Undocumented Patients

[srercg6]

What do you think about undocumented patients who abuse the hospital system? Anyone have undocumented patients who basically live at the hospital because their families can't take care of them, and they can't go to a facility because of their undocumented status?

[Tenebrae, BSN, RN]

Pardon my ignorance. I don't understand "undocumented patients".

A patient whose nurse skimped on the paper work perhaps?

[Avid reader]

What happened to Thurston Howell lll, Lovey Do? Are you going to Gingerly step around this answer or give a Skipperly response or Gilligan out?

[Davey Do]

What happened to Thurston Howell lll, Lovey Do?

The patient is currently being cared for at...

[nursel56]

How do you know they're undocumented?

[catsmeow1972, BSN, RN]

I recently just had such a patient. This patient had been at another local hospital for a number of months, with some pretty definitive issues, which just by reading the H&P and history, those months seemed medically justified. This patient was on my unit because the daughter brought her in with issues related to noncompliance with the directions from the previous facility (antibiotic compliance and the like, probably due to the price.) The person made some significant progress with us, but could have benefited from some time in a facility for PT/OT, etc. That was not going to happen due to no money, insurance or anything. There's probably one indigent bed in existence and that comes available every 20 years or so.

So we come to a point where, as an acute care facility we can't do anything more for them. Home was not an ideal situation but doable. The problem is that the lack of compliance will land them in the ER for small things that a primary care clinic could handle before it got bad, if she could even get into the local indigent care clinic. And so the circle begins again.

I did find it a little odd in this situation, that there was enough money available to pay cash for a medical transport home, but not to much impetus to make steps toward getting documented. That being said, there are probably many underlying things going on that I know nothing about. My take on it is that, as the bedside nurse, my job is to take care of the patient's immediate needs, not play social worker. It's a crappy, stupidly expensive utilization of medical resources but it's nothing that I am in a place to allow my personal judgement cloud my responsibility of caring for my patient.

[GrumpyRN, NP]

We did have a patient on the geriatric psych unit, Thurston Howell, who was there for months and months. But he wasn't an undocumented patient.

Whenever a patient is now there for an extended amount of time, we often ask, "Will this patient be Thurston Howell II ?"

OK, you really needed to explain that one for us Europeans. I thought you were really, really violating HIPAA. . Had to google it to find out.

[FutureNurseInfo]

I guess I will be playing a devil's advocate here. I do agree with the commenters on here about caring for the patient no matter the status. However, I do also understand where the OP comes from.

[heron, ASN, RN]

I guess I will be playing a devil's advocate here. I do agree with the commenters on here about caring for the patient no matter the status. However, I do also understand where the OP comes from.

I don't. Would appreciate an explanation.

[KelRN215, BSN, RN]

My patients are children with terrible diseases. I couldn't possibly care less about their immigration status. I am grateful that they have made it to a place where they can receive treatment for their illnesses.

My most recent one was a teenager from Central America. He came, on his own, to the US with a note from his parents that he was seeking refugee status. He, a minor, was detained by INS for a month before being sent to live with a family friend. A few months later, he was diagnosed with leukemia. In the US, ALL has a very high survival rate. In the rural village where his family lives, he most likely would have died. How he was able to get on Medicaid is not my concern. I am happy that he made it here before he was diagnosed and will likely survive his cancer.

[traumaRUs, MSN, APRN]

In the last few years, our big hospital has actually paid for airline tickets to send them back to their country of origin. These were dialysis dependent pts who did not have insurance coverage and therefore the big two dialysis companies wouldn't touch them in the outpt environment.

[MrChicagoRN, RN]

How do you know they're undocumented?

Lack of a valid social security number is often the first clue.

We have a good number here in Chicago. My last hospital had a patient there for more than a year before finally airlifting them home.

Most are not rude, just grateful for whatever care they can get, and staying under the radar.

[TTLS]

Lack of SSN does not necessarily mean undocumented status. When I first came to this country on a dependent visa (H1) I did not have a SSN because my visa status did not qualify me for one. However I had legal presence.