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Discussion

clinical day

I am confused about something. I know I am just a student, but I am kinda scratching my head. My patient I was responsable for has a large necrotic wound on calf approx 12x6, (they did surgical debridment), he was just dx with diabetes II, malnutrition, metabolic acidosis, hyponatremia, hypomagnesia, and has no ins, middle aged. I performed am care on Tuesday and he asked for a walker, the nurse told me could not have one because does not have ins. I did his complete am care (he prob could have done his own but looked sad, did not feel well and liked having the attention) the next day I went to get update on my patient and during the night he had to have a bm, refused to use bedside commode (he also refused day before, pride I guess?) went to go to the bathroom in a hurry (pressed call light with no response quick enough, (when ya gotta go ya gotta go) FELL. was not hurt thankfully, but I don't really understand why they just won't give him a walker or cane? I don't get it would it not be cheaper to provide device than surgery for broken bone or sued? I don't get it!?!?!?!? :confused:

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    Was this in a hospital???

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    That is strange.. I know many of our ICU pts coming in as traumas don't have insurance but if they are well enough to walk with assistance, they are given a walker to use while they are with us.. When they are well enough to transfer to a regular floor the walker goes with them. They do not keep them, they are for use while in the hospital.

    If a walker or other devices are needed for "home" use, the doc writes a prescription for it. It is then up to the pt or SW to then get the needed items if they are not going to rehab.

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    What does "ins" mean? Is he non-weight bearing on that leg? If they don't want him walking all the way to the bathroom, did they try and explain the rationale to him?

    Edit: got it..insurance :) But that is pretty ridiculous. I've had heart surgery patients without insurance, its not like they refuse them a walker...just push them out the door a little faster than most. Feel bad for this guy...

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    yes in a hospital, I feel so bad for him....

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    That's absolutely insane. I have never in my life heard something that ridiculous. Compared to the cost the hospital is going to eat for his entire hospital stay, treatment, etc. is the cost of a walker really going to be the line in the sand? I suppose you're learning early which hospital not to work for when you earn your degree.

    Maybe you could mention it to your clinical instructor and she/he could look into it with the nurse manager?

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    • Author

    ins means insurance, I don't know about pressure on leg, it stated in chart bathroom privlages, no pt orders or anything, he is in so much pain hurts him just to lift it

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    That's just crazy. It shouldn't matter if a pt has insurance or not! Get them what they need! If he can walk with a cane/walker, or whatever go get him one! If the pt can use a bedside commode, go get one! Geez!

    On our unit we have a clean equipment room that stores walkers, canes, bedside commodes, wheelchairs, etc just for pt use. It's not like they are charged for them. They are used as needed by all the pts on the unit. Crazy.

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