Patients on Medicaid

Nurses Relations

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I hope not to offend anyone out there, but I would appreciate some feedback on taking care of young to middle-aged adults who are on medicaid. It seems that so many (I realize not all) are some of the most difficult patients to care for; they often are rude, demanding, and unappreciative of nursing care. I have cared for many who demand tests/procedures/an extra day or two in the hospital/supplies that they don't really need; doctors often admit to just giving them what they want, rather than arguing. I have had medicaid patients say to me after I suggest to them, they can probably purchase an item for cheaper at the store, "Oh I don't care, I'm on Medicaid". Recently, a woman openly admitted that she had another child because she wanted more Medicaid money. When a woman has six kids by different men, and lives off Medicaid, I asked myself, "how does this happen"; aren't there people out there monitoring this system". About a year or so ago, I was taking care of a woman - and because the census was extremely low, patient-nurse ratio was 2:1 (unusual but nice). Anyway, I took so much extra time visiting with, caring for and going way beyond what I really needed to do to ensure quality nursing care, and at lunch, her Diet Pepsi wasn't on her tray. She gets on the phone and proceeds to rant and rave about this to a friend. I could hear her end of the conversation. Yes, she was a Medicaid patient.

Wow, I was blown away and got quite upset. I can't believe these are isolated incidences. Many nurses I work with are able to identify Medicaid patients just by their behavior.

As I said earlier, I don't mean to offend, but I am interested to learn if others out there in the nursing world encounter the same type of thing. I realize it is not right to label or generalize people, and I don't let it affect how I care for people; I certainly don't like the way I feel when confronted with this behavior. Any responses are welcome.

Thanks.

Specializes in Med surg, Critical Care, LTC.

I actually had a medicaid patient say to my face "you keep working now, someone needs to support me!" then he laughed. I've got to say, that me, mid 40's with two herniated and 3 bulging cervical discs, chronic pain, depression, PTSD, functional agoraphobia - who COULD be on disability but refuses - having been spoken to like that by a 20 something HEALTHY (but my back hurts!) male on disability - I've never wanted to beat the crap out of anyone more than I did this arrogant jerk!

Where I live, we have the highest welfare roles in our state, per capita! There are literally generations being raised on welfare in my small rural city. Someone needs to overhaul this system.

It's original purpose, for those who found themselves on hard times, but would be off welfare ASAP - I have no problem with. That is a good system - however - allowing these young, LAZY people to be on welfare/medicade for vague "disability" issues, is abuse not only of the system, but abuse of taxpayers as well.

Blessings

I actually had a medicaid patient say to my face "you keep working now, someone needs to support me!" then he laughed. I've got to say, that me, mid 40's with two herniated and 3 bulging cervical discs, chronic pain, depression, PTSD, functional agoraphobia - who COULD be on disability but refuses - having been spoken to like that by a 20 something HEALTHY (but my back hurts!) male on disability - I've never wanted to beat the crap out of anyone more than I did this arrogant jerk!

Where I live, we have the highest welfare roles in our state, per capita! There are literally generations being raised on welfare in my small rural city. Someone needs to overhaul this system.

It's original purpose, for those who found themselves on hard times, but would be off welfare ASAP - I have no problem with. That is a good system - however - allowing these young, LAZY people to be on welfare/medicade for vague "disability" issues, is abuse not only of the system, but abuse of taxpayers as well.

Blessings

And they're popping out one baby after another and getting them diagnosed with ADHD and/or bipolar disorder, often before their second birthday, and getting them on SSI for this.

:madface:

It's because of people like this that people who really are disabled can't get assistance.

Specializes in Labor & Delivery.

