"I have an ethical problem"

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Specializes in ER.

This was really cute. We have a wonderful young nurse cross training in our ER, she was really helpful yesterday. So she approaches one of us, asking where the charge nurse is. My colleague said ''what do you need, maybe I can help?''

So she says "I have an ethical problem", and proceeds to tell us that she is discharging a patient who is homeless, and doesn't feel comfortable with that, and wanted to find him resources, etc.

Out of the mouths of babes. We told her that we get homeless patients all the time, that we can't solve all their problems for them. If they come to the ER homeless, they leave homeless, that we tell them to go to The Mission for guidance.

She was rather taken aback, I saw shock on her idealistic, fresh young face. I think she was thinking maybe ER is not for her after all.

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Specializes in Pediatrics, Emergency, Trauma.

That's the LEAST of ethical problems...if anything you gave her inaugural "welcome to Nursing" issue.

You could've "softened the blow" to steer her to the local mission where she could help the homeless population during her off time.

All in all, I think she'll be okay.

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Specializes in Peds, Neuro, Orthopedics.

That reminds me of a homeless patient that was stunned that we were dc'ing him back to the street. I guess he thought we'd buy him a condominium or something. He stated to his nurse, "You're sending me back to the street?!" and his nurse said, "Well, that's where you came from."

Yeah, I know it's not therapeutic communication...

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Specializes in ER.

It's really sweet to see young nurses so full of idealism and patient advocacy. Reality sets in all too soon. Sometimes you see young nurses who are already cynical, and disdainful of patients with poor coping skills. I'll take a nurse like this young woman any day!

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Specializes in Critical Care.

I give them my address. They can come live with me when they need a roof.

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Specializes in Oculoplastics.
I give them my address. They can come live with me when they need a roof.

Are you joking?

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Specializes in ER.
Are you joking?

Nope. More time for therapeutic communication when your off duty. And you can help them house hunt.

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Specializes in CRNA, Finally retired.
Nope. More time for therapeutic communication when your off duty. And you can help them house hunt.

Wow. Do you have a death wish? My first thought was this constitutes a flagrant boundary violation. Harsh words..I know, I know. But YOU are not the answer to their problems and can NEVER be the answer. You didn't cause their homelessness and you can't cure it either. Meanwhile, you are putting yourself in danger and aren't helping them accept help from the existing array of services.

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Awww, poor baby. What a sweetie.

I had a hard time with that when I first started Med-Surg. For those of you who haven't been exposed to it, homeless fill up the beds in winter d/t exposure, pneumonia, etc. It's hard to send them back out when it's cold.

On my first unit, back when I was a CNA, we had a social worker whose main job was finding shelter placement in the winter. Mainly, we just kept them until first thaw or until we chose to believe the patients when they stated they would stay with a friend/family member.

Now that I'm older and "bitter," I just send them out on their own recognizance, since I know that they're going back out on the street no matter what I do anyway.

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I work on a Med/Surg floor and this "ethical problem" is common for us. Actually, it always irritates me when we keep patients for days after they should have been discharged while the SW or CM looks for a place for them to live. It sounds heartless, but that is not our problem. My problem is having a fairly healthy 'patient' who thinks it's his/her privilege and right to be waited on hand and foot, complaining when I'm "Late" with their PRN medications (even when they show no signs of needing them) and I can't say "Look, I've got 6 other patients, 3 of whom had major surgery in the last 4 hours, 1 with chest pain, 1 with low urine output, and 1 with a critical value that I need to page the doctor for. it's 0200 - and you're lucky to be here. Stop demanding you get your PRN meds 'on schedule' and stop chugging soda like Coke and Pepsi are going out of business."

They were homeless when they came in, and I can't cure that in 2 days. I can't even cure it in the extra 4 days we kept them. They're still homeless a week later.

It's cute the new nurse actually thought she could help this.

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It's worth considering though that for plenty of folks, keeping them for a few extra days in order to find a shelter bed may actually prevent one or more readmissions. I work in the community and plenty of my homeless guys get discharged to the street (literally, to the street, not to a shelter bed or anything, just booted onto the curb in hospital pyjamas and shoes if they're lucky) and then everybody's surprised when they get readmitted because they got sick again?

I had one guy, 85 years old, demented (MoCA of

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I had one guy, 85 years old, demented (MoCA of

85 years of age,dementia, and homeless? Yikes!

Seriously,someone early in his hospitalizations failed him.

That would make anyone wonder why the hospital kept discharging this elderly,demented man?

That guy should have been placed somewhere(nursing home) the first time it was found he was homeless,esp at that age and with his condition.

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