For all of those on Medicaid

[ShayRN]

I honest to GOD do not know, nor care, what insurance my patients have when I am taking care of them. I really don't. (FYI)

[Fribblet]

Look I don't like this sort of generalization. What do you do? Go and check their insurance status?

Has it occurred to you if you only have this "problem" with people on medicaid that the only other common thing, apart from medicaid, is you? As you clearly know how they are insured then it is entirely possible that you treat the medicare patients differently and they are reacting to that?

If you think people do not sense contempt you are very wrong.

Another poster who fails to read the thread.

[DolceVita, ADN, BSN, RN]

Another poster who fails to read the thread.

Yes I read that claim you don't check. What I think is you make a reasonably educated guess based on stereotypes and treat them differently. You probably don't even realize you are doing it.

[Fribblet]

I asked a legitimate, non-snarky question because I was honestly curious about data that would back that sort of position. I didn't deserve the rude response. Certainly it is acceptable to speak from one's own experience, but making flat-out statements along the lines of "Most ER abuse isn't from the uninsured. It isn't even from the insured. It's from people who are on government sponsored health insurance" without prefacing them with some sort of qualifier to that effect invites confusion and argument.

There are in fact other ways for nurses to become aware of a patient's insurance status. For example, when a family member of mine was hospitalized for a week while uninsured, his nurse and tech on a certain shift became aware of that lack because each walked in while someone from the business office was grilling him on how he planned to pay for his care without insurance - three hours after he'd come back to his room from major surgery. I certainly will not claim that's standard operating procedure, but it's one example of how medical staff can become aware of such circumstances without the patient mentioning it. Moreover, if I'm on Medicaid (I'm not, but this is just a hypothetical), I shouldn't have to worry about whether my care will be affected if I slip up and mention my insurance/payment method - say, by requesting someone assist me in obtaining Medicaid transport after my treatment is completed. In no way, shape, or form am I supporting the entitlement mentality you describe (which as other posters have noted is hardly limited to the Medicaid population).

I did not mean to attack you, merely to seek information that had not been clearly provided in context. I will overlook your attack of me based on your clear frustration with this thread and topic in general. Thank you for the clarifying portions of your response and have a pleasant evening.

My apologies, man. I'm so tired of defending my opinions from people who fail at reading that I didn't expect a legitimate post that asked an intelligent question.

I have no studies to back up my anecdotal evidence (nor have I claimed to). Although I feel my experience is so common in the ER that it almost seems universal, that there has to be some sort of objective evidence for it.

I don't treat people on Medicaid any different than people with no insurance, or the few people we see who actually have private insurance. I don't treat people who are on Medicaid and have entitlement issues any different either. I sure as hell vent about it to my coworkers after they leave.

I have no problem for people who ask for a Medicaid transportation home. It exists for a reason (although I rarely call it for someone with a legitimate problem.). I've called the Medicaid van for some of the sweetem orst patients, and for some of the most worthless.

And this is to the rest of the people on this thread who failed to read the thread and also have no experience in nursing:

I'm sorry if I'm irritated by the idiot who calls 911 for a hang nail (oh and can I also get a pregnancy test and can you feed my kids that came along with me? And since I'm here I need an x-ray for my foot that I injured 2 weeks ago.) then cusses us out when we send her to triage, cusses out the triage nurse, and the ******* about the wait and threatens the ER staff with "You ain't gettin' a dime from my Medicaid,. I'm going to call them!" Then demands we find her transportation home.

Up until the point she tells us she has medicaid, we don't know. By the time most patients tell us they're going to need a Medicaid van home, their care is already complete. It's hard to provide substandard care to someone who has already received all they're going to get.

If Obama would work to cut out the waste, we wouldn't need to throw more money into healthcare to insure more people.

[DolceVita, ADN, BSN, RN]

One doesn't need to be an ER nurse to spot stereotyping.

[Fribblet]

Yes I read that claim you don't check. What I think is you make a reasonably educated guess based on stereotypes and treat them differently. You probably don't even realize you are doing it.

How am I treating anyone differently?

We're talking about people who act like a**holes. I treat all my patients the same. I'm even nice to our FF narc seekers until they start getting abusive, then I call security.

Also, you're complaining about people making assumptions as you yourself are making assumptions. Pot, I'd like you to meet Kettle.

[Fribblet]

One doesn't need to be an ER nurse to spot stereotyping.

And who are we stereotyping exactly? We're talking about a specific group of people who are on Medicaid who behave poorly. No one has claimed to be talking about ALL Medicaid patients, which has been pointed out time and time and time and time again.

Again, read the entire thread. It's obvious you haven't.

[DolceVita, ADN, BSN, RN]

I've only ever had people who have state insurance tell me "I'm paying your salary by being here! My medicaid pays for you."

