[Hallrunner]

This is the crying I wasn't able to do when I had to do this.

I had a patient, an old man with terminal lymphoma, who was being held over the weekend for placement because he was homeless. When the MD found out that he had $193 in the hospital safe, he discharged him.

After many attempts to find excuses to stay, none of which I could then justify to the MD, the patient resigned himself to go. He had multiple bags of possessions and no shopping cart waiting. I had to take that sick old man down to the street and dump him out, in the driving rain, on a Sunday.

I don't care what he did in his life to become homeless. He didn't deserve that. I was sorry to be the instrument of that cruelty.

[mercynurse]

There really are alternatives...churches, shelters, Salvation army, etc Were none of these an alternative?

[Aaron C.]

you could have told the MD that you weren't doing that...

I mean, I don't know what the repurcussions would have been, but you could have done that.

I can't say what I would have done in your shoes, but either way you shouldn't feel responsible.

Life is hard. If anything it should give you a little more perspective on life...

I'm a people watcher, and I pay attention to people. It's saddening, but then again, you can look at it like going to the fair..."you always come home feeling better about yourself"

[Hallrunner]

The social worker had searched for two days looking for a spot with no success.

The MD discharged him because he had money for a room. Formal placement would have had a better result and not parted a destitute man from his life savings. But they needed the bed.

[Hallrunner]

I don't believe that I could have refused to do it given the circumstances.

I am always grateful for the opportunities I have been given and for my position in life. You are right. Many times I have said, "Wow, glad that's not me." It could easily be me. I have learned a lot from my patients, and some things that happen I now understand due to observing them and their problems.

It was just this one particular thing that struck me and never left. I'm getting it out of my system. Thank you for listening.

[Aaron C.]

Glad you shared it with us...

I think it was a good time to post it too, considering the holidays.

We took a TON of presents to this family tonight, who otherwise would not have been able to have a christmas. We left them on their screened in porch because the little boys weren't in bed yet.

I only wish I could be there to see their faces in the morning. It will surely be their best Christmas ever. Everyone in my wifes office, as well as a couple of other people, went in on it. My wife and I alone spent over 100 dollars on them.

I don't know what they look like and I probably will never see them but it sure made me feel good...thinking back to when I was a kid and how great Christmas was. We never went without and didn't know what it was like not to get lots of Christmas presents.

Tomorrow's gonna be a great day for those little guys. Their family doesn't have a car/phone/etc... so it will surely be a great surprise to them!!!

[CharlesAngel]

I refused once to discharge a patient that was too much for his wife to take care of on a Friday night. She needed help at home and home health could'nt visit until Monday. I told the doctor if he looked hard enough he could find a reason to admit this patient. His response was "Anne I can tell your an ER nurse" I asked him what he meant. He said that I "got too attached to my patients I saw repeatedly". I told him I fight for my patients despite what the criteria is to admit them. I don't feel you should feel guilty but it is through our experiences we learn to react to our future challenges.

[Hallrunner]

Giving presents to little kids is a good way to cheer yourself up when you're down. I recommend it to everyone. Toys are not a luxury, they are a necessity. You did good.

[Hallrunner]

Thank you for your comments. All I can say is I inherited the problem from another nurse. The order was already written. I wasn't the one who told the MD the guy had any money. I don't know how this MD found out. He would have had to peruse the chart and see it on the blue sheet. I don't know what his thoughts were or what was in his heart.

When the nursing supervisor of the hospital is requesting the bed space and pressuring for a discharge, and when the attending physician has written an order for discharge and departed long before you ever arrived to think about it, well, it isn't so easy. It sounds cool to fight for your patient, but it really wasn't my call. I am not qualified to manage the total flow of the hospital. From the standpoint of professional responsibility, I feel I did what I had to do. But from the humanitarian or moral aspect of it, I regretted having to do it. I resented the cirucumstances that caused me to have to discharge this guy like I did. And I do feel guilty.

We have hundreds, maybe thousands, of people who are needy like this in my area. You can see them begging at the off ramps, sleeping on the hospital lawn, hanging around the lobbies. It sucks. I have no solutions for any of this. Portable toilets, that's all I've got.

[Aaron C.]

I hear ya!!!