The Revolving Door

The homeless guy left. The doctors got together and decided to cut off the narcotics, so there was no reason to stay any longer, but the story is a bit more complicated than that. First, he got dressed in his own clothes and said that he was going downstairs to smoke. A nurse asked him to wait a few minutes and said that she would take him down. He said okay and the next thing anyone knew, he was gone. We figured he wasn't coming back. The appropriate people were notified and we were all happy. We were glad to be rid of someone who scared us with his demands for drugs.

Some time went by and then the elevator opened and the homeless guy stepped out. He was back and he wanted drugs. We refused to give him any and so after some arguing, he said that he was leaving again.

We went through the motions of trying to convince him to stay, but out hearts weren't in it. I was standing at the elevator with him when the door opened. He started to step inside and I sure wasn't going to tackle him. I quickly cut off his name band and said good-bye. Getting his name band off was a top priority. We don't want problem discharges with homeless people to be traced back to our hospital.

The proper people were again notified. And then, guess what? The elevator door opened and he stepped out again. If the secretary had been a little faster getting him off the computer, we would not have been allowed to take him back. He would have had to gone back to ER and started over with his quest for drugs. Because he was still on our computer, we had to take him back.

The supervisor went into his room and then came back out with her eyes big. She said that he was complaining of chest pain that felt like he was being stabbed by two knives.

We were not impressed. We had heard that one before, only his chest pain before was in his lower abdomen. He had a full work-up and cardiac problems were ruled out, along with various ailments that might cause tummy pain. Now, the supervisor wanted to start over again with this nonsense.

Sighing, I called the doctor. Sighing, the doctor agreed to come and look at the patient, in the meantime, an EKG was ordered. The doctor had a rather loud discussion with the patient asking him to be honest about his symptoms so that we would know how to treat him. The patient stuck to his story and demanded dilaudid to ease the chest pain.

Someone needs to tell the patient to lie better and say it's chronic back pain. For that we would would just give the dilaudid. For a potential heart attack, the protocol is different and doesn't involve dilaudid. It creates work for us and doesn't get him what he wants. Don't drug-seekers ever talk to each other and share what complaints work best for getting drugs?

When the doctor refused pain meds and wanted to do a full cardiac work-up, the patient started calling him a f...ing bastard, at the top of his lungs. The doctor didn't react and continued to read the patient's chart. We called security because we were starting to get scared. The patient was pacing around all wide-eyed.

The patient then said something about the doctor being a Jew. The doctor calmly asked him if he had something against Jews. The patient said yes. Another argument ensued. Security arrived and the doctor told the patient to go wait in his room. The patient refused. The doctor told him to either leave the hospital or go wait in his room. The patient chose to leave. He was handed a form to sign releasing us of liability, he signed it and then left.

This time, the secretary got his name off the computer immediately. He could not come back, not that he didn't try. Later, the supervisor saw him getting on the elevator to come back here, so she stopped him and told him that he must go to ER if he wanted any more treatment. That is the last that we have seen of him for now. But he will be back. He comes to our ER several times a week.

After he left, we only had two patients on the floor with three nurses and an aide to take care of them. And, we were busy. It's amazing how one or two patients can take up all of your time.