I've never had someone say to me: "My Blue Cross/Kaiser/Cobra/etc pays your salary!"

The Medicaid families single themselves out, unfortunately. The bad apples spoil the bunch. Regarding medicaid though, it's been my experience that the bunch is by and large bad apples. The respectful and grateful are few and far between.

Hmmmmmmmm. No stereotyping here then.

Also, please stop being so ridiculous about my having not read the thread. It is not the case.

Once you start talking about individuals you will not be stereotyping. In fact I read very carefully the language style "these people" as using. It was very illuminating. Your most recent post uses the words "specific group". There also, by virtue of your word choice, support my supposition of stereotyping.

Nuff said. Off to bed for me.

[Fribblet]

Hmmmmmmmm. No stereotyping here then.

Also, please stop being so ridiculous about my having not read the thread. It is not the case.

Once you start talking about individuals you will not be stereotyping. In fact I read very carefully the language style "these people" as using. It was very illuminating. Your most recent post uses the words "specific group". There also, by virtue of your word choice, support my supposition of stereotyping.

Nuff said. Off to bed for me.

Did you fail reading? Were did I say "All Medicaid recipients everywhere are the same?"

Who are "these people" you speak of? I don't think I've used the term "these people" in any of my posts.

[carolmaccas66, BSN, RN]

Fribblet

Did someone really call 911 for a hang nail? What a waste of time & money. Those types of calls should be recorded so management can hear them.

Yes I have dealt with some of those patients. The 15 year old who has the baby, hands it to mum after being taken back to her room, announces that mum is going to 'look after it' (Mum is sitting in the corner nursing baby & looking all worried), then says Saturday coming up she is going out to party to 'screw around'. And no I'm not making this up - I was there when she said it. We are raising a generation of spoiled, useless, promiscuous, unintelligent young people - some of the older people who haven't led very good lives aren't much better. Someone once said you can chooose (when you get older) what kind of life you want to live - but these people don't WANT to be responsible for anything in life at all.

As CrunchRN says: 'These were almost all people physically and mentally capable of working....' And I tell you, I have met many many Medicaid/Medicare patients who know how to squeeze every single cent out of the system, and what they are and aren't entitled to - and if they aren't entitled to something, they damn well will shout & scream & carry on till they GET it (no exaggeration). And the kids see all this with their own two sweet eyes.

There is no shame on being on welfare. I claim welfare payments inbetween working - & my sister & her hubby exploit the system to the max. He (supposedly) can't work, they got money for a mortgage on a pension, get heaps of money for their kids (keep having more to get that money!) And my sister accounts for everything down to the last cent - she even showed me one day - so her welfare payments won't get cut.

It is good though reading other people's opinions - it makes me think, yes this does sound harsh. And yes we've met these types of people in all jobs (try doing barwork & hospitality every weekend, working late hours). They come in, gamble away all their rent/mortgage money, then I asked how they are going to pay their bills? And the answer is they will just go down to the welfare office 1st thing Monday, cry poverty & get another cheque (check). They know exactly what they can get. Oh & another classic was working in the busy dining room one day - this woman dumped her little kid down on the steps, says 'I'm going gambling, you look after him' then takes off! We tried to talk to her, she told us since she was in our establishment babysitting was OUR responsibility!! The kid wasn't even supposed to be IN there! We ended up calling the police that day.

Maybe blame the government for making claiming welfare too easy.

I am working parttime and not long ago, tried to claim help with buying a SECONDHAND textbook, I wasn't greedy. Was told no, cos I was working. The girl with 4 screaming kids in the booth next to me was told (I overheard this as she was right next to me), yes, you can have the vouchers for your kids clothes, shoes, vouchers for food, whatever you want! In Australia you are not denied vouchers/help if you have kids - that is why they have them. And no I hardly ever ask for help with buying anything.

The point we are making from telling all this is that we are all fed up working our butts off, and these types of people - not everyone - race into our varied work places, and DO demand everything be done for them. And yes it is mostly those with 6 kids, no partner (or the partner couldn't give a damn) who don't want to be told, no you can't have such and such now because there's only one of me and I have 6 other patients. And in the doctor's surgery, they would make ONE appointment to have a child looked at, then expect the other 5 to be seen AND have treatments done!! They are uneducated, selfish users these people and they know it!

I still reckon the best solution is to keep a computer history on them all - when they come to the ER/ED (wherever) look at what services they have wrangled out of the sytem, & say ' Well unless [whatever] is NOT an emergency, you will have to pay $2 up front towards care today'. Better still, employ some people to go round their houses at 7 am to bang on their doors and get them up to go out job hunting - not sitting in front of the TV playing their WiiFi or watching DVDs.

