Former Patient Asked Me For Money

Anisettes, BSN, RN · Dec 1, 2009

What a sad world we live in when we start to question our compassion. Could it have been dangerous? Maybe, but I bet the twin sisters who sat down to Thanksgiving dinner with their brother a few days ago never thought they were in danger of their brother shooting and killing them, but he did. We are none of us guaranteed a tomorrow. Take care of yourself and exercise caution, but don't overthink everything or you'll paralyze your good nature.

I'm really not PC, I give money, food, whatever to anybody, anytime. Drunks never left my ED in the morning without breakfast (I know, shoot me - I don't care). I give money to people I KNOW are going to drink it away. But I'm not homeless and broken but I do know what it feels like to just want everything to 'go away' and if a bottle of wine gets someone through a darkness of spirit I never want to experience, then so be it - I'm certainly not curing him by NOT giving away my pocket change and I'm the last person to judge anybody or instruct them on how I think they should live their life.

I really can't advise anything but what I do myself - follow you heart and your gut. Don't ever let a dirty body and torn clothes keep you from seeing the struggling person inside it. The Light is in us all and we're only lost or wrong when we can no longer see it and be affected by it.

I think you did a kind thing and giving him the food was right. The tiniest acts of kindness can be immeasurable in their impact - just as can thoughtless cruelty or even worse - indifference.

Emergency RN · Dec 1, 2009

Never get personal with a pt, and never take the job, ...off the job. The worst part of it you've already alluded to; you're going to have continued professional contact with him and you've already undercut your own position. Next time he needs or wants something on the unit, guess who he's going to go to? If you want to be a good Samaritan, direct him to the nearest homeless shelter. While a patient may fail to see the difference between professional and personal contact, you should always remain on your guard and keep both very separate.

7student7 · Dec 1, 2009

Thanks for the replies. I feel so bad for the man it really clouds my judgment. I guess it would be best for me to educate myself on the shelters and relief places in my area... I never thought of it until now.

Also, Anisettes, I see your point about not being indifferent. I feel that way too. I'm just fairly new to this and trying find where to draw the line in the future. These sad things are really starting to get to me.

Anisettes, BSN, RN · Dec 1, 2009

I guess it would be best for me to educate myself on the shelters and relief places in my area... I never thought of it until now.

I know a lot of people have the opinion that it's best to "Just refer them to X, Y, Z." Which would be great - IF those places were able to accomodate the sheer number of people who need their resources. Most homeless people already KNOW the places exist and know they probably can't get in for the night (or feel safe in those places if they can - how'd you like to bunk down with petty thieves ready to separate you from what little you have, somebody just out of prison, somebody strung out, somebody with a serious psych disorder and off their meds?).

If you're a woman with a kid - you're lucky (as such luck goes) you have a few more options. If you're a single man - you can pretty much forget it. And many places just aren't safe, sleeping on the street is safer as I mentioned. If the resources were able to keep up with the demand and if such places were actually better than the streets, you can believe you'd walk past fewer people camped out on the sidewalk. There's a reason.

It's easy from the comfort of a working or middle class life to say "refer them here or there", then you can feel good about yourself that you 'did the right thing' and 'didn't contribute to their addiction'. Then you can look past them and continue on your way with a clear conscience to the comfort of your warm home, because hey, it's not your fault, it's nothing to do with you, you didn't make them homeless or drunk or addicted. And that's okay - it's everyone's right to live their life the way they choose. The world is full of all kind of people. Which is part of the reason it is the way it is. And to clarify - there is nothing wrong with referring people, but don't do it so you can smugly say you 'did something'.

There are no easy answers or solutions to the problem. But if you feel different - as you obviously do, then don't ever let anybody talk you out of it. Do what you can, when you can, it's all anybody can do. Can you save everybody? You can't even save one, but that doesn't mean do nothing. But for the Grace of G'd go all of us and we forget it at our peril.

