homeless pt's?

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This is my first winter in the ER. The weather just turned really cold and yesterday I had 3 homeless pt's come in with vague complaints...one had just moved from a warmer climate to our bitter cold dry climate and was pretty sick with an asthma exac. 2 of the homeless pt's I had were found a shelter for the night and one was admitted for etoh detox. But trying to find a place for them took me a long time. Not only did it take me a long time, but it seemed that everyone was just too burned out to really help.

My question...How do you deal with your feelings on this. My heart just about broke. A few of the long-timers said things like "these people have made choices in their lives and this is what happens" Or "you can't fix the planet" or "don't feed them, they just come back"

I'm no bleeding heart. I do see that people made choices and took the road that lead them down these paths. I'm just curious to see what your feelings are about homeless pt's in the ER. Do you feel that they are "wasting your beds" are you able to go home and forget about the pathetic pt's? I guess I'm just looking a way to figure out why I feel guilty about having so much when people have so little.

[traumaRUs, MSN, APRN]

I too was wondering what this meant. However, my interpretation is that these people are pretty helpless and need more help than we can provide.

[TweetiePieRN]

I work in the Midwest and its cold. I'm an ER case manager and one of my jobs is finding resources for people. However, the homeless continue to strain our dwindling resources. I too feel very sorry for these people. If these people don't have a family that is involved, they end up in very precarious circumstances. Many die. It is so sad.[/quote

It is very sad. Call me cold hearted but:

People have to make many choices in life.

Many don't have family involved because of their anti-social, non-conforming attitudes and behaviors. Others are on the street because they won't take their medications, stop drinking, or stop the drug seeking.

In the majority of cities in the U.S. there is a wealth of programs available to help people UP and OUT.

There are rules members of society must follow and it is a CHOICE to follow the rules in order to be helped UP and OUT. Like taking medications, like stopping alcohol, like stopping the drugs.

The true sadness I feel is that life is too hard for some, so they succumb to the immediate "easy" way out.

Then on the other hand I think: If a human being is not strong in mind and heart and soul - do they NEED to be here? Isn't it sad for the weak to have to endure life's trials and tribulations if they haven't the mind, heart and soul to survive?

Do we do these people any favors by attempts at "saving" them?

I see your point. I do tend to somewhat agree on this. Survival of the fittest. I am not saying that people are worthless if they are weak in body or mind...but not everyone is meant to be on this planet until old old age.

[Jerico, BSN, RN]

I see your point. I do tend to somewhat agree on this. Survival of the fittest. I am not saying that people are worthless if they are weak in body or mind...but not everyone is meant to be on this planet until old old age.

Precisely!

Everyone who is placed on this earth is not meant to be a survivor. Survival of the fittest is exactly what I think is the reason they do die at an earlier age.

There have often been times when I see a "bad case" come into the ER - filthy, drug addicted, very sad.

That is when I feel most fortunate for what God has done for me, and for what I have done with what God has given me.

I also think about how we never know who is inside that filthy drug addicted person. Therefore I treat them as though they are special - with even more kindness than the more "fit" - these people are very fragile is what I have come to believe.

[GingerSue]

Originally Posted by Jerico

"I am not saying that people are worthless if they are weak in body or mind...but not everyone is meant to be on this planet until old old age"

some may be weak today, but perhaps can be stronger tomorrow?

I would try to find ways to help somehow

[babynurselsa, RN]

I have very different feelings about someone who has fell on hard times and needs some help versus someone who has made milking the sytem a lifestyle choice. There are those out there who are content to live like this and they will flat out tell you so. They want the handouts and do not want to hear any talk about getting a job, or doing thier own part to change their situation.

These are the ones who don't NEED ER care thye just know we can't turn them away when they say they have chest pain or just had a seizure while they smirk at you and request a meal try and while your at it I don't like that channel so change it.

[joyflnoyz, LPN]

Austin is overrun with "homeless" For a while, I'd give a buck--until my husband gave a guy some money for "gas" and before Tom could get out of the parking lot, the guy hit up someone else. So I'd go buy food and hand it to them....you know, the signs that say "HUNGRY --ANYTHING HELPS" ?? UNTIL I saw one guy just throw away the food I took my time, my money and effort to turn around, purchase it and take it back to him.

Can't tell you the number of times we've offered to take someone somewhere and feed them, and have been turned down. "Uh, no thanks, but a couple of bucks will be just fine"

What did I see a couple of weeks ago? Sun was going down. "Homeless cripple" guy with his sign and CARRYING A PAIR OF CRUTCHES running across the road.

NEVER again will I help anyone standing on a corner and begging.

These people are making more money than I am per hour.

Few years ago there was a business owner in Detroit area who went around and handed out hundreds of business cards, and told each person "I have a job for you- just come and get it"

Not one single person showed up for a job

[bethin]

I work in the Midwest and its cold. I'm an ER case manager and one of my jobs is finding resources for people. However, the homeless continue to strain our dwindling resources. I too feel very sorry for these people. If these people don't have a family that is involved, they end up in very precarious circumstances. Many die. It is so sad.[/quote

It is very sad. Call me cold hearted but:

People have to make many choices in life.

