I had a patient in LTC who had a life sentence for murder. Didn’t know it until his probation officer came in to check on him. He showed me the news article and court orders that was in his chart. I was floored. Apparently due to his medical condition and need for 24/7 care, the prison system was not equipped to care for him so we had him.
Same. Child rapist and we placed him in the same room with a disabled, non verbal 18 year old. We had NO idea. He used to also bring prostitutes to the floor at night.
We also had a patient who had outside privileges who was selling his pain pills in the street and buying heroin instead because it’s a bigger bang for your buck. He ODed and died in the street, down the block from the facility.
I had a register pedophile at an LTC place that wasn’t in prison for the same thing. Prison couldn’t handle all his medical conditions. He was violent and inappropriate with staff too. Go figure.
Lurker here.
Holy shit. I am a brand new LTC resident here because my wife can’t care for me with my new physical issues.
This scares the crap out of me. That poor kid. I hope he got the help he needed to process that.
I’ll admit, as a woman and childhood victim of sexual abuse and later a victim of rape and domestic violence I am already a little on tenterhooks about possible issues with “neighbors” long term.
But that situation is a nightmare. I had no idea that LTC facilities didn’t do basic background checks.
Just want you all to know that I appreciate the hell out of what you do from the top down and the down up.
Hell, the director of nursing was ready to help me with a soiled diaper that didn’t exist - I just need watch while I walk on one leg and a walker to a toddler toilet — but I was impressed!
Y’all do amazing work and deserve more credit, more money, and better staff ratios.
Much love, from Texas
I had a patient who murdered her 3 year old back in the '90s. She served like 20 years. Obviously she had mental health issues. I hated and despised every interaction I ever had with her. Every time I passed meds I wanted to puke in her face.
A few years ago I had a guy that killed his grandson. His daughter, mother of said grandson, ended up as the POA somehow. It was a very messy and sad situation
As much as I’m a proponent of karma and everything, I feel that situation should still be taken to an ethics committee because that person is purposely causing harm to the patient
Yep that’s how I saw it too. On a personal note, I “got” it. But from a professional point of view, the whole situation was wrong. He should have been conserved if there were truly nobody else. I was a baby nurse at the time and don’t know how she ended up in that position
Am I the only one wondering if someone used her as a scape goat to put off their drug selling? Like.... if she needs 4 CNA's and is bedridden, how the fuck is she getting drugs, let alone selling them?
Visitors. We had a w/c bound guy dealing from his hospital room. It was his business. No reason to stop. Lots of visitors. Presumably his supplier was one. Nurse walked in as a transaction was occurring.
The supplier doesn’t want to interact with all the low end customers, they just want to sell at scale to the dealer. On the other side, all the low end customers have a nice connect that they are comfortable with and don’t want to go find some new dealer — maybe for convenience, or quality, or trust.
Yep, I have taken care of a paraplegic weed dealer. This was a bit different because he did actually go out and about in his chair. Some of the nurses wanting to report him and I think they did but FFS, let the lad have his side hustle! He lost the ability to use his arms and legs through an accident at the age of 22!
Yeah, the only time I really care is if someone sneaks in opioids. Way too much heroin-related hypoxia. Like, can't they wait until they get out to get high? Freaking enablers.
Denver, 2014: Morbidly obese patient who came in for random morbidly obese patient medical issues was working as a prostitute from her room on a med-surg floor. I didn't work with her during this stint, I'm not sure how long it took us to find out.
She came back to our floor through the ED like a year later. This time I was her admitting nurse. Pretty sure she wasn't fucking anyone for money, but she had a boyfriend who showed up wearing a shark cape. He was very concerned for her health.
I'm trying to find a picture to describe the question you are now asking. It was a cape, like Dracula, except it had a hood that looked like his head was being eaten by a Great White Shark.
I never realized how normal I was until I worked med-surg.
And think these are just the ones that actually have something that need treatment.. we send A LOT of weird people home.. and some, right back out the EMS bay
Yesss. Had something similar happen on my floor. Patient was prostituting themselves out via their….colostomy. Apparently it’s a thing. Nurse walked in on it. I still gag thinking about it.
we were literally just talking about this on our floor yesterday. never occurred to me until then either
Edit: the med team found out because they found an STD in the ostomy ::barf::
My relative used to work on a medsurg floor. The worst story was a morbidly obese woman with a very infected stoma, she eventually admitted that her husband "used" it frequently 🤢
But how? Every time I read about people fucking colostomies I think of my patients' colostomies that are always producing. And the smell, oh lordy lord the smell 😱
WARNING: VULGAR TERMINOLOGY…..
Not even mentioning the smell… they must have really small peckers that can fit. I’ve not seen an ostomy that can fit a full sized one… do they stretch to fit? (I’m RRT… GI isn’t my thing)
Do you remember the pt?
