The Bitter Truth on the Baltimore Hospital Patient Dumping Video

[1truekhaleesi]

If you haven’t already seen the video, it is below.

Imagine you are a nurse or a doctor, working in an emergency room in a city where drug abuse is high, mental illness is high, homelessness is high, and violence is through the roof. It is just about a full house in the ER, and in walks a frequent flyer. The frequent flyers are people the nurses, the doctors, and the techs see all the time. This frequent flyer is probably homeless, has a mental illness, is combative, and refuses to help themselves.

They always come into the ER, complaining of something that the ER sees as small, and their medical issues would be better suited for urgent care to handle. They probably wouldn’t be here if they helped themselves. For example, there are places where you can get prescriptions filled for a lower cost or even for free. And of course, there are shelters to give them a place to sleep. And when you ask why they aren’t helping themselves, they have no response or they tell you that they burned all their bridges with all the local shelters. So you admit them to the last bed, and they get a clean bed, warm blankets, tv to watch, and food to eat.

A few hours pass and EMS arrives with a young woman bleeding out. Or a elderly grandfather having a stroke. Or a young teenager who overdosed. At this point, your charge is screaming at you to discharge your frequent flyer. Since you know your frequent flyer is combative, you call a coworker to help you. But still, your frequent flyer refuses to help themselves and it nearly impossible to even get them dressed.

Of course, you can't just throw them out on the street so you call the social worker. The social worker provides resources to help them like local shelters, feeding closets, places they can get prescriptions filled for free or at a cheaper cost, and local goodwill. Of course, whether they help themselves or if they burned their bridges is up to them.

Still, they are being combative to staff. Security is called to help you discharged your patient. You give them a bus pass, and a small bucket filled with basic essentials the hospital always has. Like deodorant, razors, hairbrush, socks, toothbrush, toothpaste, mouthwash, etc and then security walks them to the bus station. By now, some idiot has pulled out his phone so he can go viral over something he doesn’t understand because he hasn’t worked in healthcare. He is asking questions to the security guards, and the security guards can't answer these questions because of HIPAA.

We have a society that make snap judgements on videos they see on facebook. I’ve had patients that come in repeatedly saying they’re suicidal because they’re lonely and they know they will have a 1:1 sitter to talk to if they say they’re suicidal. When the temperatures drop, we get a lot of chest pain and non-descript abdominal pain – homeless people have nowhere else to go and they know they can at least get a sandwich, a drink, and warm up in the ER for a couple hours while we run labs on them. Detox and drug seeking are ever-present. There are few options for a lot of these people and they don’t have the support they need to actually resolve any of this, so we’re stuck in this limbo of staying alive repeat ER visits.

I am sorry but there is only so much we can do. This is a hospital not a dumping ground. We can't fix everything. People think hospitals have endless resources but we really don’t. Way back when, people could go to a psych facility for just about anything. For example, a woman whose husband just left her could be admitted. Now, we live in a society where a persons fate is up to the individual. And unfortunately, a vast majority of the homeless population has mental illness issues.

Obviously she has mental illness issues and can't make decisions by herself. But what can you really do? Especially since she has probably burned all her bridges with whatever resources like food closets or shelters that are available. Put her in a cab to where? Use money from what fund? She is one of thousands a day that visit ERs. Admit to where? Psych units are busting at the seams with patients waiting days and sometimes weeks for a bed. Gov’t social workers are overloaded. Where was her family? Clearly she doesn’t live them. If they cared about her, why aren’t they taking care of her? To be honest, I have no doubt that they love and care for her. Most likely, they simply dont have the emotional strnegth to help her. This population is over looked and hidden which is disheartening. They can often times be very difficult to manage and potentially violent.

People don’t know the whole story. I am sorry but medically speaking, she had no reason to be there. And she didn't qualify for the psych hold. Lets be real this is Baltimore. ERs across the country not just inner city hospitals, are always full. Since this is Baltimore, someone probably got stabbed or shot, and therefore needed a bed more than she did. The healthcare system is broken and this is one of the ways it shows. The hospital can only do so much. People offer criticism but never ideas on how to fix it.

[Whatthefluff]

I can understand what you mean- even hospitals have a capacity limit.
But the woman in the video is clearly unable to help or defend herself. Plus, it was cold out and she was wearing nothing but a hospital gown.
I have enormous respect for doctors and other hospital staff, but they could have done SOMETHING. Think of the woman like a younger human being, vulnerable and defenseless in any way. It is the hospital's duty to not only save lives, but to protect the general population and make sure everyone is safe. By just kicking the poor woman outside causing her emotional distress, this action caused more bad than good.
I can understand if you were talking about a homeless person who had the option of going to a homeless shelter or something like that. But this woman is mentally ill and she cannot care for herself as easily.

[1truekhaleesi]

We could start with more funding for psych units. Unfortunately whatever psych units are available, would rather take a person threatening to kill themselves or others over a person who is say, depressed.

[Whatthefluff]

Very true. I find it very unfortunate, going slightly off-topic, that there is still such a stigma against mental health despite people's best efforts.

[oddwaffle]

That means the system itself is failing.

You have an overpriced system that makes preventative measures expensive so people only go to the hospital when they are in critical conditions.

Any economist can point out you have a market failure and it's showing by increase stress in other markets. Patients that could be treated at home or by general practitioners would not and they over stressed the other markets such as ER.

Nurse practitioner, increase nurse wages, increase general practitioner wages, increase doctor licencing, reduce healthcare costs, reduce medicine costs... etc. potential solutions get beat down by interest groups.

