Has anyone seen a pt involuntarily discharged???

Specialties Urology

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okay, i work in an area where there are only fmc hdus. has anyone ever seen a pts involuntarily discharged? what were the circumstances?

thanks.

I have discharged 2 patients from my unit for abusive / disruptive behavior. We had our department meeting with them and gave them their 30 day notice paperwork.

I don't put up with patients being abusive to my staff. One of them ended up in a psych ward and I do not know what happened to the other, since NO center in the area would take either one of them.

Agreed, but that level of respect needs to go both ways.

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I have never seen a pt discharged. I've seen pts threaten and assault staff. One even threatened a sec'y with a knife. As long as pts are making money for a unit they don't get discharged in my experience.

As a program manager, they would be arrested and taken to jail.

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Specializes in Nephrology, Cardiology, ER, ICU.

I take exception to your post about the pts paying for their care...uh no way, no how! Medicare is the reimburser for ESRD patients that have worked under the system. For others that have NEVER worked or spent most of their adult lives INCARCERATED the state's medicaid system funds their dialysis.

When pts ARE paying, then we will see greater compliance. As it is now, if Uncle Sam foots the bill, why be compliant?

I do have private pay patients and most of my patients are compliant because they are a partner in their care.

However, I will never, ever put up with a pt spitting on me, hitting me, pinching me, or otherwise attacking me - they belong in jail!

And...in IL, its a felony to assault a healthcare worker in the performance of their duties.

I'm sorry for your bad experience (and its evident from your previous posts that you feel wronged by dialysis personnel). I sincerely hope that you have gotten your complaints resolved.

However, that is not the reality for most of us.

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I worked at a state psych unit many years ago. We had a patient who constantly complained and was non-compliant. She was always talking about how she wanted to leave this unit and about "her rights". Anyway, her doctor got sick of her complaints so he discharged her from the psych unit. She refused to leave the unit stating "No one's going to force me out." Security officers arrived and she was then physically removed from the unit.

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Specializes in ICU, Pediatric Pulmonology, Med-Surge..

Yes. I was working back then in Chicago as PCT. Nurse called security after the pt refused to be discharged, they came and took the patient in the wheelchair to the lobby. I guess they called taxi. Is all I know. Hope this will help.

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Specializes in Dialysis (acute & chronic).
I take exception to your post about the pts paying for their care...uh no way, no how! Medicare is the reimburser for ESRD patients that have worked under the system. For others that have NEVER worked or spent most of their adult lives INCARCERATED the state's medicaid system funds their dialysis.

When pts ARE paying, then we will see greater compliance. As it is now, if Uncle Sam foots the bill, why be compliant?

I do have private pay patients and most of my patients are compliant because they are a partner in their care.

However, I will never, ever put up with a pt spitting on me, hitting me, pinching me, or otherwise attacking me - they belong in jail!

And...in IL, its a felony to assault a healthcare worker in the performance of their duties.

I'm sorry for your bad experience (and its evident from your previous posts that you feel wronged by dialysis personnel). I sincerely hope that you have gotten your complaints resolved.

However, that is not the reality for most of us.

I totally AGREE with you on this one!!

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Specializes in Dialysis (acute & chronic).
Agreed, but that level of respect needs to go both ways.

My staff do respect the patients and if they don't they get discharged too. So respect does go both ways! But when a patient is physically harmful to the staff, the police are called.

I don't agree with CMS guidelines with giving them a 30 day notice of discharge when there is physical harm being put on healthcare workers. I say just put them in jail.

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Specializes in Medical.
When pts ARE paying, then we will see greater compliance. As it is now, if Uncle Sam foots the bill, why be compliant?

I work in the Australian public health system, where the government pays for health care, including dialysis. I know I find it hard to remember, when I see my frequent fliers across all specialties I work in, that they're the exception not the rule. However, though some of our patients are non-compliant with meds, diet and fluids (though I have trouble with the term "compliance"); the vast majority of patients, with renal disease or otherwise, are interested in their health outcomes, participate in their treatment, and appreciate the care of their health team.

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Specializes in Nephrology, Cardiology, ER, ICU.

Is there any consequence (other than poor health) for your pts that are noncompliant?

Just curious how its handled in socialized medicine.

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Specializes in Medical.

Patients who are abusive have consequences, but off the top of my head ... otherwise not particularly. I work on an acute mixed medical specialty unit, which includes renal (PD + transplant on ward, HD performed in a separate unit) + endo. We have a handful of frequent fliers, about 2/3 of whom are non-compliant, but they comprise maybe less than 1% of our patients.

PS I know it's a commonly used term in the US, and only in the US, but I really hate the phrase "socialized medicine" - it carries a lot of implicit ideology. Not having a go at the OP, just expressing my position

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Specializes in Nephrology, Cardiology, ER, ICU.

Thanks for the info - I apologize for using the term "socialized medicine." Here in the US, it isn't a particular ideology but synonymous with universal healthcare. Did not mean to offend.

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Specializes in Medical.

No offence taken - I'm sure your usage wasn't intentional or used with agenda :)

Food for thought: the use of words to carry a whole lot of baggage that flies under the radar only works if the people using them don't have their attention drawn to it or think about it. As you point out, 'socialized medicine' is a term only used in the US, which is also the only Western country that doesn't have a universal health care system, but does have a strong health care special interest lobby, a very strong anti-communist history, and a uniting ideology of independence and minimalist government involvement.

The word 'socialized' imbeds the idea that universal health care is linked to socialist ideals, and therefore hooks into fears and concerns linked the these last two elements, and is fed by the first.

It may be framed as a synonym, but how often is used exclusively in discussions about universal health care and/or health care reform? How often to people use the two interchangably? How often do you say 'universal health care' instead of 'socialized medicine'? Just something to think about.

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