It's Not MY Responsibility to Get YOU Home...

[Music in My Heart]

This post is equal measures vent and question.

First, the vent:

In a variation of something that happens with some regularity, a patient arrived by ambulance in the middle of the night for something that was not an emergency condition. After an hour or so, the patient was discharged home at which point the patient was unable to find a ride. The patient then became angry at me because I (a) wouldn't let them stay back in a treatment bay, (b) wouldn't provide them money for a taxi, © wouldn't call the cops to ask if they'd provide a ride, (d) wouldn't try to find food for them, and (e) wasn't particularly sympathetic to their situation.

As I said, this is something of a regular occurrence for us and people seem to think that it's our responsibility to get them home again (and to provide them food while they wait for a ride home).

It drives me bananas, especially since it's very rare that they actually have an emergency situation and that they're often frequent fliers.

Now the question: How do your facilities handle it when patients are to be discharged but state that they have no means to get home?

[Orange Tree]

We give them a sewing pattern and tell them it's a map. Then we just stand there and wave until they decide to start walking.

But seriously, taxi :)

[miss81, BSN, RN]

If they are from a nursing home or personal care home we call the home and tell them to arrange a ride for the pt, that is there "HOME." If not, there is an on call social worker that we call and he/she MAY arrange a ride depending on the situation. There are a few frequent flyers that our ED that have written "policies" re: when they visit. One actually states, "If Jane Doe is not suffering from a medical emergency as determined by the ED doc and/or has not rec'd treatment tell her that she found her way to the ED she can find her way back from where she came from."

[rn/writer, RN]

I see this as a byproduct of a public assistance approach that encourages passivity. Ask nothing of the recipients. Teach them that their well-being is someone else's responsibility. Reinforce the idea that if they have a problem they need to be rescued through someone else's efforts.

Maybe if you don't help them out, they'll hesitate just a little before coming in again for a non-emergent complaint with no way home.

[Freedom42]

Frequent flyers automatically ask for cab vouchers, which my employer no longer provides except in the most dire of circumstances. But I don't tell the flyers that. I tell them that we no longer provide vouchers, but I can take them out to the waiting area, where they're welcome to use a phone to call family or friends. If, after an hour, they're still dialing, I'll see if a voucher is feasible. If they're not making any effort to arrange transportation, I don't worry about it.

As for food, I tell FFs this: We serve food at regular breakfast, lunch and dinner times. Obviously we make exceptions as needed. But we've got a few regulars who come in obviously angling for private room with TV and table service. They're put in remotely located rooms with no TVs whenever possible. (What do I mean by FF? I mean patients who visit upwards of 85 times a year.)

[Music in My Heart]

But seriously, taxi :)

As in, "cab voucher" or as in, "here's the number?"

[shoegalRN, RN]

We tell them the bus schedules are out in the waiting room.

If it's after hours, a social worker may provide a bus pass. If the buses have stop running, it's sucks to be you.

[Orange Tree]

As in "cab voucher" or as in, "here's the number?"[/quote']

They get a voucher. And most of the patients who get them expect to get them and have gotten them 1000000++++ times in the past.

[Music in My Heart]

They get a voucher. And most of the patients who get them expect to get them and have gotten them 1000000++++ times in the past.

Kinda hard to stomach when you hear management talking about salary freezes, cutting benefits, or reducing PTO - not to mention working short-handed.

Also tough to stomach when you look at your share-of-cost for visiting your own ER.

[LegzRN]

Out to the waiting room for a little FLT (fluorescent light therapy)...

maybe a turkey sandwich if I like you.

[steelydanfan]

We tell them the bus schedules are out in the waiting room.

If it's after hours, a social worker may provide a bus pass. If the buses have stop running, it's sucks to be you.

And usually, these are the pt's who seem to have the money for false nails, cell phones, cigaretttes and tattoos.

[BEDPAN76]

It could be YOU! We are all only a couple of paychecks away from being in this position. My heart goes out to patients who have nowhere to go.