And BTW to all those who say people can't work due to lack of childcare, a friend told me not long ago that their childcare is SUBSIDISED by the government! So yes they can go out & work - but no-one MAKES them. (& I'm not talking about people with very tiny babies).

It's enough to make you just give up and join them!

So we are not having a go at everyone. I have met some lovely young people, with kids who work part-time struggling on welfare, while these lazy, ignorant good-for-nothing moms & dads sit back & laugh at them. I blame the government for all of this, and I am saying so in my next letter to my member of parliament after our next election. I am even going to draw up an action plan.

I agree everyone is due health care. But when one of the hospitals asked for just a gold coin DONATION off these welfare people, to help out with costs associated with tea, coffee, sandwiches etc in the dining room so they could provide better facilities for everyone, there was nearly a riot, I kid you not.

I could go on and on. We have all had these experiences.

These losers know what they are doing and in a way are very, very smart. They know they can use & abuse us - and simply get away with it.

[SharonH, RN]

Sorry for the wasted space friends, but wanted to allow the post to show whole. Listen med/surg... geriatrics, you can pretend to be anything you wish on the internet and it not only bores me but your lack of knowledge insults me. Your 20 years is clearly not as a case worker RN, nor your supposed "er" experience. Your falseness is so clear, that I'll leave your lies and nonsense alone.

Although the fact that you claim to work with the poor impresses me, as I do that on a daily basis. It is indeed challenging to meet their socioeconomic needs with those that truly need them.. vrs those that are stealing the klenex, boxed lunches and demanding the taxi vouchers for the sore throat that brought them here.

Sorry, we'll have to agree to disagree, but when I admit the real deal, with no insurance and treat the constant BS with the state card... I have the experience to see where the system is wrong and my tax dollars are wasted.

The pure fact that you defend this abuse, speaks volumes about you.

You clearly have a reading comprehension problem. I did not defend any abuse especially yours, but then again that is the problem isn't it? As I stated before, you need to get out of the ER and get a fresh perspective because you are definitely burned out and that has affected your ability to discuss issues in a rational, thoughtful matter. Trust me, it is because of my vast experience that I know what I am talking about. Your limitations both as a nurse and as a person are glaringly obvious.

[SharonH, RN]

Look I don't like this sort of generalization. What do you do? Go and check their insurance status?

Has it occurred to you if you only have this "problem" with people on medicaid that the only other common thing, apart from medicaid, is you? As you clearly know how they are insured then it is entirely possible that you treat the medicare patients differently and they are reacting to that?

If you think people do not sense contempt you are very wrong.

Exactly. If you have a problem with most or all Medicaid patients and that includes my little friend who can't comprehend from my previous post, then the problem is probably you.

[carolmaccas66, BSN, RN]

You know, a lot of us have family members like this and that's probably why this topic presses so many buttons for so many people.

It seems (to me anyhow), similar to people who are all fired up against drug addicts and alcoholics (even if they're nurses). I always want to ask, "Which relative in your family is an addict?" Getting emotional about this stuff doesn't help. How can we empower young girls into believing that they can do something else creative and worthwhile besides having babies? I'm getting better at stifling my resentment of the "gimmies" and just remind myself how petty and means most of their lives are. Now to mean that I don't ever

want to ***** slap them and say "Wake Up!"

'Getting emotional' is part of our make-up - we are only human.

Where does it end molly coddling these types of people though? Why can't teenagers be made to at least attend parenting classes before deciding to have children (or accidentally having children).

These types of people are producing precious childrenm, and are extremely irresponsible to say the least. I have always tried to talk re important topics with the mothers with '6 children' re goals in their life, the welfare of their children, suitable accommodation, include their partners (if they know who the partner is as he is usually long gone), and about contraception (to both partners). And it all usually falls on deaf ears. They come back next year with the next baby, and have a holiday in the hospital, leaving stressed-out grandparents (who are not coping at all) looking after their other kids. And most of the ones I have met couldn't give a damn. Why should they? Everyone is running around after them. And some of them aren't even that young; they just form extreme emotional attachments to any guy who shows them a smidgeon of attention and bingo! baby number 7 is on the way.

We DO try to empower people re the whole baby thing, but we can't stop them unfortunately. And if the government decided to put millions of dollars into programmes like this, I wonder if it would do much good.

And I will tell you something else, until you have seen cases of severe child abuse, you will have no sympathy whatsoever for these people. And they are just given counselling, have to attend psychology appointments - lame stuff like that, then the cycle of pregnancy & abuse starts all over again.

And I think until people start demanding that young girls - and guys - are made to have some sort of intradermal contraception, the situation won't change. I have even heard of girls digging out contraceptive devices in their arms so their parents wouldn't know with home knives etc to get pg to get the money, & for many other wrong reasons.

Perhaps if a new, internal, long lasting method of contraception is invented, the situation may improve.