Charity Patients

Nurses Activism

Published

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.

Specializes in Clinical Research, Outpt Women's Health.

Honestly, I just thank god I am not them. How horrible that your life is that kind of quality and that you perceive that as being so good that you want to live no matter what.

While I agree their behaviors suck and can see how you might want to turf them to the the street I would just try to be kind considering how lucky I am versus what they have made of their lives.

Up Vote Up Vote ×
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?

People tend to act compassionately towards those who are personalized.

It is easier to mistreat/abuse someone who is distant or depersonalized.

Using the term “charity patient” to describe another human being certainly sounds like depersonalization to me.

By regarding someone as stupid or irresponsible, perhaps even an unworthy individual, one can rationalize that the individuals’ deficiency of character makes it acceptable to treat them without compassion. That attitude is in my opinion not compatible with nursing ethics.

OP, don’t you think it’s possible that a person who has lost both his legs, has a colostomy and who has kidney failure also suffers from for example depression? Caring for patients with unpleasant dispositions may be challenging, but it is our job.

While I personally prefer “pleasant” patients it’s in my opinion the angry, frustrated, depressed or dejected patient that present the real professional nursing challenge.

You say that you have patients that are non-compliant to the point of dying (!) and that their reason for this is to stay in the hospital. How is it possible that this doesn’t make you understand how poor/dire their other options must seem to them?

Do you envy their quality of life? I don’t. I consider myself fortunate for not being in a place where causing myself harm seems like a reasonable choice.

Up Vote Up Vote ×

It's funny how you think I am judging these patients when you are judging me! I do not provide less care for these patients. I rarely have them and I have a lot of integrity and pride in my work that i do not let emotions get the best of me. I am only concerned that rules and regulations are set to where we are enabling these people. For example, the able bodied son. Why can't someone step up and refer him to a job? Gods mercy knows no bounds but he also do only like laziness. He is the one giving all these extra fluids to his dad. He may need daily dialysis soon because of his noncompliance and he doesn't get there without any help from his son.

Up Vote Up Vote ×

The reason why I started this forum is to ask about policies on charity patients and understand them. I am not depersonalizing these people by calling them charity patients. Should I refer to them by name? You know the answer to that. I only wanted to be specific to a population group since this is a forum. Obviously, no one knows and turning this into an attack against me. I am not against caring for these individuals. I posted this in the activism, political part of this forum because that is the opinion I want to hear. You think I'm judging them? Look, you are judging me so you are no better than myself.

Up Vote Up Vote ×
Specializes in Pediatrics, Emergency, Trauma.

Caring for patients with unpleasant dispositions may be challenging, but it is our job. While I personally prefer “pleasant” patients it’s in my opinion the angry, frustrated, depressed or dejected patient that present the real professional nursing challenge.

This. :yes:

I think the most complex nursing patients are the ones that need help the most.

The most you can do is get case management involved; find out about resources for your patients. Most social programs are now cut on the federal level, meaning states who are already cash strapped have less money to work with; that's the MAIN reason why you have an uptick on very complex pts-physically AND mentally and socioeconomically....when the economic tanks the poorest of the poor in health and in economics are in an using of needing the MOST help; some of these pts were doing well and haven't since the mid 2000s when the economy was going south and people a) didn't notice it because it wasn't affecting them or b) it was being ignored because it wasn't affecting them.

I think for the most part these it's are ripe for teaching for disease management; find out if your area has disease management programs for the pts; in the meantime, approaching the resident with goals that are appropriate for them and what they will do is the MOST a nurse can do; as far as the undocumented worker; the most one can do is find out what the goals of the patient are and move towards arrangements with case management in alternative settings if possible.

Cross one bridge at a time for your pts needs and the rest will follow; it's not black and white; nursing care needs to be done; and the issues in the OP are not insurmountable with the right goals and interdisciplinary teams involved.

Up Vote Up Vote ×
Fiona, what is wrong about calling someone a charity case? What is horrifying about that? These patients have a common denominator - noncompliance. Have you had anybody beg for your forgiveness but do the same sin over and over again? Have you ever been abused? There are people who are deserving help, they should be the one receiving it. Why are these behaviors being rewarded? If you like them so much, can we send them to your facility?

I am now in my second decade of my career. Under the universal healthcare system that Canada has, I don't know if my patient is a multi-millionaire or on Welfare. I work in what Americans would consider an inner city hospital and the homeless and addicted are part of our patient base. We also are the regional centre for the high Arctic and provide care to the Inuit populations up there and most of the First Nations peoples of the NWT and Yukon.

Yes, I've worked with people who have the same illness over and over and it's self-inflicted. Why would anyone ask me to forgive their sin? I'm not a priest or a member of the spiritual services team. I am there to care for their physical issues and find the right sources of care for their spiritual and social issues.

People you obviously wouldn't consider deserving of care I enjoy working with. I have managed to help one sex trade worker leave the business and get a new life. Would I identify him when he occaisionally stops by and say "Hi". No, that's his business to decide to disclose how the system helped him.

Yes, I've been abused. Verbally, emotionally and physically. I was assaulted on the job not by what you would consider a "charity case" but by a respectable grandmother. I wound up with four months of PT and a fear of being alone in a room with female patients of her age.

Don't worry about "sending them to my facility". We already care for them.

I hope never to wind up in your facility to be judged by you. I am sure you are god-fearing individual that believes that charity begins at home and all are equal in the eyes of the creator.

Up Vote Up Vote ×

Lol lol

Up Vote Up Vote ×

Fiona, I am trying to raise a question which is an analogy to what these patients are doing, not asking for your life story! I am not guilty of anything you accuse me of and if you think of me as the devil, so be it. My objective is to research the situation and possibly come up with a solution and maybe utilize resources in a better way. If money can be saved, it should be for free clinics, cheaper medicine and care people who wants to get better.

Up Vote Up Vote ×
Fiona, I am trying to raise a question which is an analogy to what these patients are doing, not asking for your life story! I am not guilty of anything you accuse me of and if you think of me as the devil, so be it. My objective is to research the situation and possibly come up with a solution and maybe utilize resources in a better way. If money can be saved, it should be for free clinics, cheaper medicine and care people who wants to get better.

It's probably none of my beeswax :facepalm: but I counted six :woot: question marks in your post adressed to Fiona. Don't be surprised when she answers your questions.. ;) ;) ;)

Up Vote Up Vote ×

Fiona, you are from Canada so do you even house illegal immigrants? What does Canada do with them? Your healthcare is free so it is easy for you to take everyone in so you don't have a choice. Now I know why your britches are so tight up in a knot. I bet you think US is a capitalist pig. Here, I heard people say that Canadian hospital sucks.

Up Vote Up Vote ×
It's probably none of my beeswax :facepalm: but I counted six :woot: question marks in your post adressed to Fiona. Don't be surprised when she answers your questions.. ;) ;) ;)
I understand she doesn't get it but I know why, she's Canadian and their health care is free.
Up Vote Up Vote ×

No. YOU don't get it.

Our healthcare isn't "free". My taxes and every other Canadian with an income who pays taxes pays for our healthcare system. That's why it's called Universal Healthcare.

Yes, we have illegal migrants here. We even have Americans try and claim refugee status here when they decide to desert from your military or feel that life is just too hard down there. We accept a fair number of refugees from around the world every year and healthcare is provided for them.

You started this thread. If it doesn't go where you want or you don't like the responses don't get all defensive and start name calling.

You are correct, you sound incredibly immature and poorly educated about the world at large. You do realize that Canada developed insulin, and has some of the most advanced cardiac care in the world.

Up Vote Up Vote ×
+ Add a Comment