3 hot's and a cot

I don't think it's JUST yours, but maybe not all that uncommon.

Psychiatric hospitalizations are on the upswing, and there is even spending going on to build or expand new psych hospitals. Insurance companies are definitely paying.

The key is the physicians & what the referral base is.

Has any noticed that their psych unit in turning into meals and housing for the homeless drug addicts? Or could it just mine?

A lot of the homeless have severe mental health problems. Sadly a lot of the Skitzophrenics on the units are homeless.

Given that over 1/3 of all prisoners have diagnosed mental health problems (a low estimate in my opinion), I would rather deal with the homeless patient in a psych ward than the other option, sitting in a prison cell. Happens way too often, and it truly is a shame.

Mark :Crash:

many of our frequent fliers return to our unit + for cocaine with their unfilled rx's in their pocket!!! 3 hots and a cot is alive and well, where i work

It is true that many of the patients we serve in our psych hospitals are homeless, drug addicted and non compliant with medications. It is happening, according to APNA all across the country. As care providers we know that the side effects of psych meds, lack of family and community support all cause a revolving door effect. I do take issue with the "3 hots and a cot" analogy, and ask how would any of us really feel having to depend on people who have already written us off as "lost and parasites"? The 3 hots we provide are NOT all that and the cots are not SERTAs, so big deal for the receiver of our benevolence:)

I have seen the narrowing of the gap between the patient we serve and the server, it's just a "key" away.

yes nanacarol... some nurses consider these patients parasites, unfortunately i did not use that term... you did..the pts i am talking about have choices!!! they have no side effects because they dont have their rxs filled..they use illicit drugs though....they choose not to go to our na mtgs etc.. its frustrating of course but i, as well as the other caring nurses on our unit talk amongst ourselves about our frustrations..we do not treat the pt different...you make it sound like we have no compassion..i thought this website was open to talk about our feelings re: practice issues..i didnt know our supervisors would be listening.

staff nurs... i love bedside nsg !!!.20yrs +++5 yrs psych

You are correct that this is a site for all to discuss their feelings, I believe all includes the supervisors. Forgive me if you and others were offended by my attempt at giving the advocacy side of psych nursing to the new nurse who might be interested in psychiatric nursing as well as the student just coming on board. I don't doubt that you are a caring nurse and I value your right to voice your view, allow me the same opportunity.

Thanks

Suzepsychnurse rocks! You go girl!

It appears 3 hot's and a cot is now universal and not just to locality. The homeless are using our hospitals as hotels. They receive 3 meals, snacks, excellent health care, and expect us to be at their beck and call. They usually threaten Suicide to enter our facility. They can be our worst nightmare. Sometimes they threaten to report us to administration, or a state agency. They attempt to dictate exactly which medications should be prescribed, which almost always includes, Xanax, Ativan, Valim, Oxycontin and the list goes on and on. They demand we take their vital signs every 10 minutes, when they fall below :balloons:prescribed perimeters for their safety. Here in Florida, we also have winter homeless. They only come for the season. This is fraud. They use our tax dollars illegally, and no one reports it. We are dedicated to caring for the psychiatric patient, that isn't high on cocain, heroin, marajuana, ectasy, xanax bars, or taking opiates, and the list goes on and on. Also, our average inpatient stay is approx 3-4 days, but they usually say they're not ready for discharge, because they're still suicidal. They refuse to go to a homeless shelter. However, when it's the first day of the new month, they achieve a miraculous recovery to collect their checks and spend money on their self prescribed "medications", not those prescribed by their physicians.

its definitely something thats been going on in my workplace. it seems like u have pts that come in for 3 hots and a cot, but keep in mind that a lot of homeless people do have some sort of mental disease (i.e. schizophrenia, and thus a valid reason to be hospitalized). However, lately, Ive noticed some pts come in to the hospital on a regular basis, often after they have spent their SSI money, and come in for at least 17 days, using and abusing the whole system. Some of these pts even choose which type of medications they would take, thinking that they only need such meds. Funny if u think about it.

What you and others describe is real, what is missing is the recognition (beyond what we have been educated to believe) these citizens are mentally ill. They are not able to make rational decisions for life issues. The safe haven is many times the hospital ER or the psychiatric hospital. Trust my 20 + years of experience, they (for the most part) would rather be one of US than live in the mental hell that is their life.