Pt on 180 waiting needs new hip, but waiting for state bed

[espresso_dreams]

Hi, I have a patient who is desperately in need of a new hip. It's bone on bone, and is in renal failure, so there isn't much that can be done for the pain. We are checkout holding this patient on a 180 day hold, which may turn longer, depending on how long western state takes to get a bed open.

I don't know what we're doing in terms of planning hip replacement surgery for this patient, or even if we can, as we are a shirt term facility... but I can't stand watching this person suffer! To the best of my knowledge, we are waiting for the state bed to take over care on this matter, but this person can barely walk now and again, is suffering terribly! Until I got into psych, I never saw so much uncontrolled pain...

Should I report this?

[vintagemother, BSN, CNA, LVN, RN]

It is good that you care so much. However, sometimes there isn't much you can do, due to the way the system works.

When I worked in a psych unit, there were a few times I can recollect that a pt appeared in dire need of additional medical interventions.

The case that comes to mind is an older pt who suffered broken facial bones s/p assault by another pt. However, because the pt had a state appointed guardian, and the MD at the local trauma hospital didn't deem his injuries life threatening, the guardian wouldn't consent, d/t liability issues.

This occurred on a long term psych unit with many serious forensic cases.

On the acute short term unit, nothing was done for long term problems.

Things i I did to help me to learn what/if anything could be done were to consult case Mgrs, charge nurses, MDs, admins, other nurses, to determine what I could do. Sometimes, I was given an action plan and other times nothing could be done.