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?
I think most of these people are talking about folks who are very obviously abusing the system. I would hope that most nurses would try to help some one who, say, is in a town they just moved to and fell out some where and was brought to the ER, or some similar situation.
I gave a cab voucher to a pt. last week - he was here to be seen because he was mugged (hence no wallet/cash) and had the crap kicked outta him. I didn't want him to walk home, alone, by himself.
One of my co-workers came over here from a third world country. All alone. Didn't know a soul in this country.
As a *******' teenager!
Lives in a nice place now. Drives a fancy car.
No, it's not just "abusing" the system.
It's adults wanting to be pampered and hand-held like hapless children.
If a teenager coming from a third-world country, unfamiliar with this society; can find their way ... what's your* excuse?
cheers,
* : By "your", I'm not pointing the finger specifically at you. Just making a statement :)
If you called EMS because it's 3am and your tooth has been hurting for 8 years, then you get handed the telephone to call for a ride.
If you legitimately cannot find a ride, and you came for something that's at least urgent- then we'll generally take pity on you & pay for a cab ride home.
Our ER has a 2 hour wait time after someone is discharge before we will CONSIDER calling a taxi for them if the bus is not running.
And am I a big ole meanie if I say I kind of enjoy telling the "abdominal pain x 4 months, came in by squad, btw I need a pregnancy test" patient that? :)
Of course we make exceptions for for elderly people, non-FF with legitimate transportation problems, patients who have somehow melted my cold heart with their story, etc.
BTW, *most* of the patients who throw a fit about not getting an immediate taxi end up finding a ride home. Who knew!
2 times per night, I personally load up my mini van and drive all the stranded patients home. As we are ambulatory Ed, we don't take ambulances so they got here somehow but usually some drama resulted in them being stranded.
So, I put on my nun's habit (which I wear when not working in the ER) and drive them home, I also purchase their prescriptions (as I am so high paid as a nurse) and make sure they have cleaned out the towers of all supplies which may or may not have a practical use at home (nebulizer set ups work great for shunting the baking soda on the volcano science project)
In reality. We are ambulatory. We have no cafeteria. We have frozen healthy choice meals that area given few and far between. We also do not give cab vouchers. Period. We will call the Medicaid cab but that's it. That's only If I like you(no really it's based on how busy we are)
Also, we have a policy no ride at bedside, no ride on narcotics. No Narcs unless ride is present and remains present.
It's less a matter of having nowhere to go than having a destination but expecting someone else to get you there. I feel for folks who do not have a car. But those who come in on an emergency basis when their complaint is not an emergency should not expect to be ferried home on someone else's dime.
Bus tickets, yeah. But cab fare because you decided to come after hours for something that could have waited until morning, that's just enabling. You can snooze in the nice warm ED waiting room until the buses are running again.
This isn't cruelty. It's a lesson in practicality. And planning. Adults need to start thinking like adults and understanding that their poor decision making will have an affect on them. As long as we shield people from the negative results of their mistakes, there will be no incentive for them to change their thinking or their behavior.
it's less a matter of having nowhere to go than having a destination but expecting someone else to get you there. i feel for folks who do not have a car. but those who come in on an emergency basis when their complaint is not an emergency should not expect to be ferried home on someone else's dime.
bus tickets, yeah. but cab fare because you decided to come after hours for something that could have waited until morning, that's just enabling. you can snooze in the nice warm ed waiting room until the buses are running again.
this isn't cruelty. it's a lesson in practicality. and planning. adults need to start thinking like adults and understanding that their poor decision making will have an affect on them. as long as we shield people from the negative results of their mistakes, there will be no incentive for them to change their thinking or their behavior.
of course they should. if something has happened 100 out of 100 times in the past, it is perfectly reasonable to expect it to happen again.
we created this system, it's not surprising people use it.
I just wanted to say that in some towns there are no taxis or bus systems. My town was like that for a few years recently (I live in a city in central Mississippi). I am not saying the hospital should take up the slack at all. Some of these people are just failing to plan, and that is their fault. I believe that if you are a person who has a condition that legitimately lands you in the ER on a regular basis then you should have developed a transportation plan, even if you no longer live in your hometown.
I gave a cab voucher to a pt. last week - he was here to be seen because he was mugged (hence no wallet/cash) and had the crap kicked outta him. I didn't want him to walk home, alone, by himself.
One of my co-workers came over here from a third world country. All alone. Didn't know a soul in this country.
As a *******' teenager!
Lives in a nice place now. Drives a fancy car.
No, it's not just "abusing" the system.
It's adults wanting to be pampered and hand-held like hapless children.
If a teenager coming from a third-world country, unfamiliar with this society; can find their way ... what's your* excuse?
cheers,
* : By "your", I'm not pointing the finger specifically at you. Just making a statement :)
There are plenty who come to this country and ride the welfare system harder than anyone. But you make a good point, it is just a pretty narrow one.
I think most of these people are talking about folks who are very obviously abusing the system. I would hope that most nurses would try to help some one who, say, is in a town they just moved to and fell out some where and was brought to the ER, or some similar situation.
For sure.
I've sent patients along their journeys with my personal food in their backpacks and a cup of my personal coffee in their hands. We've taken up collections to get patients bus tickets or even to buy their 'scrips.
I'm talking about the ingrates who not only abuse the system but the staff as well. If you're going to be a mooch, at least be kind and courteous. If you're a jerk, I really couldn't care less what happens to you 2 seconds after the D/C orders are written and I boot your butt out the door.
The question that cracks me up is "do you validate parking." We have a hospital parking garage, and the only reason to park there is to be in the hospital. No other businesses nearby or whatever that would use the garage. Why would we need to validate parking when you're ALREADY GETTING THE HOSPITAL VISITOR RATE on the parking?
We live in a big city where parking is expensive, so you really don't drive anywhere expecting NOT to have to pay for parking.
I think we ALL have seen that 1 patient every now and than that touches us and makes us "human" I have been known to provide motrin. We had a baby in with a fractured femur who had to go the pedi hospital, dad left to get the other kids straight and the mom was at the hospital. The car seat (booster) was in the car with dad, we require it to transport. One of the nurses still had the booster in the back of her car that her child just outgrew. she gave it to this little one. (it just happened to be a princess booster) the little girl was over the moon.
There is one homeless guy I kinda like, I give him scrubs. That's all he needs. We also have been known to let him take a shower at the ED. He's grateful, he leaves, it's all good.
Parents who are trying and can't afford the Motrin but have the tylenole etc those are the ones we help.
The ones who demand a hand out those are who I have issues with.
Agreed, there are certain people that I just want to go the extra mile for, and I don't expect them to do backflips of gratitude in return. But when I put myself out to do extra, and the person is ungrateful about it, it really makes me hesitant to anything extra in the future.
Roy Fokker, BSN, RN
1 Article; 2,011 Posts
One of my co-workers came over here from a third world country. All alone. Didn't know a soul in this country.
As a *******' teenager!
Lives in a nice place now. Drives a fancy car.
No, it's not just "abusing" the system.
It's adults wanting to be pampered and hand-held like hapless children.
If a teenager coming from a third-world country, unfamiliar with this society; can find their way ... what's your* excuse?
cheers,
* : By "your", I'm not pointing the finger specifically at you. Just making a statement :)