Homeless working the system, multiple admissions

heron, ASN, RN · Nov 27, 2014

Uh-oh! :angrybird1: :bored: :cautious: :blink: :banghead:

caliotter3 · Nov 27, 2014

I would treat them with the same level of respect and care that I treat any other patient. I am not there to judge them to their face.

Whispera, MSN, RN · Nov 27, 2014

I think they must be desperate for food and shelter, in order to willingly be hospitalized, especially on a psych unit. I have huge empathy for them, and treat them with respect. Besides, if their lives are terrible enough, who can say their magic words, "I'm suicidal," aren't completely true?!

heron, ASN, RN · Nov 27, 2014

Some nights, I'd break out the magic words, too. It can get lethal out there, especially when you don't eat regularly or have a place to really wash up.

The problem has been escalating for at least thirty years. The healthcare, social services and criminal justice systems are stuck with an overwhelming situation.

adnrnstudent, ASN, RN · Nov 27, 2014

I think they must be desperate for food and shelter, in order to willingly be hospitalized, especially on a psych unit. I have huge empathy for them, and treat them with respect. Besides, if their lives are terrible enough, who can say their magic words, "I'm suicidal," aren't completely true?!

Are you kidding? They leave 1 hospital and march right to another within hours. They are working the system and living like kings! I don't even understand how hospitals are getting paid for this.

I got a patient I discharged from my full time gig and that night I went to my registry gig and he was there. Read the admission note. "Patient states he has been off meds for 2 weeks!" ROTF!

heron, ASN, RN · Nov 27, 2014

OP, you clearly need to vent - so vent away and get it off your chest. That's one of the things AN is for.

Some of us have a very different perspective. Is there anything we can do to help you?

KelRN215, BSN, RN · Nov 28, 2014

Are you kidding? They leave 1 hospital and march right to another within hours. They are working the system and living like kings! I don't even understand how hospitals are getting paid for this.
I got a patient I discharged from my full time gig and that night I went to my registry gig and he was there. Read the admission note. "Patient states he has been off meds for 2 weeks!" ROTF!

I have yet to encounter a hospital in which the patients are "living like Kings".

Perhaps the patient- if acutely psychotic- thinks it HAS been two weeks since he last took his meds.

adnrnstudent, ASN, RN · Nov 28, 2014

Perhaps the patient- if acutely psychotic- thinks it HAS been two weeks since he last took his meds.

Nah, just working the broken system.

lifelearningrn, BSN, RN · Nov 28, 2014

There is definitely something wrong with a system that discharges mentally ill people back onto the street with no home to go to!

mrsboots87 · Nov 28, 2014

I think its not our place to judge. This is pretty similar to drug seekers constantly going to ER. Or people without insurance using the ER for pregnancy tests and other basic ailments. And what I mean by "similar" is that in each of these situations, even if they make you want to pull your hair out, it is not your job to judge. I know judging is just so easy, but your job is to be compassionate and care for them. You dont know what their back story is or or why that person is homeless and needs to "take advantage of a broken system." Its pretty cold out right now, maybe they dont have warm clothing and dont want to freeze. Does this make it right for them to do that? No. But at the end of the day there isnt anything you can do about it if they have been admitted. All you can do is show a little empathy and care for them until they are discharged. The person who "lied" about being off their meds for two week. Maybe they have been off their meds before and hurt somebody or themselves or lost time or some other terrible issue. They are homeless and dont have money for their meds and are trying to make sure they get them by being admitted. This may not be the case, but how do you know its not? You dont. It has to be annoying to deal with this, but at the end of the day you get to go home to a warm bed and a house with food. They get to sleep outside in the cold while hungry. It wont hurt you to just feed them, medicate them, and show some compassion, even if they shouldnt be using a hospitals resources like this.

adnrnstudent, ASN, RN · Nov 28, 2014

There is definitely something wrong with a system that discharges mentally ill people back onto the street with no home to go to!

See many of my pts prefer to be in hospital to nursing home or group home so they get themselves kicked out of so may places and no one will accept them back, but they are little angels in the hospital, because they prefer it with us.