Whats the longest you've had a pt be admitted for?

nursenatalie, ADN, RN · Jan 11, 2006

We had a pt for 364 days after gastric bypass. Complications abound, he was back and forth between the surgical floor, telemetry, and ICU.

nursemomruns · Jan 11, 2006

When I was doing an preceptorship in rehab while in school, there was a pt who was a quad (secondary to accident) who was permanently at rehab. No insurance-couldnt go to nursing home. Not a US citizen-couldn't get any medicaid (i think that was it, the details are a bit shady) family in other country. other country a third world country w/o capabilities to care for him. I have no idea if he's still there, alive, dead, or if they found somewhere else for him to go-
As far as acute care, we have a pt on my floor who's been inpatient since March. pt was unable to get off vent after CABG. All weaning attempts unsucessful.Not even doing well with trach trials. Trach/peg/severely weak-can't roll self, sit up alone, stand alone, anything.
He keeps having other medical issues. LTC has been considered, but there is only one LTC facility in our area that is vent capable. (i dont know if there aren't beds or they dont want him to go yet)So its 10 months and no end in near sight.
SO...whats the longest inpatient you've seen and why were they there?
(when i was in school, i had no idea people stayed in the hospital for 10 months!)

3 years. Similar situation. Patient was a woman on a vent and no LTC facility available in the area that took vents at the time. When a vent-capable LTC opened, she was transferred. Yep, 3 years. But that was 22 years ago.

TiffyRN, BSN, PhD · Jan 11, 2006

I think you will find some of the longer stays are from years ago when patients stayed in hospitals in conditions that could be easily now handled in LTC.

The longest I know of is from a few years back (like 9) and it was a vegitative state individual, trached, PEG'd from a severe anoxic event. He was in the hospital about 26 months before he coded for the last time (he did this off and on every couple of months). The real reason he stayed in the hospital was some financial arrangement issues (he would have been a charity case). Around the same time we had another gentleman who was in the hospital for just over 2 years due to no local LTC's taking vent dependent patients, he wound up having to be transferred 8-9 hrs away by ambulance.

Some of the older nurses I work with now in the NICU speak of many years ago some of the "chronic" babies being in the hospital for over 2 years to the point where they rolled around the unit in baby walkers. They were trached and had G-buttons and back then it wasn't common to send such a complex infant home. This was pre-surfactant and these poor kids that survived had horrible lungs.

grannynurse FNP student · Jan 11, 2006

The longest I have ever had was a group of trach peds patients. They were kept for ten years, in an acute care facility and Medicaid paid the bill.

Grannynurse

Daytonite, BSN, RN · Jan 11, 2006

Back in the mid-80's we had a gentleman admitted to our stepdown unit from the ICU who had suffered a stroke. He was vegetative, trached and on a ventilator. We had him on our unit for a whole year minus the two weeks he had spent in ICU when admitted. He was on one of the old Clinitron beds with the porcelain sand in it. What a big klunker that thing was to move around--not to mention the two times it sprung a leak and we were slipping and sliding in the "sand" until the company rep came in to fix it. He had tube feedings and a couple of UTIs that required ATB's.

Now, this part I could understand, and still don't. At Day 365, his insurance was no longer going to pay and his Medicare had run out long ago. His wife decided to finally pull the plug. The man lived for another 24 hours. Guess love comes in all amounts of dollars and sense. Very sad story.

I worked agency part time and was on a stepdown unit one night that had a patient on a ventilator who was alert and oriented who had been there for 3+ years. Guess who got stuck with him? I think this was probably before subacutes had opened their doors for this kind of business.

Gompers, BSN, RN · Jan 11, 2006

Some of the older nurses I work with now in the NICU speak of many years ago some of the "chronic" babies being in the hospital for over 2 years to the point where they rolled around the unit in baby walkers. They were trached and had G-buttons and back then it wasn't common to send such a complex infant home. This was pre-surfactant and these poor kids that survived had horrible lungs.

Our nurses talk about that, too! Babies who got teeth and were advancing past regular baby food. Babies who said their first words on the NICU. Babies who were learning to walk, even!

The longest I've personally seen in the NICU is almost a year. One baby left a couple of weeks before his first birthday, so we threw him a party and he even ate some frosting from his cake. Most of our vented trached babies stay for at least 6 months before they're stable enough to go home or to a peds nursing facility. Average is about 7-8 months. They have to be on exactly the same settings on the home vent for 30 days with no more than a 10% increase or decrease in their Fi02, so that 30 day count usually starts over again quite a few times before we can finally discharge!

Cute_CNA, CNA · Jan 11, 2006

Psychiatric patients can stay for months on one ward, and years at one hospital.

brianaerrn · Jan 11, 2006

When I worked on a Cardiac Telemetry floor, we had three different instances where pts with an LVAD stayed 18 mos+ basically for rehab. No rehab facilities or home health agencies in the area take LVAD pts.

hipab4hands · Jan 12, 2006

The longest patient on our unit was 6 months. Pt. started out with spinal surgery, developed a wound infection, and was hospitalized. pt then picked up various noscomial infections/decubitus ulcers/ and psych issues. (No wonder after being in the hospital for so long).

This patient was one of the most difficult persons I've had to deal with. Most of the nurses refused to take care of her because of her verbal abuse of staff. Some how, I was able to make a connection with her/ negotiated with her about tx times/ pain meds/ and had no problems with her.

CseMgr1, ASN, RN · Jan 12, 2006

The longest I can remember a patient of mine being cared for in an acute care setting was three months. This was back in the mid-to-late 70's, when payment was still Fee-for-Service. This was an elderly gentleman who was dying with pancreatic cancer. He was too sick to be placed in a nursing home or receive Home Health, and Hospice didn't exist back then. He and his family were lovely people, and brought each shift Tupperware containers filled with the BEST homemade sausage and biscuits I have ever eaten in my life! :)

lpnstudentin2010, LPN · Jan 12, 2006

wow and i thought my five days this summer was bad