Yeah, I usually make them feel really bad about it. I will speak really loud so Granny understands (they always leave their hearing aids at home) that she's not going back home and I'll go something like "SO......ARE YOU WANTING TO PUT GRANNY IN A NURSING HOME? IS THAT WHY YOU ARE HERE?"
Why are we even involved with this? Have the families make the calls, transfer the records, etc etc.
Yup. Wheel me onto the beach to see one last sunrise. Then snap a .357 round into my brain pan. Turn me off like a light switch
Hendrix or Bombay Sapphire?
That's crazy. I've worked in some interesting cities but have never seen that.
Miami and NYC.
Every place I've ever worked the first time, I suggest that the nurses laugh and encourage me to give it a shot. I've never seen it motivate anyone in the end. It's entirely possible that maybe in the end some justice does happen, but I'm definitely not seeing it in the Ed, where the families just put all numbers associated with the hospital on ignore, even when you make that threat
Yeah but what about "this old geezer is a drag. We're out on this. It's not her, it's us. Don't call us. ✌🏼 <Revs car on way out>"
Yeah, which is why I've always found that attempting to threaten them with adult protective services just gets them to ignore me even more.
Depends on the state, filial laws are a thing and family is responsible do shelter in those states
I just walked into my day shift at what is normally a very chill free standing in a miami suburb. Busy during the day but usually really quiet at night sort of place. Pretty normal to have 5-6ish patients from midnight to 6am, with that number being frontloaded towards 12-1am. Just arrived and the board shows that they saw 21(!!) from midnight to 6AM. 22 if you count the person they left waiting for me.
How much of that was flu in under-resilient losers
Let me see. <checks> 4. That number is way lower than it should be and I am not thrilled. Lots of weirdly complex medical complaints on the final diagnosis list. I would be happier if it was just the usual stream of weaklings with flu A wanting it confirmed.
Welp, it's the hospitalist's lucky day, 7 straight social 'ambulatory dysfunction' admits in a row. It's xmas, even if you guys had a case manager in the ED, he/she won't be in today. Hopefully you work at a place where you don't get a lot of pushback for these sort of things. If not, good luck.
6/7 you say??
Thank you *tips hat*
Nah the culture is good. We try to send them home if there is family and a prayer, and normal days we are good about getting PT/CM to run by the ED to check possibilities.
Unfortunately, depending what state you are in.
They have a legal obligation to take them back unless the facility no longer meets their needs (42 CFR § 483.15). This has to be a significant change that prevents them from caring for the patient (i.e., patient is now bedridden and they are in an ALF instead of full SNF). A transfer to the hospital is just that -- it is considered by CMS to be a temporary transfer and not a discharge from the SNF to the hospital.
I’m glad to hear it was lovely and peaceful for your FIL. MAID is a substantial part of my HPM fellowship this year. I’m in one of two states in the US that accepts patients who are not state residents, so the opportunities are plentiful. Though what occurs to me is that @RustedFox’s retirement plan may not include the requisite estimated life span of 6 months or fewer to qualify.
Is it morbid how many of us are going to be able to tell similar stories?