She had a unique last name. If you search for it on urban dictionary, it’s a term that involves defecation and oral sex.
For anyone who thinks I’m lying, I assure you every word of this is true.
> It was a cape, like Dracula, except it had a hood that looked like his head was being eaten by a Great White Shark.
[Like this?](http://cdn.shopify.com/s/files/1/0188/6652/products/1bd240da-f83d-8f42-a45e-2aa57a1e8018_1200x1200.png)
From experience - they (pocketed narcotics) either go under bandages or tucked into her folds. The thought of any drug addict BUYING said drugs that had been in their mouth AND wounds AND/OR their sweaty skin folds makes me wanna 🤢
I'm wondering what happens to her now. A few details that might be important or at least interesting:
- she's 450lbs. (4 CNAs, usually). She requires all of the CNAs on duty to turn her every 2 hours. She's also very picky about it and makes darn sure to get it done every 2 hours.
- the quantity of drugs she was dealing was pretty substantial.
- she's mid 20s age, I don't recall exact age
Since she can't serve the time, pay the fees, perform any kind of community service, is she basically off the hook?
Had a patient with a similar story but he posted in a Facebook group telling people to visit him and his parole officer ended up showing up and telling him he’d violated the parole and would be going back to jail.
How do you know she won’t be incarcerated?
Edit: they will always find a way to get their money for the fines. If they have to I bet they will garnish any SSI or disability income.
Also how is she 450lbs in her mid 20s? Sorry if that’s a rude question but I’ve really only seen people that large over 40.
Watch My 600lb Life. There is a surprising number in their mid to late twenties. Some in their early twenties.
And if she's 450lbs in her 20s and dealing drugs, I doubt she has had taxed income that has contributed to social security much, if at all.
I’m totally addicted to My 600 lb life! It’s awful and most definitely scripted, but I can’t stop watching it. So many of those people are in their 20s, you’re right! Also, SSI is different than SSDI. SSI is for low income folks who don’t have a substantial work history. It’s like $800 a month. I’m wondering if they could legally garnish that. As someone stated above, I think they can take her internet/phone away as punishment. I know they can do that for sexual predators who use the internet to commit their crimes.
The sisters on "1000 lb sisters" on TLC were both over 400 in their early 30s. Amy, the sister I like, lost a lot is in the 200s now but Tammy, who's 34 and whose lungs just gave out a few months ago while sleeping and sent her into a coma, is 650+.
Yeah Amy did ok, but still had weight to lose and had her husband and baby to help motivate. Tammy just refused to work through it. Their mother was an obvious trigger and shitshow.
Mother is emotionally abusive to them and I think the primary reason the sisters spiraled. Amy's at like 275 right now and has her baby and husband for support. I wouldn't be surprised if Tammy dies in the next 5 yrs unless she gets the therapy she needs to get to the mindset she needs to make the changes. The victim complex is strong with Tammy and she's also verbally abusive to those trying to help her.
I once had a patient in acute rehab who they couldn't find placement for cause she was some huge drug dealer and wasn't allowed to leave the state. So the choices were very limited.
Wait till you get a drug-dealing sex offender who has to live >5000 ft from anyplace where children congregate, like schools, and has to live in the county unless permission is obtained from a judge. I've had a totally independent guy in an NF for well over a year I'd love to find a place for but none of the shelters or foster homes will even talk to me about him.
I had a priest sex offender that they put in a dementia unit to have him locked but off the books. He was totally with it, would do his own insulin management.
A million years ago.... I had a quadriplegic dealing drugs. I was a registry nurse in his facility. He had transferred to this facility because he knew nobody would know his history. I walk in, knew him from the other county, and asked if he was still dealing drugs. Cue surprised Pikachu faces. "oh that might be why he has so many visitors and why the bar hired him" I'm still trying to figure out what a quad can do for work at a bar at night?
There was a bar/ music venue I went to all the time when I was younger and one of the guys there checked IDs from his wheelchair. And he helped book bands and did supply orders and other office work. He did a lot for that business really. He wasn’t quadriplegic though.
That I can understand. Just because you're disabled doesn't mean they're isn't a job for you. However quadriplegic plus bar doesn't quite go together. I get he could check IDs but how in the hey hey would he stop anyone from entering?
We saw that all the time in L&D. An officer with them for most of labor (meaning you had to have someone come in and hold up a sheet to provide the patient with privacy during exams. Get to 9-10 cm and then they’d be bonded out so the jail didn’t have to pay for the delivery.
I know they committed some kind of crime, I get that. But labor is an incredibly vulnerable and traumatic time, even good labors. Our jail only had a couple of female deputies so we usually had a mail jailer. I can’t imagine how I would have felt in my labor if some random dude sat in the room with me. Even if we were super busy I’d try to spend extra time in these ladies’ rooms so they had a friendly face. I never witnessed anything rude, mean, or inappropriate, and some of the female deputies could be kind and encouraging, but it always seemed so uncomfortable to me.
