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Discussion

money is evil (rant)

so there is this pt on my floor right now who has been there for almost a month with confusion/thyroid abnormalities. he is a frequent flyer for chf and also happens to be a complete jerk. he screams out into the hallway constantly at all hours day/noc is very demanding, you just leave his room and before you make it down the hall he is yelling again. we have tried several techniques for limit setting with him but nothing seems to work- he just yells out. this behavior caused another pt to fall- going to check on this "poor man who is yelling and no one is paying any attention to him". he was originally admitted for "heart failure" because he became confused at home, stubbed his toe, it bled, he saw the blood and called 911 saying someone was in his house trying to kill him. his (30 yrs younger) wife can't take it anymore and wants him placed in a NH. so there he sits. for a bleeding month. while other pts have a huge STEMI, are intubated with a balloon pump, the works and are d/c 4 days later. his insurance must be awfully yummy for the hospital. EVIL MONEY! this pt is being treated for heart failure and thyroid abnormalities with PO meds, btw. it is so frustrating to come to work every weekend and find him STILL THERE. in a monitored bed. GRRRRRRRRRR! thanks for listening.

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:o Been there, done that. There are some people that would make a saint spit....

Wow it sounds like you could be talking about a couple of patients that come to my hospital. They yell, fuss, and make all sorts of demands, keeping you from caring for the other patients. There is one in particular whose name we do not dare speak when we have an empty bed, because if we do he is usually admitted within 24 hours. But what gets me is that we stick to the physician's orders - ie fluid restrictions, special diet, etc..... but the physician comes by and says he wants such and such, go ahead and give it to him so he doesn't leave AMA.

Sorry didn't mean to go on my own rant. Guess it's nice to know that I am in good company.

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what gets me about this specif. pt is that the only reaeson he was admitted/has been there so long is that he is wealthy and a personal friend of the attending. it is a complete misuse of resources.

Sounds like the nasty old guy that we just had in our LTC! Even the residents disliked him. If he didn't get immediate attention when he was up in his WC, he would slide himself out onto the floor.

Been there done that too. I think sometimes these people are experiments in time. To see how long we can keep them until they get a big MRSA/VRE case and we can keep them (then in isolation) for another several months.

Unfortunatly, if the man is wealthy and is able to pay the bill after the insurance denies the claim he can stay as long as his money holds out. I actually know of a case where this little old lady LIVED at the hospital for several YEARS before she passed away.

I might suggest, moving him as close to the nurses station as possible so he can see people moving around in the hallway. It is much easier to stick your head in the door as you go by and reassure him(i know you'd rather do something else)that you are not far and to use the light instead of yelling. It will take a while but hopefully he will get it and calm down a bit. Good luck.

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