Hospital frequent flyers??? Whatever happened to it being an acute care facility!

[RNdiva505]

Why oh why can Nursing not be so simple ...A policy may be used for this this but tweek it just a little it can be used for that. For instance, a patient could be a young gentlemen continuously being admitted for hyperglycemia and stay for weeks on end acting like a baby due to the fact that we MUST help this perfectly independent young man wipe his butt and accomadate his every need (i.e. pain meds, food at 2 am, crying for no reason). Because it is our job, we have to make sure no skin break down, pain under control... Why can we not refuse to clean his butt and make him do it hisself....Oh that is right...A nurse would get in trouble for not doing it!!!

I have had a patient once state that my hospital was much better than the rehab facility he was attending that is why he keeps coming back or a patient say that he loves the beautiful woment that help him and thats why he likes coming back...What the heck, man!

How does a person like this fall through the loop hole of psychiatric need, not acute care need?

Why is it that I have to practice "woo sha" to take care of the patients who think the hospital is the Hilton?

Please share some of your frequent flyer crazies?

[Fribblet]

If a patient in my ER suddenly is unable to do any self care. I inform them that I'm going to get the case manager involved so we can get them placed in a nursing home. If they are unable to wipe their own ass or pull the blanket up by themselves, it is too unsafe to allow them to return home, but, sadly they can't stay here.

Often it "cures" these patients.

[ZippyGBR, BSN, RN]

I think these are perfect examples of the "customer satisfaction" craze that has been sweeping healthcare and nursing by our business minded jacka**es. The business majors don't know about these patients. Unfortunately for us nurses we know them all too well- every facility has at least one.

Hospital eats the cost every time one of them comes in- EMTALA and state funded charity care. These patients hurt those who are really in need with no insurance. Also, the end result of these patients- it eventually costs nursing FTE's. This is why hospitals cut nursing staff numbers. If they operate in the red because of no reimbursement from their usual sources, they start eliminating jobs( of the little guys/gals of course never the big cheeses salary) INHO- if the CEO salaries were cut- that money saved in their salary could be dumped back into the hospital system- hire more nurses, provide a cushion for these frequent flyers with no insurance, and depend less on state funding(our taxpayer money, which in some areas, is larger than others) They need to keep their paws out of our taxpayer pockets and start reaching into their own.

which is yet another reason why single payer systems benefit the provider unit whether government run or private - you get paid for bed days occupied ( with the exception of where there is some kind of penalty system for HAIs or preventable readmission)

[xtxrn, ASN, RN]

If a patient in my ER suddenly is unable to do any self care. I inform them that I'm going to get the case manager involved so we can get them placed in a nursing home. If they are unable to wipe their own ass or pull the blanket up by themselves, it is too unsafe to allow them to return home, but, sadly they can't stay here.

Often it "cures" these patients.

Yep, done that with some knee and hip patients.... find out in a hurry who wants to go home :)

[nerdtonurse?, BSN, RN]

The thing is, I've argued for people to stay longer...that little old lady or fella that for some reason is just setting off your alarm bells. I've had the "something's just not right with this person, I'm serious, please, can we take a look at his brain, I don't thing he's confused because he's 65, I think he's confused because there's something wrong that's fixable." And I shudder to think how many times I've talked a doc into a letting me get a troponin that came back positive, when the docs were thinking it was GI.

I also had a patient who came in for chronic anemia all the time, they were doing the whole GI series again, EGD and colon, 3rd time this year and after talking with her for 10 minutes, discovered a history of extremely heavy periods, passing large clots, midmonth bleeding and pain in the lower LEFT quad. Called the doc, said, "hey, before we go messing around in the GI tract, can we get a pelvic U/S? I'm worried she's got something going on with the ovaries." An EGD (negative), a colonoscopy (also negative) and a U/A (negative for blood), later the doc gave in just to shut me up, did the pelvic U/S, and Houston, we had ovarian cysts bigger than Pluto. So while I'm ready to kick the whiney well to the curb, I'm also all about fighting to get someone who's truly sick treatment.