I havent read all of these post but a fair majority of them. I just had to add my opinion. I didnt see it as an attack by the original OP on medicaid patients. Just her opinion of what she see's in her place of employment. I can very much see both sides of the debate. Almost all of our pt's are medicaid or tricare (active duty military) and with alot of these families there is abuse of the system. I work in L&D and see time and time again young girls having baby number 4 or 5 (or more) with bad attitudes. I think this is more related to the ages of the clients served, usually young, than the type of insurance. There is an attitude of entitlement from them and it is hard to deal with. HOWEVER I also have been a young single mother who has relied on medicaid myself. I was divorced after my husband left for another woman, and my children were both young. Each of my children has special needs and qualifies for SSI. I was treated terribly by social workers that wanted to know why I didnt work or wasnt married. I was to humiliated to explain my husband ran off with another woman and my baby was having open heart surgery and couldnt attend daycare. I think the difference in my situation is that when my kids got older and were medically stable I went to nursing school to earn a good income, chose not to have anymore children d/t limited resources and tried to turn my situation around. It's still not perfect but much improved! So for those that need a helping hand....so be it! But for those that dont try to help themselves...well I feel different about that. If you cant afford the kids you have, dont have more. Just my opinion, which we are all entitled to have.

Specializes in ED.

Back when I was in nursing school, my husband left me and moved to Georgia (I'm in New York). I was literally in school at the time, I found out he left when I got out of class. I was left with no job, no money and 3 children ages 6, 2 and 2months. I applied and recieved welfare, medicaid, food stamps and WIC. 5 days after I finished school, I was working full time and stopped using any social service program. Welfare was meant to be used to help a person get on their feet, not to be used as a way of life.

Now, years later, I also see Medicaid patients on my unit. It's not Medicaid patients that are rude and demanding and incredibly lazy. Many aren't that way at all. However, the majority of the drug abusers, alcoholics and what I like to call professional patients are on Medicaid. It is this group that is lazy, rude and demanding. It just so happens that this group is also usually on Medicaid. I think that it what the OP is really seeing.

Im am 100% with OP. I understand people need assistance. That does not give pts the right to treat staff like garbage with a sense of entitlement. I am human too and I have feelings just as they do and they have no right to treat me this way. Amd I dont care who it offends but the truth

Specializes in ER/EHR Trainer.

I can't even believe this thread is still viable.....

It's been four years since I posted on this thread....

The reality is RUDENESS is not tied to poor people!

ENTITLEMENT seems to run rampant regardless of socioeconomic status!

And, most importantly....when a patient is in the hospital; IT'S NOT ABOUT YOU!

M

With all due respect a strep throat and D&V (unless you have comorbidities) are not emergencies and there is definitely a problem with the system if people are being encouraged to go to the ER, instead of their PCP (which would be more appropriate) whether they are on medicaid or not.

I went to the ER when I had diarrhea and vomiting last year, turned out I was also severely dehydrated. Spent 5 hours hooked up to an IV being rehydrated and given potassium. Waited in the ER for 2 1/2 hours even though when I arrived I almost passed out and could not walk because my muscles had stiffened up. Sat and watched people go in ahead of me that were out of the treatment room within 20 minutes so one can assume they weren't that serious.

As for Medicaid, not everyone that is on it feels and acts like they are "entitled" and abuses it. I was approved for it a couple of months ago but I haven't been to the ER once and I've seen my PCP one time. I only have 2 prescriptions and I'm sorry to say(for those who believe all medicaid patients are drug seekers) neither are for a narcotic drug. When I was sick last year and needed surgery I couldn't get in to see a neurosurgeon because I was self pay. I had to go to the ER and be referred to their on call NS and to this day I've never received a bill for his service. He is not the norm though. Now that I have Medicaid I can get in to see any of those specialists that wouldn't see me last year because they all take Medicaid.

People here talk about how entitled and rude Medicaid patients can be. What about the entitled and rude VIPs that pass through your hospitals? Do they receive the same scorn and disdain?

ah, a blast from the past....teetotum, woody, daytonite (RIP), tazzy......and a few name changes.

Specializes in ICU, step down, dialysis.
ah, a blast from the past....teetotum, woody, daytonite (RIP), tazzy......and a few name changes.

That's what I do when old threads get bumped up like this...look at all the posters I used to read from years gone by. I remember all of those you listed very well :)

Specializes in PDN; Burn; Phone triage.
ah, a blast from the past....teetotum, woody, daytonite (RIP), tazzy......and a few name changes.

You guys need to start a wiki.

Or at least a thread of passed AN members.

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