7student7 · Dec 1, 2009

I'm not trying to judge anybody for having addictions. I was only worried about the addictions from a safety point of view. I certainly didn't want to be attacked by someone who was high or having an episode, no matter how much they'd regret it later. A few of my friends at work have been sent to the hospital for bites, attacks with makeshift weapons on the unit, etc. It may sound mean, but I KNOW this particular man wasn't always in complete control of himself and probably couldn't afford his meds. Nice or not, he could still have been confused or particularly paranoid at that moment.

I also worry about seeing him at work again because of his emotions. On the male floors, a LOT of them become overly attached to the younger female staff. I don't want to encourage that by giving special treatment.

I have no issue giving food, or even cash (if I had it) to a person who needs it. But I DO have issues when it gets me personally involved and/or interferes with my job. It's where they intersect that it gets tricky.

Thanks for informing me about the shelters though. Like I said, I'd never really though about it before. I didn't realize they were so inadequate.

Anisettes, BSN, RN · Dec 1, 2009

RAMCDA - you're right to keep your professional detachment and have a proper regard to your safety, I didn't mean to imply otherwise. My rant is more a personal soapbox issue against what I see as a growing compassionate apathy in general, we've become so cynical, so hard. It seems like we have everything - but do we really? We're losing something important, something intangible, but the most important part of what makes us human, and to be honest the older I get, the more it scares me. End of rant. Stay safe!

chicookie, BSN, RN · Dec 1, 2009

I haven't had a chance to encounter this but if I did it would really depend on the patient/person. If like you, I felt safe and I had something to give then yeah I would give it. (Lets face it, even with this job I can't even afford soda anymore. ) You follow your feelings. I think its better to give and not question yourself about it then to not give and then feel guilty the rest of the time. You do whatever your gut it and go with it. At least even if you were wrong you did what at the time you thought was right and no one can blame you for that.

allnurses Guide · Dec 1, 2009

Hmmmm....

As a psychiatric nurse, I can honestly say I've never been in that situation. I've never bumped into any of my patients out on the street; mostly I guess because the two psych jobs that I've had have both been at least 40 minutes away from where I live and usually shop. So... wow, I'm not sure what I would have done.

PROBABLY, for safety's sake, I would not have approached him in the parking lot at night. I would not have drawn

attention to the fact that I had seen him at the hospital; it IS technically a violation of some sort to walk up to someone and say "Hey, I remember you from such-and-such hospital", or say anything similar. I dunno, I guess it MAY depend on how you word it.

Overall, I think you have a wonderful heart and you did a nice thing for him, but it probably wasn't particularly wise.

TheCommuter, BSN, RN · Dec 1, 2009

In the type of situation described, I'd much rather maintain professional distance instead of crossing boundaries that should not really be crossed.

I give small amounts of money and/or little gifts to close friends and only certain family members. Since I don't formulate personal friendships with former patients, I do not give them money or gifts. My lack of charity might seem cold, but I am not a human ATM machine.

pagandeva2000, LPN · Dec 1, 2009

I had a situation once when I was a psych tech where a male patient was admitted and had a very expensive shaving kit. I told him I would keep it in my locker and he can tell me whenever he wanted to use it and I did. Suddenly, he became obsessed with me. When he was allowed to go out on grounds priviledges, he would call me from a public telephone and whisper insane fantasies. I told the psychiatrist about it and we had a group meeting with the patient and he screamed obsentities at me.

I left the job a few years later and once, I saw him on the train. It didn't appear that he saw me and I felt safe, but a few months later, I ran into an ex co-worker and she said "Mr. Jones (not real name) told me he saw you on the train one day. He said he will always love you and was going to follow you, but had to get back to the hospital in time for dinner". Scary. I never considered myself to be one that would break boundaries, but, now, I am even more careful.

chicookie, BSN, RN · Dec 1, 2009

I left the job a few years later and once, I saw him on the train. It didn't appear that he saw me and I felt safe, but a few months later, I ran into an ex co-worker and she said "Mr. Jones (not real name) told me he saw you on the train one day. He said he will always love you and was going to follow you, but had to get back to the hospital in time for dinner". Scary. I never considered myself to be one that would break boundaries, but, now, I am even more careful.

On the bright side he obviously loved dinner more than you.