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.
Apparently, those who call my comments snotty or think that I was saying that medicaid patients are stupid and don't deserve the same caring attitude from their nurse totally missed what I was saying. Medicaid patients should be more gracious and kind BECAUSE they are forcefully taking money from anyone who pays medicaid taxes. Medicaid is not insurance due to the fact that a person doesn't have the right to opt out. If anyone decides they would rather pay for something else besides their private insurance they can. Try that with medicaid and you will go to jail. Healthcare isn't a right if someone else has to provide it against their will. So, I expect them to be gracious, no matter what circumstance happened to put them in the position that they use medicaid, because I have to take more time away from my wife and family to provide insurance for people who can't or won't make the sacrifice or do what is needed to provide it for themselves. Time equals life and you have to spend time working to provide for yourself and family. So if I have to spend more time working to pay for medicaid for people I don't know then that is time and life I don't get to spend with my wife and family.
i certainly do not expect gratitude from medicaid recipients.
if anything, the people that genuinely need this assistance, are likely to be filled with shame, guilt and ambivalence.
these types of feelings can and will elicit resentment, if anything else.
resentment for the hard times they're experiencing.
resentment r/t inability to pay their way.
resentment r/t OTHERS paying their way.
i can tell you, from someone who has been there, that the apathy and hopelessness can be suffocating.
poverty, in the short term, can bring out the worst in people:
and in the long term, bring out the best...if they can successfully get off the system.
those who eventually get off assistance, will never forget where they came from.
they've learned values and THEN, gratitude.
it usually comes when the acuity is over.
keep in mind, i am referring to those who are truly needy.
those who learn to buck the system and make it a lifestyle, well, they just have my pity.
nothing envious there.
and so, no, i do not expect gratitude.
i can only hope that most will find their way out.
i can't imagine anyone being satisfied living this way.
Apparently, those who call my comments snotty or think that I was saying that medicaid patients are stupid and don't deserve the same caring attitude from their nurse totally missed what I was saying. Medicaid patients should be more gracious and kind BECAUSE they are forcefully taking money from anyone who pays medicaid taxes. Medicaid is not insurance due to the fact that a person doesn't have the right to opt out. If anyone decides they would rather pay for something else besides their private insurance they can. Try that with medicaid and you will go to jail. Healthcare isn't a right if someone else has to provide it against their will. So, I expect them to be gracious, no matter what circumstance happened to put them in the position that they use medicaid, because I have to take more time away from my wife and family to provide insurance for people who can't or won't make the sacrifice or do what is needed to provide it for themselves. Time equals life and you have to spend time working to provide for yourself and family. So if I have to spend more time working to pay for medicaid for people I don't know then that is time and life I don't get to spend with my wife and family.
Thanks for clarifying. I don't know why anyone would think that these comments are snotty.
So if I have to spend more time working to pay for medicaid for people I don't know then that is time and life I don't get to spend with my wife and family.
You wouldn't have this problem if you were rich. If you were rich, then you could pay your taxes and still have the time and the means to spend with your family. Why aren't you rich? If you worked hard and sacrificed, then you'd be rich already. And don't tell me it's because you have to pay so many taxes either. Lots of rich people came up from the bottom using nothing but their bootstraps and they were able to become rich despite paying taxes so the problem must be that you don't want to work hard enough. Therefore you get what you deserve.
Earle, I agree. I can't imagine that a person could ever have a good life being in that situation. My heart goes out to them especially ones that really need the help. But, that is the problem with medicaid. It takes the human element out of compassion and help. If someone did need help with their bills and they came to me for help I would do whatever it took to help them, plus it gives me the opportunity to screen out ones who don't really need it and are just looking for a free lot in life. Medicaid takes away the responsibility and connection that people should have on a personal level to each other, and it takes away the freedom recognized by old America in the founding documents that people can be selfish bungholes and not help anybody if they don't want to.
Are selfish people awful? Yeah, they are but you cannot force someone to be compassionate or to have a heart. Communist countries force their citizens to be compassionate and provide for the many and no one can say that that is the ideal situation that you want to live in.
