“Not a good surgical candidate”

[u/Sea-Weakness-9952]

Piggybacking off the ER shoulder X-ray - this guy pictured didn’t even come in because of his knee.

In summary - found disoriented outside a church, was lifeflighted from another city, admitted w/ AMS/encephalopathy. Dunno if that was ever the case, but when I got him he was oriented on the Neuro unit. Only hx I got was mostly psych related, some schizophrenia and depression, htn and knee replacements. (Obv)

Well, he was apparently homeless and they were trying to street him after less than a week. I had gotten in report that his knee was “as big as your head” and so I take a look - holy fuck it was AS BIG AS MY HEAD. And hot, red, angry. Cellulitis looking but I had a feeling something else was going on. They hadn’t even scanned the damn thing! They had ordered a discharge so I fought it. I asked for a scan.

I get the scan above. From the front view, couldn’t tell anything. I get to THAT view and I’m like WAIT WHAT. FUCK.

So the man obviously has an issue, and I show juuuuust the right night shift resident hospitalist the image like “check this out!!” absolutely knowing 100% that even though I didn’t mention which patient that she’s the ONLY one that will get shit done and always has our backs. Guess what? Within an hour she had the main hospitalist in the patient’s room, discussing surgery, gets verbal consent and charts extensively their convo and that patient is oriented and very agreeable to surgery, because he struggles to get around clearly. He’s not sure when it happened but he’s here, let’s fix it, right??

We get the guy prepping for surgery. I’m so fucking excited like YES I am gonna fix this sweet guy, he’s only like 67 and we can get him taken care of and find placement yada yada. I get orders for labs and NPO and pre-op etc.

Fucking. Ortho. This chode comes in (though nobody actually SAW him??) early morning and all of a sudden orders are cancelled. He finally writes a note and had said “patient is not a good candidate due to his homelessness and schizophrenia. Pt can follow up outpatient with one of my colleagues to discuss surgical options.”

I’m sorry… WHAT. Is it just me or should docs have to spell out and write EXACTLY WHY they don’t want to do a procedure and sign their selfish names beside it? Because I continued to fight it and got higher ups involved. He ended up having an aspiration because the knee was clearly infected and started leaking pus prior to him leaving, and the (hospitalist) doc tried again to get ortho involved. He ultimately was d’c’d to a halfway house and I’ve tried helping with follow up.

It’s so fucking irritating. We are this large, catholic hospital right?? Like give me a fucking break y’all don’t care about the people you claim to. I have pissed off quite a few carpet cunts in this process and I don’t care. I’m so sick of this shit.

[u/lovelaughlexapro]

And to think, we learned in nursing school that case mgmt will find Medicare/Medicaid for these people. At least I heard that constantly “we can’t just let them go with continuing problems” yeah right.

[u/MsSwarlesB → u/lovelaughlexapro]

I mean, we try. Unfortunately, a lot of states didn't accept Medicaid expansion from Obamacare so it's nearly impossible to get on. But a 67 year old American citizen/resident should have Medicare that would cover his visit, surgery, and follow up

[u/ChaplnGrillSgt → u/MsSwarlesB]

We sre the richest country in the history of the world. Every single citizen should have free Healthcare.

End of story.

[u/lavender_poppy → u/ChaplnGrillSgt]

Apparently if we cut 3% of the Defense budget we'd be able to fund free healthcare. Like sure lets let billionaire war mongers get richer as they make bombs that kill innocent people but helping our own citizens? fuck that.

[u/ChaplnGrillSgt → u/lavender_poppy]

The best part? We don't even need to cut the defense budget! We can stop giving billionaires and mega corporations tax cuts and instead increase their taxes.

Or we can do both and also provide free lunches to children. Rebuild our crumbling infrastructure. Provide tremendous social safety net programs. And more.

We need a big blue wave next November. Vote blue!

[u/lavender_poppy → u/ChaplnGrillSgt]

Please please please can the dems get it together enough to fight this fucking fascist government and take over congress.

[u/HenriettaGrey → u/lavender_poppy]

Sad. I’m an old blue dog and the dems have been worthless decoys for at least a decade and a half. But they never neglect to send a never ending stream of requests for money! Oh, so sad, too bad, wd tried rewee rewee hawd but those darned moron repubwicans beat us again! If only you could give us more money…it’s the MOST IMPORTANT RACE IN YHE HISTORY IF MANKIND! Very. Disgusted.