ANP 652 6

.docx

School

Grand Canyon University *

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Course

652

Subject

Medicine

Date

Apr 3, 2024

Type

docx

Pages

2

Uploaded by PresidentKouprey3370 on coursehero.com

Thank you, professor, for bringing up the discussion of safety discharges, which raised the issue of homeless, uninsured, and fall risks in the geriatric population. My hospital is a nonprofit surrounded by a mixed population of undocumented, uninsured, low- income, and homeless people with psychiatric issues. Regardless of their admitting diagnoses, we would stabilize them, and sometimes, they would be hospitalized for days and weeks. Once discharge is initiated, we hope for the best that they stay out of the hospital long enough to follow up with the resources that were provided to them to prevent readmission. However, due to a lack of education, culture, communication, and compliance, some of these patients were eventually readmitted again. The patients know the system too well, which has become a routine. Some of the case scenarios we would notice before discharge, such as a homeless patient admitted with AKI, needed HD stat due to a history of ETOH, drug abuse, and another comorbidity. Once they were stabilized, the case manager would assist with finding shelter placement for them, but they refused to go there and ended up back on the street.  Our hospital census is so high, and there is high acuity in patient status, but unfortunately, there is also a staff shortage. It is all about stabilizing the patients, either transferring (downgrading) or discharging, even if we know they will be readmitted again. We have more hospitalized patients than the staff can handle, and the ED sometimes must close due to the lack of beds. Surgery procedures are done on the patients like an assembly line but with all the issues mentioned above being disregard for safety discharges. I have been practicing as a bedside RN for over 12 years; I see that technology and medicine have advanced in treatments to prolong life, but what is the quality of life for these patients when they are not held accountable for their decision-making to take care of their health but often rely on the health care providers during urgent medical attention but not doing self-care as part of preventative care.  REPLY JS
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