Hey Sharon, what did I get that I deserve. Are you saying that since I'm not rich I deserve to pay for others medical care or that if you ARE rich then you should pay for others care?
Specializes in icu, er, transplant, case management, ps.
Everyone is entitled to their own feelings. If someone feels like they are entitled to treat someone poorly because they are working hard to support them, in lieu of the individual getting a job, they are entitled to their anger. They are entitled to feel that they are being robbed of their tax dollars. They are entitled to resent people who they consider too demanding, too lazy. They are even entitled to post their views here on this board because it is a place where we are suppose to share our viewpoints and feelings.
This being said, I am entitled, as someone who has collected SSDI for the past seventeen years and who collected Medicaid for twelve months, to say that I paid into those systems, the first since the age of fifteen and the second one, since nineteen. And I am only drawing on systems that I paid into. And if I could, I would come off of SSDI. It certainly doesn't afford me the life style I had become use to, back in the 80's. And for those of you that are paying into the Social Security system today, thank you. I am sure that I have eaten up what I put into the system by now. And I hope that those who resent people living off of them, have saved a large amount of money and/or have understanding private disability insurance companies, who will not deny you. You will need them. And by the way, if you have put money into 401s or IRA's, don't try to take your money out. If you do, you will lose about 48% of it, in penalties and taxes for early withdrawal. Our government doesn't care if you have lost your only means of income and need the money to live, now. And this is only right because you have gotten a tax break from depositing it and you are taking it out early.
Now that I have managed to make almost everyone angry, I'm sorry. I am just trying to look at the systems from both sides. Everyone is entitled to their own feelings. What we are not entitled to is to pass these feelings on to those that cause them. We are suppose to be professionals. And as professionals, we are suppose to be able to hide our personal feelings. But we are not always successful, regardless of what we may think. Our personal feelings have a habit of creeping out to the surface.
Hey Sharon, what did I get that I deserve. Are you saying that since I'm not rich I deserve to pay for others medical care or that if you ARE rich then you should pay for others care?
No, I'm saying that if you were rich you would be able to pay your taxes and spend time with your family. If you would only work harder, were smarter with your money and saved more you would not need to work. Therefore you are not deserving of my sympathy or my understanding. If you can't spend enough time with your family, that's too bad.
Shaggy, do you have any idea what a small percentage of your taxes actually goes towards Medicaid? You're not missing any time away from your family to pay for Medicaid, and if you think you are, you're either paid literally pennies an hour or are seriously misinformed.
Consider it this way--medicaid and welfare funding have been slashed in the past decade. Have you seen even a minute drop in the amount of taxes withheld. Neither have I.
My taxes are taken out to go to a war that I don't support. At all. Do you see me saying that soldiers should be gracious to me for paying their salaries, travel and education expenses? Cuz, ya know, I can't opt out of paying for that.
This is the kind of stuff that makes me want to beat my head against the wall.
A patient who receives medicaid doesn't owe you anything-thanks, appreciation, respect, anything. They aren't indebted to you. Many of these people have paid taxes at some point. If you were to become unable to support yourself or your family, you too would be entitled to health insurance.
Careful you don't smack your head against your own clouded judgement when you fall off that pedestal.
The amount in NC is $236 per child, to those who grew up into the system and who are selling their food stamps to buy incidentals, that is a lot of money! It's another $236 they can sell their food stamps for and spend on whatever they want to.
The single digit numbers are the # of people per household. The dollar amounts are what the HOUSEHOLD recieves--and that's a maximum. That's a lot less than $236 per kid.
Not to mention, when you sell your food stamps, you don't get dollar for dollar the amount their worth. You get around half, give or take 25%. And they're much harder to sell now that the FS are on an EBT card.
