissions from two hours away. We have to turn sick people away who need help because some other people don't like their options.

It also doesn't mean OP is crapping on their patients either. You can still treat you patients well while thinking what they are doing is wrong.

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By the way, I work with a certain type of population that for some reason believes they are so special...I've worked in a prison with bona fide criminals who weren't as bad as the people I serve now.

If you're homeless with a crack addiction, i find it exceedingly distasteful to be as picky, as demanding, as self righteous as you are. Three hots and a cot with snacks and entertainment. nd you still have stuff to complain about. Ugh!

I'm curious to know how you feel when other patients complain? Is it only because they don't have homes they should feel grateful for the basic human right of healthcare and not have opportunity to complain?

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Same problem where I work, and no they are not acutely psychotic, they just know how to work the system, they need to get out, get a job and pay for a place to live, just like I do. But its easier to draw a check than work. It makes me sick knowing that my hard earned tax dollars go toward their monthly checks and medical cards. I had a patient before that was spending her SSI check on crack, then came in with a medical card for treatment off of the crack, so not only are we supporting her crack habit with our taxes, our taxes are providing her a medical card to be detoxed, our Government is so messed up. Who is helping these people get SSI? And no I'm not talking about the true Psychiatric patient's for example who are severely depressed or have Schizophrenia, I am talking about the lazy people who don't want to work, so they play mentally ill to get a check & a hospital bed. It makes me sick! And please tell me why Psychiatric centers have turned into Detox facilities??? Go to a Detox place, I love when the detoxers get upset because they have to room with a Mentally Ill patient then complain about it. I tell them, I'm sorry this is a Psychiatric Center what did you expect?

I get told weekly from people that they lied about being suicidal just so they could detox there.

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Specializes in mental health / psychiatic nursing.
If they are having a pattern of being readmitted from a group home, you make their hospital stay as uncomfortable for them as possible, no tv in the room , no phone, etc. This has to be coordinated by the floor manager, nursing coordinator... Ive seen this done before.

I worked at a group home for psych patients for a while and for our most frequent-fliers to the local EDs this was part of the issue. One of my frequent fliers told me he went to the ED because they have free wi-fi which we didn't have in the home. I asked him why he didn't just go to the public library which also offers free wifi? Sometimes he went just because he was bored. Other times because he was impulsive - he had a non-emergent issue already scheduled for follow-up with his PCC but waiting one more day just wasn't going to cut it - he'd go to the ED they'd see he already had a referral and send him home - then he'd complain about how nothing was done.

It was very frustrating on our end to have our residents returning to the ED over and over again, particularly when we knew that wasn't the place for them to get the treatment they needed. One would frequently hit up 2-3 local EDs a day because he needed some one to talk to - our staff tried to make time for him, but with 30+ residents it wasn't always possible to sit and talk to him for the hours on end he needed. We tried redirecting to his case manager's open office hours, to a community support group that was involved with his care, and encouraged use of an after-hours call line for support - but for whatever reason he preferred the ED. As much compassion as I had for him and his situation it was still difficult to know how much he abused the system.

I understand the OPs need to vent about feeling like patients are abusing the system - some certainly are. I do wish there was a better way of coordinating care and providing support so that these frequent fliers could get all the support they needed through means other than the ED.

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I blame the admitting physician for poor assessment of admission criteria. If a patient has 9 admissions in less than a year then they are not likely to benefit from another 3 day stay especially when they refuse to participate in the treatment interventions we provide.

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Bingo, gzussu, you hit it right there. Yes, the system is definitely broken and people taking advantage of this broken system are who make healthcare costs increase to ridiculous numbers to cause financial ruin for those honest hard-working people who do pay their bills and not live off the said broken system. Yes, many frequent flyer are truly ill and their illness causes them difficulty with follow up and with ability to live in crowded homeless shelters and halfway houses. The truth is, most frequent fliers are not truly ill, they choose to remain homeless because they do not want to be a productive member of society and feed off of the system. We are not jaded, we are realists who are tired of our tax dollars paying for these people to abuse the system, particularly when while they are doing so, they are entitled, rude and demanding to staff, act out, threaten and sometimes actually cause bodily harm to staff and other patients so that they can have a warm bed, meals and roof for a few days or as long as they can milk it until moving onto the next facility. I like seeing sick people get better but there is just no helping those who don't want to be helped and who don't need it in the first place.

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Yes, these people seeking disability simply because they don't want to work are the lowest of humanity that we must deal with. Many people is their disability money to buy drugs and alcohol and hospitals for food and housing. Trump said he was going to fix this country; what is he waiting for? We need mandatory drug and alcohol testing for all who are receiving any kind of government aid.

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Specializes in Hospice.
Yes, these people seeking disability simply because they don't want to work are the lowest of humanity that we must deal with. Many people is their disability money to buy drugs and alcohol and hospitals for food and housing. Trump said he was going to fix this country; what is he waiting for? We need mandatory drug and alcohol testing for all who are receiving any kind of government aid.

Why did you like my posts? I couldn't disagree with you more. Frankly, your posts put me in mind of the stories of Russian trolls tasked with fomenting anger and discord among the US electorate. You've certainly blown all the dog-whistles.

"These people"? Really?

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Bingo, gzussu, you hit it right there. Yes, the system is definitely broken and people taking advantage of this broken system are who make healthcare costs increase to ridiculous numbers to cause financial ruin for those honest hard-working people who do pay their bills and not live off the said broken system. Yes, many frequent flyer are truly ill and their illness causes them difficulty with follow up and with ability to live in crowded homeless shelters and halfway houses. The truth is, most frequent fliers are not truly ill, they choose to remain homeless because they do not want to be a productive member of society and feed off of the system. We are not jaded, we are realists who are tired of our tax dollars paying for these people to abuse the system, particularly when while they are doing so, they are entitled, rude and demanding to staff, act out, threaten and sometimes actually cause bodily harm to staff and other patients so that they can have a warm bed, meals and roof for a few days or as long as they can milk it until moving onto the next facility. I like seeing sick people get better but there is just no helping those who don't want to be helped and who don't need it in the first place.

The largest proportion of people "abusing the system" I encounter at work are middle class, employed, insured people who can't be bothered to take steps to manage their chronic illnesses, but instead want to get admitted to the hospital every few weeks so we can "fix" them again and prop them back up for another month or so.

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