Dumping patients in the ER

Published

I know it's nothing new, but I'm sick of people sending their elderly, usually confused, family member to the hospital for something like weakness or mental status changes and then either not show up after the ambulance arrives, or if they brought the patient they leave without notifying anyone of how to reach them.

So after the big workup that goes with that complaint, when the patient is ready for discharge, there is no family member to be found.

This patient took up a bed in the ER for 6 hours after discharge while we tried to locate family. The poor patient, who had a touch of dementia, cried and cried "I want to go home." At one point the patient even said "They just dropped me off and left me here!" That about broke my heart. The next shift after I left was able to finally get a family member who lived 2 hrs away to agree to come for the patient.

What do you do in this type of situation? (And yes, we did consult social services on this particular patient)

Up Vote Up Vote ×

Normally we get them in our LTC. We had 3 admits like this this year. Very little info except old charts from the hospital. This is so abusive. Abandonment.

Up Vote Up Vote ×
Normally we get them in our LTC. We had 3 admits like this this year. Very little info except old charts from the hospital. This is so abusive. Abandonment.

I know what you mean, we got one little lady, a ward of the state, been severly abused by "family". We finally got her physical wounds healed. Been with us almost a year now. Never had a visitor that I know of. Sad.

Up Vote Up Vote ×

I'm sure those of you in LTC's see this type of thing quite a bit, people getting abandoned by thier families. It's very sad. One of my co-workers used to work in LTC and some of the stories I've heard are just pitiful. :o

What I have seen a lot of however is folks that come into the ER that usually live at home with family. The family members call an ambulance, tell the paramedics what's going on, then never show up at the hospital and we can't reach them by the phone numbers we have on record, if we have previous record of the patient. Or they bring the person in, then when they get to an ER room the family disappears, and doesn't come back for hours. In the meantime, the patient has been worked up, and has been DC'd from the MD's standpoint.

This type of thing happens sometimes at the holiday time, I guess families see the ER as a way to get a babysitter for a few hours so they can run errands and do shopping. :madface: But we're still seeing a lot of this going on recently.

Up Vote Up Vote ×

This is probably a dumb question, but, I've never worked ER, but I'm curious. What would happen if family NEVER came back, I mean, if you tried to call and contact them and nobody shows up. What do you do then? In LTC when state places somebody with us, we have them forever and become their "family". I can't imagine just being dumped in ER, though, I guess it would be just like when somebody dumps a newborn. Does state come in and take over. Do you just keep them until you find a place for them or what. I've never really thought about how the hospital would handle a situation like that.

Up Vote Up Vote ×

So far, I haven't had a situation where we never find a family member. The patient I mentioned in my first post was probably the longest hold I have had. If there was someone who we could not find a family member for, we would have to do a social admit (as opposed to a medical admit) to the hospital and let social services sort it out: either find a nursing home placement or another family member willing to take the person.

The thing that is so frustrating though is that the ER bed this person is taking up for hours is needed by others waiting to be seen, all because of a selfish neglectful family. It also sucks for the patient who doesn't understand why they have to stay, and eventually got mad at us, accusing us of kidnapping her and holding her against her will. I felt so sorry for the patient.

Up Vote Up Vote ×

we have sent the police out to "politely" ask the family to ANSWER THEIR PHONE.

Up Vote Up Vote ×

I've seen soo many relatives try to dump their relatives on the hospital because they couldn't cope or didn't want to before. It breaks my heart every time.

One, which admittedly I nearly lost my cool with, was a girl in her 20s, still lived with mum, mum was an alcoholic and kept falling etc while drunk. Her mum was always drunk and she had noone to help. We done every test possible because the daughter came out with a ton of symptoms which the pt didn't exhibit. It was a cry for help, I didn't spot it. The daughter refused to take her mum from the ED, said she couldn't do it anymore. Initially, I said that she had no choice and told her the docs had cleared her mum. She walked out, then came back. Thankfully, by that time I'd figured it out (had too many alcoholics in my family) and got handfulls of helpline numbers for relatives etc. I talked to her about my experiences and she smiled and said thank-you and would try.

Also had the most heartbreaking experience of seeing a very old person just dumped outside the hospital, unable to walk, in the middle of winter. I'd just started ED at that time and couldn't believe they done that... took security some time to realise he'd been dumped :(

Up Vote Up Vote ×
Specializes in Med/Surg.

This really bothers me. I had a similar case when i worked on the telemetry unit. We had this sweet old lady who had some cardiac troubles and never had a visitor. she would always asked if i liked her, and if i was going to come back to take care of her every time i would leave the room. she got better and was d/c'd and the family was nowhere to be found!!! we finally got someone to admit her to a nursing home. I felt so bad for her that i made sure i took the time to lable all of her clothes so that her name would be in her clothes, and packed all her stuff together, including all the things that the nurses had bought her. i lost many a tear because of that. I don't understand how people could be so cruel.

Up Vote Up Vote ×
Specializes in ER/SICU/Med-Surg/Ortho/Trauma/Flight.

God I hate when people dump there loved ones on us. it sucks for the pt. What ever happened to honor thy mother, father, grandparents. etc.

Up Vote Up Vote ×
God I hate when people dump there loved ones on us. it sucks for the pt. What ever happened to honor thy mother, father, grandparents. etc.

Please do not think that I am okay with the "Granny Dump", but we have no clue what their family life is really like. A while back we got a "dump" . A really sweet, polite, friendly older man with a bunch of medical problems and only needed a small bit of assistance. Nothing that couldn't be managed at home with a sitter. Where was his family? Turned out this guy beat the snot out of his wife and kids, verbally abusive etc. So there is always more sides to the story?

Up Vote Up Vote ×
Specializes in ER, ICU, L&D, OR.

I dont blame families for what they do, the elderly usually do need assistance.

Now however I do get tired of nursing homes sending people over because of constipation and they dont want to give an enema. Or they run a bit of fever and they refuse to give tylenol. Or any of a 100 things that nursing homes find to send their pts over to us. Usually in quite unclean condition.

I still remain the King Locally for reporting nursing homes to Adult Protective Services. Hopefully they will get cleaned up before I get there.

Up Vote Up Vote ×
+ Join the Discussion