Patients overstaying their welcome in hospitals

Nurses Relations

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I just watched Rock Center with Brian Williams tonight on NBC and he had a story about patients in hospitals that are no longer receiving acute care, but stay for years because they do not have anywhere else to go and can not be kicked out. I have heard of a few months stay,,,but 2 years? That's a long time.

Have any of you actually known patients that were 'stuck' in the hospital with no where to be discharged to?

Specializes in LTC, Psych, M/S.

Having worked m/s and ltc - I have seen many of these situations. The bottom line is they are going to bankrupt the system.

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We had another GB syndrome, flaccid up to his eyeballs. No movement. Family fought tooth and nail to get them to stay in the ICU. Didn't work. Just shows, you either need a ton of money or be homeless to stay in an ICU for an extended period of time.

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Specializes in OR, Nursing Professional Development.

We had a patient in our ICU or step-down unit for 8 years before he finally died. Trached, vented, something had gone wrong during surgery in a southern state, family had him transferred to home area. No one would take him- not LTAC, not nursing homes, no one. Even though it was long before my time, there are a lot of nurses who still remember him and his family. Very sad case.

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Specializes in PDN; Burn; Phone triage.
I have had families who don't want their loved one to go to on to rehab or a SNF as well because they realize the ratios are different and the focus of care less acute. Have had some fight it pretty hard actually. :(

I work on a burn unit and this issue seems to come up with a lot of our long-term patients who end up needing to be transferred to rehab. Family freaks out. Can't convince family that there really is nothing more we can do - pt's basically healed but intensive rehab is CRITICAL in the burn population. Even an overstay of a few days and suddenly the patient has cdiff, is starting to get delirium again, etc. We finally wheel them off to rehab and they're walking out under their own power a week later. Makes you want to rip your hair out at times.

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Having worked m/s and ltc - I have seen many of these situations. The bottom line is they are going to bankrupt the system.

I tried to reply to your message but your allnurses inbox is full.

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Specializes in NICU, PICU, PACU.

Happens in NICU a lot, we have kids with special needs, no family to take them and the specialized foster care is full. We have had kids in our unit for a year or little more. There is only one children's rehab in this area and they are pretty strict about family being involved. They give them 2 weeks and if they don't comply the child gets sent back to a comprehensive peds floor or a nursing facility if able, but those are usually full too.

Most insurance companies will not pay for full time home care, and there is a shortage of home care nurses in our area. So these poor kids are stuck.

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Happens in NICU a lot, we have kids with special needs, no family to take them and the specialized foster care is full. We have had kids in our unit for a year or little more. There is only one children's rehab in this area and they are pretty strict about family being involved. They give them 2 weeks and if they don't comply the child gets sent back to a comprehensive peds floor or a nursing facility if able, but those are usually full too.

Most insurance companies will not pay for full time home care, and there is a shortage of home care nurses in our area. So these poor kids are stuck.

Had a similar situation in a local well-know peds hospital. Child was admitted for what they thought was abuse--turned out it was a genetic defect. He was 3 months old on admit. Because he needed round the clock care, no facility would take him. Last I saw him, he was being raised by the staff. I ofen saw him in a little wagon at the reception/nurses desk or the assigned nurse would take him around with her. However, much of the time, he would play in his crib, while still being monitored. Sad.

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Specializes in M/S, ICU, ICP.

Heavens yes. Our longest stay patient was 2 years and a few days. The patient became vent dependent and required full nursing care as in long term care and there really are few long term care facilities that take vent patients. Patient really had no family and no insurance. Once placement was located it was 2 states away and the patient lasted one month until the patient expired. Needless to say the patient received ICU care with our hospital because that is where our vent patients stay, but the patient left without any skin breakdown or secondary infections. I was so proud of our nurses!

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this is especially true with KSA public hospitals. There's an ICU long stay conscious patient of more than 10 years.

In my ward, there's this general's mom who was admitted two years prior to my arrival and still there 6 years later.

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Specializes in Critical Care/Coronary Care Unit,.

At a hospital in FL, on the telemetry floor, there's a patient with his own room. He's vent dependent with total awareness, but not being able to move anything. He has literally been in the hospital for years since no one will take him as he is uninsured. He came from a foreign country seeking care and not being a rich foreigner....well, the taxpayers get to pay for his extended stay. I've also seen cases where patients stay in the hospital for months.

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Why on earth don't they fly him back to his own country? The amount of money it is costing, will far outweigh sending him back.

It can be done- and it should be done. Get social services involved, contact the consulate of his own country, and have them arrange a flight crew to send him back.

We did this a while back with a women from Sweden. Her daughter was married to an American Doctor, and lived here in the US. She apparently was becoming ill, and her sons, who were BOTH doctors, decided that it was a good time to send Mom for a vacation to the US to visit their sister. They DID obtain an international medical insurance policy, ,"in case dear old mom got sick in the US". Low and behold, she wasn't her 48 hours, got sick, and had to be hospitalized. She went into respiratory failure, got septic, etc, and was very sick for a long time. Her daughter and son in law, (the doctor), refused to obtain a power of attorney over her because if her international medical insurance policy ran out, they did not want to get stuck with the bill!

I contacted social services, spoke to the doctor, and they arranged for a Swedish medevac unit to fly to the US, pick her up, and fly her back to her own country.

The daughter did not want her to be sent back to her own country, because she said that they would, "roll her into a closet and close the door". In other words, there would be no special efforts to keep her alive. She did not care that if the insurance ran out, she had NO legal status here, and was not eligible to Medicaid, MediCal, etc. Just let the US taxpayer, and the hospital eat the cost of her medical care!

It is worse than ridulous what has been allowed with foreign nationals.

If the hospital does not know how to fly someone overseas, have them contact the nearest AF Base, and get the information from them. I was a flight nurse in the AF reserves, and in Flight School, we learned how to care for patients in Stryker frames, infants in incubators, patients on ventilators- there are special vents, and medical equipment that is used for aerovac.

The USAF Medevac crews, fly medically fragile, and combat injured patients all over the world.

There is NO excuse for this. Send them where they came from, and send the bill to his government.

PM me if your hospital has questions. I would be happy to help.

JMHO and my NY $0.02.

Lindarn, RN, BSN, CCRN

Somewhere in the PACNW

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Specializes in OR.

I have taken care of a patient who was from Mexico and lived in Florida homeless for a long time. He was found unconscious in the streets and after being in our hospital for a long time was able to open his eyes and breathe on his own. Alcohol destroyed his brain though and he needed a peg tube, never spoke. Hospital (non profit, religious hospital) tried to contact family and they refused to claim him. So they actually chartered a plane and flew him to Mexico and dropped him off at a local hospital!! I know this becasue I was the nurse who discharged the patient with the air medical crew to fly him back! really crazy!

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