Charity Patients

[sammiesmom]

I am not aware of hospital policies but I am just curious why my floor keeps 3 charity cases and they have been in the hospital for over a year!

1) an illegal immigrant who has family in US but will not take him (I heard they are homeless which I doubt)

2) a patient who is a double amputee who colostomy and dialysis patient who keeps on getting fluid overload because he will not adhere to fluid restriction. He is also very rude to nurses and treats nurses like trash and also asks nurses to bring juice to his jobless but able bodied son who lives with him in the hospital

3) lady with self induced respiratory acidosis because she will not wear her bipap

What kind of policy, regulation that keep them in the hospital? Thanks.

[Mindful, RN]

... what state do you work in?

[Pangea Reunited, ASN, RN]

It's illegal to "dump" patients, and those patients sound difficult to place. You have them because no one else will accept them.

[sammiesmom]

Why can't illegals be taken back to Mexico? Why patients who are continuously documented to be non compliant to the point of dying, and I know for sure they do this to stay in the hospital, be given a warning that they will be refused treatment?

[Flare, ASN, BSN]

i don't know that there would be any policy to house #2's son. If he is not sick and he is costing your facility money (i/e getting a meal, using linens, supplies, etc) then he should be restricted to regular visitor hours and should not be allowed to use any hospital amenities. Sounds to me like sonny should get a place to live and care for his father properly and there will be no problems.

[nichefinder]

welcome to america, where individual responsibilities are long forgotten as a society and other hard working people must carry the burden. i think it all stems from lack of education in the family. i laugh though. back where i came from (and most of other countries) if a patient is non compliant and acts like a fool, the hospitals won't care for them and practically throw them out (dump) because the society as a whole will not accept lack of individual responsibility. a healthy concept to have

[cardiacfreak, ADN]

Is this an acute care hospital? Our utilization dept would be all over that

[Mindful, RN]

... are you working in a red state ?

[uRNmyway, ASN, RN]

... are you working in a red state ?

Lol, do you ever make any productive comments on here? Seems like any time I see you say anything on AN it's all about republican/conservative bashing. I think the concerns OP has are legitimate. Staff being treated terribly, for patients who are not trying to get better, family who abuse the hospital's generosity, etc. If this is acute care, this is definitely outrageous. Then again, as a pp posted, you probably have them because no one else will take them. I've had patients like that before. Kept being re-admitted because the places we'd find them placement at couldn't handle them and would make up reasons for them to be sent back to the hospital. Then conveniently they have the bed to someone else.

[jadelpn, LPN, EMT-B]

Depends on how motivated case managment is. Plus, there are some facilities that have a "skilled care" or "long term care" bed availability.

There are no skilled care facilities in your area? Again, this would be up to case managment.

For #1, steps should be taken for him to be sent back to his country to be cared for there. If he is in the country illegally, then in fact he needs to be back where he can be put into skilled care at home. Again, case managment needs to remedy this.

For #2, He should be able to get some sort of insurance including Medicare, SSDI, etc. Seriously, there is not one reason he could not go into a nursing home or skilled care. Who is bringing him fluids so he is not compliant? Again, someone dropped the ball on this one.

For #3--see above.

Your discharge planning team is really not great. I would also bring to ethics committee--BUT this is a moot point if your facility does have skilled beds--and a number of hospitals do--

[Mindful, RN]

... California is a blue state that has patient safety laws

[uRNmyway, ASN, RN]

... California is a blue state that has patient safety laws

Ok do yeah, repeat what I said, never anything productive to any conversation, just republican/conservative bashing. As if anything that can go wrong MUST be because of them, and anything from 'blue states' must be good. Please.