Apparently, those who call my comments snotty or think that I was saying that medicaid patients are stupid and don't deserve the same caring attitude from their nurse totally missed what I was saying. Medicaid patients should be more gracious and kind BECAUSE they are forcefully taking money from anyone who pays medicaid taxes. Medicaid is not insurance due to the fact that a person doesn't have the right to opt out. If anyone decides they would rather pay for something else besides their private insurance they can. Try that with medicaid and you will go to jail. Healthcare isn't a right if someone else has to provide it against their will. So, I expect them to be gracious, no matter what circumstance happened to put them in the position that they use medicaid, because I have to take more time away from my wife and family to provide insurance for people who can't or won't make the sacrifice or do what is needed to provide it for themselves. Time equals life and you have to spend time working to provide for yourself and family. So if I have to spend more time working to pay for medicaid for people I don't know then that is time and life I don't get to spend with my wife and family.
Wife and family?
Hmmm....
You are forcibly taking money out of MY pocket in the form of extra taxes I pay as a single taxpayer to make up for the tax breaks you get by declaring your wife and family as deductions.
Specializes in icu, er, transplant, case management, ps.
Where are you getting this information? According to North Carolina's website, The single digit numbers are the # of people per household. The dollar amounts are what the HOUSEHOLD recieves--and that's a maximum. That's a lot less than $236 per kid.
Not to mention, when you sell your food stamps, you don't get dollar for dollar the amount their worth. You get around half, give or take 25%. And they're much harder to sell now that the FS are on an EBT card.
I kind of figured that I was correct. I had never hear of anyone receiving as much money as had been quoted. People tend to believe what they want to believe. If they convice themselves that people are cheating them, they can justify their negative attitude. I hope that none of them find themselves ever in need. I wonder if their attitudes will change then?
Shaggy, do you have any idea what a small percentage of your taxes actually goes towards Medicaid? You're not missing any time away from your family to pay for Medicaid, and if you think you are, you're either paid literally pennies an hour or are seriously misinformed.
Consider it this way--medicaid and welfare funding have been slashed in the past decade. Have you seen even a minute drop in the amount of taxes withheld. Neither have I.
My taxes are taken out to go to a war that I don't support. At all. Do you see me saying that soldiers should be gracious to me for paying their salaries, travel and education expenses? Cuz, ya know, I can't opt out of paying for that.
This is the kind of stuff that makes me want to beat my head against the wall.
A patient who receives medicaid doesn't owe you anything-thanks, appreciation, respect, anything. They aren't indebted to you. Many of these people have paid taxes at some point. If you were to become unable to support yourself or your family, you too would be entitled to health insurance.
Careful you don't smack your head against your own clouded judgement when you fall off that pedestal.
What she said :)
We are not islands unto ourselves, we live in a society. A representative democracy that has chosen to provide assistance for those less fortunate, in spite of the fact that there will always be some who take advantage of the system.
I'm sure that we all can dissect federal and state budgets and find something we don't agree with and don't want "our" money paying for; and we don't have to look to far to find how each of us is in some way on the receiving end. If expressing gracious gratitude is to be expected from all who benefit from our tax dollars, we'd be spending all our days thanking everyone we meet.
Taxes are the evil we put up with to live in this society. They are what keeps it running for the benefit of all. We elect representatives to disperse these funds as they see fit. Don't like how the money is being spent? Vote to replace the current crop.
leslie :-D
11,191 Posts
i certainly do not expect gratitude from medicaid recipients.
if anything, the people that genuinely need this assistance, are likely to be filled with shame, guilt and ambivalence.
these types of feelings can and will elicit resentment, if anything else.
resentment for the hard times they're experiencing.
resentment r/t inability to pay their way.
resentment r/t OTHERS paying their way.
i can tell you, from someone who has been there, that the apathy and hopelessness can be suffocating.
poverty, in the short term, can bring out the worst in people:
and in the long term, bring out the best...if they can successfully get off the system.
those who eventually get off assistance, will never forget where they came from.
they've learned values and THEN, gratitude.
it usually comes when the acuity is over.
keep in mind, i am referring to those who are truly needy.
those who learn to buck the system and make it a lifestyle, well, they just have my pity.
nothing envious there.
and so, no, i do not expect gratitude.
i can only hope that most will find their way out.
i can't imagine anyone being satisfied living this way.
apathetic, yes.
content, never.
leslie