Many don't have family involved because of their anti-social, non-conforming attitudes and behaviors. Others are on the street because they won't take their medications, stop drinking, or stop the drug seeking.

In the majority of cities in the U.S. there is a wealth of programs available to help people UP and OUT.

There are rules members of society must follow and it is a CHOICE to follow the rules in order to be helped UP and OUT. Like taking medications, like stopping alcohol, like stopping the drugs.

The true sadness I feel is that life is too hard for some, so they succumb to the immediate "easy" way out.

Then on the other hand I think: If a human being is not strong in mind and heart and soul - do they NEED to be here? Isn't it sad for the weak to have to endure life's trials and tribulations if they haven't the mind, heart and soul to survive?

Do we do these people any favors by attempts at "saving" them?

What do you think of the "working homeless"?? Believe it or not it's a problem. I can think of LOTS of people who try their hardest to make ends meet and it doesn't happen. One parent works a min. wage job. The other stays home with the kids because what's the point in paying a sitter who will take all your wages? I went to HS with someone like this. I still keep in contact with her. Her and her husband have 2 kids and he works a factory job. She went to social services office because they had no insurance(he's a temp) and could barely pay their bills. Even though they were at poverty level they were told that they were too rich. You say in cities there is a wealth of programs to help people. If you watch the news, you'd notice that these programs are struggling to stay alive. People aren't donating probably because they don't have any extra money, maybe one step from being homeless themselves.

I agree that some people are homeless by choice. But you can't lump every homeless person into that catagory. That's like assuming everyone living in the 'burbs has a perfect life and their kids are just angels or everyone who lives in the country is a hick. I don't like stereotypes. Maybe I am a bleeding heart but I really don't care. I give people the benefit of the doubt. I know if I was homeless NOT by choice I'd really appreciate someone with an open mind giving me a hand.

It's hard to be strong in body and soul when people have looked down on you your whole life.

[traumaRUs, MSN, APRN]

I have debated back and forth on whether to share this, but I have decided that I must. Our much-loved and cherished son is mentally ill. He is now 20 y/o and lives with us. However, he has been homeless in the past. In our area, the governor decided to cut many outpatient services. We were so lucky - our son has insurance and we could get him the care he needed. However, even now, he would have a very difficult time on his own. Maybe in a year or so, he will be doing better. He does work and has been able to complete some college credits. All I can say is don't judge, lest you be humbled like we have. Please know that most homeless folks don't want to be homeless, but can't keep it together enough to do what we take for granted.

[Jerico, BSN, RN]

I agree that some people are homeless by choice. But you can't lump every homeless person into that catagory. That's like assuming everyone living in the 'burbs has a perfect life and their kids are just angels or everyone who lives in the country is a hick. I don't like stereotypes. Maybe I am a bleeding heart but I really don't care. I give people the benefit of the doubt. I know if I was homeless NOT by choice I'd really appreciate someone with an open mind giving me a hand.

It's hard to be strong in body and soul when people have looked down on you your whole life.

Why would someone "look down on you your whole life?"? So you are saying the "excuse" for not being strong is that people may have looked down on you all your life?

Being homeless NOT by choice is USUALLY not permanent.

The old adage: "When it hurts bad enough they will change" is usually what keeps people motivated enough to change.

A person who is homeless "by choice" has something else going on, I'd say. If the homelessness by choice is what leads to their early demise then perhaps it is meant to be.

I'd grant that nearly everyone on this board would give a handout to someone homeless not by choice.

[Jerico, BSN, RN]

Please know that most homeless folks don't want to be homeless, but can't keep it together enough to do what we take for granted.

And WHY can they not keep it together? Exactly what you have said in the example of your son: mental illness.

Are people with mental illness to the point they cannot survive on their own meant to survive? That is the question.

The fittest survive, those who are not perish.

[traumaRUs, MSN, APRN]

I know that you certainly are not saying that my son should die, are you???

[bethin]

Why would someone "look down on you your whole life?"? So you are saying the "excuse" for not being strong is that people may have looked down on you all your life?

Being homeless NOT by choice is USUALLY not permanent.

The old adage: "When it hurts bad enough they will change" is usually what keeps people motivated enough to change.

A person who is homeless "by choice" has something else going on, I'd say. If the homelessness by choice is what leads to their early demise then perhaps it is meant to be.

I'd grant that nearly everyone on this board would give a handout to someone homeless not by choice.

I'd ask you something but I have a feeling I already know the answer. What if your father molested you? Of course, you'd feel pretty crappy about yourself. What if you told your mother and she didn't believe you? Your self esteem would be low. What if your boyfriend raped you and then when you went to the police they didn't believe you. Your mother of course wouldn't believe you. You run away from home because you're running from the abuse. And no, I didn't pull this out of my head. It happened.

I can tell by your previous post that you believe no matter the circumstances, even if the above happened to you, you'd still be skipping down the street. I'd like to see that.

BTW: don't roll your eyes at me. I was making a statement and you should respect my opinion.