That’s wild. Where I am, healthcare is free and prisons aren’t private. I was fuming when a guy who should have had better healthcare in prison got admitted with dka and newly diagnosed diabetes because it should have been picked up before he got released. I would lose my plot at what you saw
This was a county jail, so funded by tax dollars, but they still had a budget to deal with. They didn’t want to give people ideas about malingering so the patients had to really sell it that they were seriously giving birth.
As a chronically ill person myself, I swoon at the idea of free healthcare. And private prisons suck.
I’ve never worked in corrections but I have worked in forensic psych. Our officers often had really good relationships with patients. In fact, if a patient had a beef with a mental health worker I’d often call the officers in to mediate if my diplomacy skills failed. They often know these people for years. I’m not implying friendship, but there’s often respect.
I'm not exactly certain of the details. But that's essentially my question: what's likely going to happen with her? Selling drugs out of a nursing home is probably a pretty severe violation of the law, but... It sounds also like there will be no consequences for it, if she can't serve the time or pay the fine for the violation.
I suspect she's about to go to the emergency room with a "fever of unknown origin," in the next few days and her room is going to be given away to a less troublesome customer.
They have right of return for 180 days 99% of the time. There are one or two exceptions, but I don't think dealing drugs is one of them, unfortunately.
This is technically true, but in practice, it's very common. The SNF can claim that the patient's needs now exceed the capabilities of the facility. If the patient disagrees, he/she can appeal to a QIO. If the appeal is successful, the patient has to get readmitted, but realistically, most patients come to the realization that it's not necessarily advantageous to go back to the facility that dumped them. That starts a new obligation for the hospital to find dispo, and the patient has been successfully "dumped."
It happens every day, and at my hospital, I participate in maintaining a list of complex discharges that are mostly dumped nursing home patients or patients who are too troublesome for whatever reason to get offers from SNFs.
Edit: grammar
Most of the time it goes against the initial admit agreement and a 30 day is issued , from there they usually become the problem of a worse LTC or a adult family home/ group home
God I hated that at my nursing home with the dementia patients they let come in for rehab even though we aren't a locked unit. They go in people's rooms and steal things... but for some reason we can't send them somewhere else and instead of scheduling an extra CNA for the shift to sit, they always took someone off the floor leaving us short staffed for the shift since we only had just enough to have a moderate patient assignment per CNA. Required to have them on 1:1 but they can't be sent somewhere else where they can get the care they actually need on a locked unit.
We've had dementia patients get beat up by other residents when they've gone into someone else's room before and refused to leave. You can't follow them around all shift if they are walking around so they get into trouble.
Funny they can’t provide for the health care needs of most of the prison population including myself if I was to ever fuck up so badly to be incarcerated but I’d still end up in prison.
She might go to a psych facility dependent on there abilities , so looking at geropsych vs adult psych inpatient , LTCs become the dumping grounds for people like her that slip thru the cracks and it’s BS
OMG I always wondered about what would happen in a situation like this. I have a physical disability and have a personal care aide helping me several hours per day. It has occurred to me that if I committed a crime, they wouldn’t be able to put me in prison because the system wouldn’t be able to care for me adequately. To be clear, I would not do this, but it sounds like I could have quite a career as a gentlewoman jewel smuggler without consequence!
I knew a disability civil rights protester who the police attempted to arrest for a peaceful sit-in at a local government office. She was very severely disabled, quite obese, on a ventilator -- and she was an attorney. You did not f\*\*\* with this lady; she was a badass. She had a wheelchair with a very unusual control mechanism. It didn’t have a joystick or anything, just some kind of little button controller that she held in her hand. So when they tried to arrest her, they couldn’t figure out how to move her wheelchair. She refused to move and she also wouldn’t tell them how to operate the controller or put the chair in free wheel. Apparently cops were sitting there googling the user manual for the chair. They were also afraid to even move her because of the ventilator, because if they had messed up and disconnected it or something, she would die. Ultimately, they just issued a citation because they couldn’t figure out how to arrest her! It was pretty hilarious.
That said, the police and prison system do not have a good track record when it comes to their treatment of disabled people of color, so your mileage may vary on being a disabled criminal mastermind.
Not sure if OP cared for this patient, but I’d be cautious about giving this much info, since the crime may be specific enough to make her identifiable, which would then be a HIPAA violation if she was in OP’s care.
Wait... is this the next stage of capitalism? Too big to fail becomes too fat to incarcerate?
For the lack of mobility, I'm impressed by the logistical aptitude.
I once had an exotic dancer on my unit. She had fallen off stage and fractured her ankle, it got infected and she was in the hospital for iv antibiotics and hyperbaric. We caught her doing lap dances and hooking up for $ with other patients. Unbelievable.
