We don’t have a social worker available to us on the night shift. When we have a patient who is ready for discharge but really needs the help a social worker could provide, I recommend that he or she wait until morning when the social worker gets in.
One night last week, I went home at the end of my shift leaving three patients waiting for the social worker. That was unusual and prompts me to tell you about them.
Lady from Seattle
The paramedics brought us a lady in her seventies. A Good Samaritan found her wandering around, confused, at the bus station. The police were called. They then called paramedics who brought her to the emergency department. The medics told me she had come on the Greyhound from Seattle looking for her son. She had been reported as a missing person, having left her nursing home in Seattle without telling anyone where she was going. The medics suspected her son didn’t even live in our fair city.
The patient said she had no medical complaints. She was a bit strange and had a speech impediment, but knew she was in a hospital in California. She said she had come looking for her son, though she didn’t have any contact information for him. I had no ability, in the middle of the night, to find her a place to go. So, we made her comfortable and she slept until the social worker got there in the morning.
The social worker found out her son did live here. Though he was not expecting his mother, he was glad to come to the hospital and take her to his home.
Open Heart Surgery Man
This guy was in his sixties. Two weeks earlier, he had open-heart surgery to replace a heart valve. On discharge from the hospital, it was arranged for him to go to a nursing home to recover. He came to the emergency department after leaving his skilled nursing facility earlier in the day. He told me he left because “a nurse and I didn’t see eye to eye.” He said he was not recovered from his surgery and wanted to be readmitted to the hospital until he was able to fully care for himself. When I asked him just what problems he was having, he pulled up his shirt and indignantly said, “Well, you can see this is not healed yet.” The scar he showed me running up the center of his chest was healing perfectly well. There was no sign of infection or any other complication. So, I told him there was no reason to be readmitted. However, I also told him the social worker might help him find a different option for getting the care he felt he needed. I suggested he sit in the waiting room until she arrived. As I watched him leave, I wondered what the real story was. Had he gotten upset with the nursing home and chosen to leave? Or, had he done something to get kicked out? He was irritating enough that I figured either of these could easily have been true.
As it turned out, his doctor at the nursing home had decided he didn’t need to be there any longer and had discharged him with plans to go stay with his brother. The patient didn’t want to do that so he came to the hospital to be readmitted. The social worker made arrangements for him to get to his brother’s house and off he went.
Mary Kay Man
The third patient was a man about seventy-years-old. He came in complaining of various problems and wanting to be admitted to a nursing home. He was a homeless alcoholic and nearly blind. He had an irritating, unpleasant personality and was dirty, unkept, scraggly and smelly. Then he told me he sold Mary Kay cosmetics. When he told me that, I found it hard to believe anything he said. “Who the heck would buy Mary Kay from this guy?” I asked myself. The nurse pointed out he had a whole bag of new Mary Kay products among his personal belongs, which certainly left me wondering.
When it was clear he needed no medical care, he, too, went back to the waiting room to wait for the arrival of the social worker in the morning.
As it turned out, the social worker knew this guy well from many similar previous encounters. She learned he lost his housing when he was put in jail. He came to the emergency department that night because, recently released from jail, he had nowhere to go and thought being put in a nursing home would be the easiest way to get off the streets.
The social worker give him some direction to find housing. She also clarified that he had a legit, online Mary Kay business. That helped me understand how he could sell Mary Kay without completely wrecking their brand image.
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