Maybe it's time to nationalise the healthcare system and provide free or reduced healthcare so people can actually get preventative measures before they actually get sick.

[1truekhaleesi]

Oh trust me it is way beyond broken. Healthcare is unfortunately seen as a business and it is run by the people who have no idea what frontline healthcare workers like EMS, nurses, techs, CCTs, nurse assistants, etc all go through. Of course, there is always urgent care. People just choose to go to the ER for everything and wonder why their wait time is so long. Providing preventive measures is a fantastic place to start.

[oddwaffle]

@love_conquers_lust

Good try, troll.

[_乃尺OЩ刀_TITI]

I've seen the video but I've been aware of it because I came across the same case on the internet years ago, but it was in Los Angeles. It is wrong, unethical and immoral to just dump patients... In Ireland, where I live there are bad cases of bed shortages. Hospital overcrowding.. My mom who is a nurse upon telling her the cases of patient dumping was herself baffled and shocked...
There are problems, but this kind of things doesn't happen around here. The doctors and nurses themselves protests for the immediate attention to hospital overcrowding.

It's shocking that a first world country has that practice of hospital dumping. It's a wakeup call that is refused to be heard... Refused to be heard because doing a bit of research on how long this been happening, I came across this article for Journal of the National Medical Association dating back to 1991, citing numerical figures from the late 80's.
www.researchgate.net/.../21354723_The_uninsured_and_patient_dumping_recent_policy_responses_in_indigent_care

''A growing body of literature suggests that dumping
has become a serious problem, and public policy has
sought to address the problem. A study of 26 urban
hospitals in 12 states and the District of Columbia
involving 1066 patients indicates that dumping has
become a widespread phenomenon.''

''The uninsured are the most vulnerable to patient dumping.''

In the conclusion of the article
''Any change in the health-care system requiring increased funding through taxation is unlikely to garner much political support. Furthermore, the growing trend toward the privatization of health-care services has resulted in less opportunity for a public response to the patient dumping and uninsured problems.''

[_乃尺OЩ刀_TITI]

The conclusion rings true louder, it has got to the point the society accepts this, the public response was just basically oh that's sad but what can you do... What's interesting is the term patient dumping in the past means the transfer of patient from a private hospital to public hospital. Now it seems the definition had become more drastically dark. Patients are literally dumped in the streets.

I think health workers and people who at least gives a drop of shit, should speak loud and clear to politicians on behalf of those who can't speak like the woman in the video and the rest of patients neglected, to change the healthcare system; a system that have these cases they resort to something abysmal of dumping patients in the streets. If not, it's only gonna get worse.

[goaded]

Is it just me who doesn't see the woman's belongings? She doesn't even get to keep the clothes she came in wearing, maybe the only clothes she owns.

www.bizjournals.com/.../...led-in-fiscal-2017.html

"Maryland hospital profits tripled in fiscal 2017"
"About $700 million, or 75 percent, of the 2017 bottom line was concentrated among 24 facilities in Greater Baltimore"
"The only local facility that ended in the red is Bon Secours Hospital in West Baltimore, which reported a loss of $446,000."

[1truekhaleesi]

doesn't matter how matter how much money the hospital made. Healthcare is a business. If you want to see where the money goes, go to the ceo. Actually it probably went to the CEOs salary. Very rarely does the money made benefit patients. Plus employees tried to get her dressed and she was combative instead of cooperating. She has that many security guards with her for a reason. Again, she had no reason medically speaking to be there. And lets be real this is Baltimore. Someone probably got stabbed, shot, or overdosed. And therefore needs the bed more than she does.

[goaded]

I was wrong about her things, they show up at 3:24 in the video, in bags on the ground.

Profits in natural monopolies and healthcare are never a good thing.

[1truekhaleesi]

Unfortunately, it might never change. Amazon thinks they can change healthcare but I doubt it. The only people who can change healthcare are the ones who know what we go through. And at this point, amazon is basically a monopoly.

[Waffles731]

I have to say this take was very clearly well thought out.
I do think that we need a shitload more funding for things like healthcare especially mental healthcare wards.
I do have to say though that video did make my heart break,
I know you logically and clearly argued your view and on the logical level I agree but it breaks my heart to see stuff like that

[1truekhaleesi]

Agreed. I was sad when I saw the video but there is two sides to every story. We live in a society where a persons fate is up to them and there is only so much the hospital can do. Way back when, if a patient was a fall risk, healthcare workers would literally tie them to something like their bed or a bathroom railing to prevent them from falling. Today, that is seen as abuse and some places even argue that a patient has the right to fall.

[monkeynutts]

It's similar in Australia too, you need to radically revolutionise your labour forces in your country, because it's a humanitarian crisis. It's no where as bad here though. Simple thing would be a voluntary conscription into non combat roles of the army and get them to train thousands of medics that have multi functioning skills, some of it would be reclamation of and construction of derelict buildings others would be trained in permiculture, and crisis management skills. You have an awful lot of people just wasting away in your society, it is probably time you all get it together to fix your countries problems.

[love_conquers_lust]

Oh, look who's flip flopping. You were all up in arms about government subsidized procedures such as abortions and sex changes but now you're saying dump patients who are irresponsible and create their own problems draining taxpayer money, just like the ones "evil" Trump is supposedly targetting.

I can't take you seriously.

[1truekhaleesi]

Go away troll.

[Waffles731]

There is a difference between wanting to fix the healthcare system and hospitals doing what they can in a shitty broken system and you can want both

[smahala1991]

there needs to be more funding on health care and less on defense and strenghing of forces

[pizzalovershouse]

looks gruesum