Undocumented Patients

OrganizedChaos, LVN · Dec 28, 2016

OP, if it bothers you *that* much move to an area with fewer undocumented people or change fields. You are noticeably upset over something that can't be changed & honestly has little to do with the fact that those people are undocumented. People are people. It doesn't matter if they were born in the US or not because some are just rude. As far as family members not taking the patient home, do you know the whole story? If they are undocumented they probably don't live somewhere that is suitable for the patient to go. Also, like a PP mentioned, what if there is bad blood between the family & patient? Just because they are family they have to be forced to care for the patient? You need to look at the big picture before you judge.

SummitRN, BSN, RN · Dec 28, 2016

My employer doesn't pay me to be political.

Kooky Korky, BSN, RN · Dec 28, 2016

Response to Delaney.My views were shaped post Katrina after volunteering for six months. The only people who appeared to be working to rebuild New Orleans were the Undocumented. American workers fled or were scamming the system for something or the other. These people were abused, robbed, harassed, threatened etc and generally stoicly put up with their woes and continued to rebuild when very few others would. It made me aware of the value of their service and the horrendous conditions they endure just to be here, putting into perspective, just how bad it probably is, re the conditions they are fleeing from.
I think their situation is far more complicated than simply abusing the system.

The Americans who fled - is that necessarily wrong? To get out of flooding?

What sort of scams are you talking about by American workers?

How did those who rebuilt do that rebuilding? Where did the money and materials come from? Give some examples?

Kooky Korky, BSN, RN · Dec 28, 2016

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.

OK, but someone does have to pay for his care. You and I pay for it.

Kooky Korky, BSN, RN · Dec 28, 2016

^^ exactly what CCU said. Or sometimes it's even worse. We recently had a patient who was a post cardiac arrest with an anoxic brain injury, but not brain death. The family wanted everything done. Trach/PEG, etc. The patient is minimally functional- essentially the only thing he does is breathe over the vent and occasionally opens his eyes. He is an undocumented immigrant. So now we have basically an LTACH patient, stable, who will live out the rest of his life in one of our hospital's trach to vent PCU beds, simply because his family continues to insist that everything be done, but they are unable to pay for any of his care/private placement, and he's not eligible for medicaid.
Edited to say that I'm not saying that he isn't deserving of care in any way shape or form. Just saying that our system/way of managing this scenario is clearly broken.

There has to be a way to draw the line with this family. Perhaps he can be made a ward of whoever (other than his family) and he could be taken off the vent a couple of times. After some failures, the whoever could decide he's had sufficient chances and common sense could prevail. We do that with paying patients, why not with those we pay for? What are those hospital attorneys getting paid for? Send the bill to Trump so he can forward it to the fellow's home country.

What happens to Americans abroad who become vent dependent and vegetative?

Also, I don't understand why these patients aren't elegible for Medicaid. I didn't think Medicaid required any SSN or proof of citizenship or lawful residency.

Kooky Korky, BSN, RN · Dec 28, 2016

the problem is not of someone being rude or even being undocumented, ilegal ailen for that matter benefiting from tax revenues without paying a cent on income taxes... The problem is why does US healthcare allows abuse in the first place. and by the way, I believe abuse does exist... just work at ERs in a metroplex, you will be surprised how many same folks you see over and over and over again, and they are not even the tiniest portion of healthcare abusers. The problem lies not within one's residence status or one's "rudeness", but why the system allows that sort of abuse.

Couldyoubemorespecific?Sorry-troublewithspacebar.

Kooky Korky, BSN, RN · Dec 28, 2016

no, that's just additionally. for instance a family that has a family member who needs a LOT of care - can't do a lot themselves - but some, but the family claims they are homeless (when they clearly are not) or don't have room for the person etc because they don't want to have to take care of them, and the person can't be sent to a facility because they are undocumented so they are left to use the more expensive services of the hospital as their long term care - years.

If they clearly are not homeless, why doesn't your legal team deal with this? There has to be some loophole.

OrganizedChaos, LVN · Dec 28, 2016

OK, but someone does have to pay for his care. You and I pay for it.

But that doesn't mean we treat them worse compared to someone who is legally here. Whatever your views are, you need to drop them at the door.

BedsideNurse · Dec 28, 2016

I think most nurses work hard to give all their patients good care, regardless of them being rude, system abusers, prisoners, drug seekers...whatever, and I'm talking about citizens. That being said, as a nurse who worked at a hospital that was absolutely inundated with people who where weren't from here, there are things that can rub one the wrong way. The professional nurse (and caring human being) doesn't let that affect the bedside care given, but looking at the big picture, the common sense taxpaying citizen, and health care recipient, (and parent of at least one school aged child) should at least ostensibly be concerned for the costs and strain placed on healthcare systems and the cities they live in...In my life as a nurse most "illegals" (I know, cue the firing squad for using that term) that I've taken care of have been salt of the earth, good, hard working, & grateful people, although there have been gang members and criminals and the like...as well as the occasional strangely militant in your face entitled F-U America types (much worse than dealing with the handcuffed to the bed felons in my experience)...but we are there to take care of our patients and so we do to the best of our ability, regardless of how they got there and whether or not they are "good people or not" or pleasant to be around or not, thankful or thankless, here legally or illegally, etc...So as nurses we "deal with" undocumented patients like any other patient. I do think that hospitals that deal with large numbers people who come here illegally face incredible financial burdens because of it, as do the resources in their surrounding communities, and I think to assert otherwise is pure PC nonsense. I'm hoping our ever impotent government can finally secure the border, figure out the best immigration policy for this country, and by extension, help our health care system at large.

allnurses Guide · Dec 28, 2016

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.

Thank you. I agree, from what I've observed staying under the radar is their first concern if their immigration status came to my attention.

As some people have mentioned, I don't make a point of seeking that information, so if the patient speaks a language other than English, is uninsured and without a social support system or financial resources, they may be undocumented, or they may not.

To the OP, I would say that the quality of rudeness doesn't come along with immigration status.

Most of the abuse of resources I've seen in my most recent area of home care happens as a result of an organized effort by people who understand the system very well, and look for loopholes to exploit. Not people who fit the scenario you described.

Longleggedstar · Dec 28, 2016

Whoa! A patients "immigration status" is one word....IRRELEVANT! You are there for one reason to take care of them. There are so many categories you can put people in and I've taken care of some real sketchy people who abuse the healthcare system. Pedophiles (inmate), severe drug addicts, gang members (literally just dropped off at the ER by "homeboys"), and people who were just too lazy to even apply for healthcare benefits. Immigrants are not the only ones who can abuse the healthcare system (whatever you may think abusing it means)....if you begin to show a "dislike" or non preference towards immigrants, should you show it towards them as well? It can be hard at times (Trust me I know) but those feelings about patients need to be checked at the door.

One more thing: How did you find that out, that's a big accusation, are you 100% sure, if not is it worth the energy to even think about it?

smartnurse1982 · Dec 28, 2016

Response to Delaney.My views were shaped post Katrina after volunteering for six months. The only people who appeared to be working to rebuild New Orleans were the Undocumented. American workers fled or were scamming the system for something or the other. These people were abused, robbed, harassed, threatened etc and generally stoicly put up with their woes and continued to rebuild when very few others would. It made me aware of the value of their service and the horrendous conditions they endure just to be here, putting into perspective, just how bad it probably is, re the conditions they are fleeing from.
I think their situation is far more complicated than simply abusing the system.

From what I understand based on the news at that time,the Americans were not paid fair wages,and the illegals were paid less.