Quick question here...

[lovedocta07]

Hey im premed, and i asked this question in the pre-allo forum. Someone told me to post it here. I was just wondering what is the proper discharge policy for homeless people in the ER. Like do they get just thrown back on the streets? What if they request to spend the night.

Thanks.

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[southerndoc]

What if they show up at a hotel and request to spend the night for free? Is the hotel obligated to give them a room?

Try it at the Marriott or Hilton the next time and see how it goes.

 

[lovedocta07]

so what are the proper discharge policies..."get out and go back to streets, hope you had fun in the ER?"

 

[Arcan57]

I hope you're purposely being a troll. I don't wish that homeless people "had fun" in the ED. I hope that they got appropriate care for their acute medical problems and referral for follow-up care. Occasionally someone without a place to stay will be admitted for an injury/disease that if they had more resources could be managed as an outpatient. But to suggest that the ED has the resources to solve the problem of homelessness by offering admission to anyone requesting it is willfully ignorant.

 

[southerndoc]

so what are the proper discharge policies..."get out and go back to streets, hope you had fun in the ER?"

Some people care so much that they offer spare rooms to the homeless. So perhaps one day we will refer them to your house for a place to stay. Otherwise, we have to refer them to a shelter.

Seriously, the ER isn't here to solve the homeless crisis. We're here to treat people. Hotels specialize in temporary housing, so if people think society should shelter the homeless, then they should force a private hotel to do it and not a private hospital. Why deprive a person of a needed hospital bed because it's being occupied by a homeless person without a medical condition? Beds are already in short supply.

 

[Pinner Doc]

I think the question was an honest one from a youngin' who honestly didn't know. I took the "hope you had fun in the ED!" as a sarcastic comment, not an implication that the homeless actually came to the ED to have fun.

Honestly, in the context, implying the OP is ignorant is a bit harsh. Of course he is, and he knows that. That's why he asked. Having the foresight and the concern to ask about these things years before his (or her time), in my opinion, shows sensitivity about these issues. (so... kudos!)

 

[pdp2001]

if the weather's crappy and it's slow, we'll sometimes let people sleep in the waiting room until our social worker comes in and will try to get them to a shelter. if it's the weekend, they're SOL. we do the best we can, but they had problems long before they ever showed up on our door. we treat their medical problems, which are usually "turkey sandwich" (no joke, that was a triage complaint), and send them out like everyone else.

 

[Flopotomist]

The goal of the EMERGENCY department is to address EMERGENCIES and return patients to their baseline condition. Homelessness is a sad condition worthy of intervention, but it is a chronic issue, not an emergency. There are many other sad chronic issues that are just as worthy of interventions (eg hunger - do we keep them in the ED and feed them 3 meals a day until their social situation improves?).

If your grandparent has a heart attack and requires emergent medical attention, you want an area set aside where s/he can be cared for immediately. That area is called the emergency department. You don't want that department filled with homeless people.

Wow... I just fed the troll didn't I.

 

[WilcoWorld]

During the day I offer transport to a shelter or discharge. On cold nights I often let homeless patients hang out (not in a bed, but in an area with reclining chairs) until the morning (when social work arrives - bless their souls)and then offer the "patient" transportation to a shelter or discharge to the rest of the world. More often than not they decide to go back to the streets rather than a shelter.

There are a whole host of problems with this approach, but there are problems with the alternatives too, so this is what I've settled on as the lesser of evils.