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.

[sammiesmom]

I know it will not go where I want but I am trying to stop turning this into a moral argument but really about policy making. Your thoughts about that? Our taxes pay for these people too. US is trying that universal healthcare and so far it sucks. From what I remember, you are the first one who accuse me of judging these patients when I only complain about their noncompliance.

[sammiesmom]

[charity collector]: At this festive season of the year, Mr Scrooge, ... it is more than usually desirable that we should make some slight provision for the Poor and destitute, who suffer greatly at the present time. Many thousands are in want of common necessaries; hundreds of thousands are in want of common comforts, sir. {Scrooge}:Are there no prisons? [charity collector]:Plenty of prisons... {Scrooge}:And the Union workhouses, are they still in operation? [charity collector]:Both very busy, sir... {Scrooge}:Those who are badly off must go there. [charity collector]:Many can't go there; and many would rather die. {Scrooge}: If they would rather die, they had better do it, and decrease the surplus population. Call me crazy, and I'm just spit balling here, but perhaps the administrators have determined to care for these individuals despite the cost because it is simply the right thing to do? What do you think? Is that possible?

I can see that happening in a catholic hospital. Mine is and that is what I am wondering. We keep them because of religious reasons. I don't know what for profit hospitals will do.

[sammiesmom]

I shudder when I consider what will happen when the general population figures out hospitals can't discharge pts who refuse to go to LTC. We've have pts for MONTHS who cannot go home and refuse to be discharged to LTC. Family won't take them, or the pt doesn't want to go with family. They've been threatened by social services that Medicare won't pay the bill and they will be responsible. That doesn't work. Family tries to convince them to go to assisted living. They refuse. THEY WANT TO GO HOME AND NOTHING LESS WILL DO. Unless of course it's living in the hospital. That's a close second. They aren't charity pts exactly. But eventually they could be.[/quote']

I have never come across a patient who refuses ltac or rehab. So your facility just keeps them then? Interesting.

[sammiesmom]

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--[/quote']

Does my hospital being a catholic hospital has something to do with it? I don't think we have skilled beds.

[TheGooch]

Thanks though for hastening the process libertards.

I think you mean LIBTARD. A term I find highly offensive. You can get your point across without name calling. And the use of "tard" in any form is like I said, highly offensive.

[dianah, ASN]

Thread closed for Staff Review.