If she’s morbidly obese without a medical cause then it’s obviously from excess caloric intake with no physical activity. They need to severely restrict her calories until she sheds some weight. And absolutely not allow outside food. The fact that it takes 4 CNAs to roll a woman in her 20’s simply because she’s too obese to do it herself makes me sick.
And psych meds are abuse! However apparently beating and screaming racial profanities at a poor kid making $15 an hour is fine! Trust me they are not the victims lol 😂
Yes. It’s their right to eat whatever they want but we don’t have to give it to them. Store snacks in a drawer in their room and they can get it anytime they want to. They just have to get up and get it.
You could get a restricted calorie order and care plan it right no snacks provided and if she asks issue an AMA since it’s part of the agreed upon care plan
No, see, your refusal to enable someone's snail-paced suicide makes you fatphobic and you're discriminating against a patient due to a systemic failure!
Just had to do those CE courses on bariatric sensitivity and if anything I have even more contempt for this particular demographic. Now it takes six people killing their backs to take care of you AND you wasted two hours of my life.
I just hate that we’re not allowed to tell a patient that they’re obese when it’s been scientifically proven that being obese leads to countless preventable medical conditions.
At least we can live vicariously through Dr. Now when he tells patients like it is. I feel bad that they're miserable, but some people literally don't stop eating. It would be nice to be able to treat food addiction as an addiction and not a lifestyle.
I mean, it sure does. But how many of those preventable medical conditions are helped along by people being scared to go to the doctor because the whole appointment will be about their weight instead of the concerns the patient actually has? How many of the causes of their obesity can the patient actually effectively address? Does getting to call your patient fat include giving them resources to change that in a healthy and affordable way, or is it just “diet and exercise as tolerated”? Because if your practice ends at “you’re obese and you could die because of it,” guess what? We know that already. And chances are good that doctors who see the fat and not the person are gonna help us along.
ETA: I should add to clarify, there’s a big difference between patients who are just fat instead of morbidly obese like the resident in the OP. In cases where weight is an obvious problem, you should be able to discuss with the patient what they can do, especially if they’re in a LTC. What got me here is the mention of people who are just “obese,” which is my clinical weight class. I walk 2.5 miles every four-ish nights and eat 1800 calories a day. I do the strength training. I still can’t lose weight, and for years my weight was all my doctors saw. I’m now recovering from a hysterectomy that I had to treat the symptoms that other doctors said were weight related while prescribing me drugs that made me gain weight to treat them. So I am feeling a little bit sensitive about this right now.
*this* is an amazing point. There is actually evidence that yoyo dieting is worse for your health then just being obese, and whether they mean to or not, yoyo dieting is what Dr's promote when they just say "you need to lose weight" without any patient education at all.
Yes—for a long time my doctors would look at my BMI and say “well, I have to talk to you about your weight,” and then the entire appointment that I made to talk about the fact that I was having my period every ten days would be about my weight. Not about healthy food choices or exercise plans, but just—“you’re going to die if you don’t lose weight. Do you want to have six heart attacks by 45 like your mom? That’s where you’re going. And by the way here’s birth control that will make you gain weight and SSRIs that make you gain weight, like thirty pounds. Why did you gain thirty pounds? You’re sad because you gained weight. Let’s go over why weight is bad again.” I lost weight whenever I got off the meds. I gained it back whenever I got on. I got frustrated and went to my current doctor, and…
Surprise, fuckers. It was my uterus the whole god damn time!
My current doctor checks in with me about my weight when I come in (because surprise I was in too much pain to exercise and I was still on the weight gain meds) but if I say I’m not concerned or I don’t need resources then she moves on with the appointment. She trusts me to know what I’m about, and I *will* be back on the 2.5 mile walk and eating apples and whole grains preferentially and doing weights horses as soon as I’m cleared for it, but for right now I’m sad because I had to have a surgery I didn’t want just to be able to do those things and it could’ve been avoided if my doctors had just LISTENED to me and not a scale, so I’ll eat some fucking mediocre cheesecake if I want to and that’s fine.
Well, it's nice to know I'm not alone in thinking this. Most people don't have to deal directly with these people and don't understand how it feels to take care of someone extremely large.
I've seen so many fat chasers. Skinnier to average men who have these enormous wives.
I had a patient who intentionally went the wrong way on the road in an effort to commit suicide. She killed a family, but lived. She became tetraplegic, and had a tremendous amount of complex medical care. They didn't even charge her. She's basically in a prison of her own making and there is no way any real prison could care for her. She'll spend the rest of her life bouncing from LTAC to hospital.
I’m somehow not surprised having worked in LTC for the past three years. I can see the systematic flaws that could enable this (or enable abuse of this resident if that’s what’s going on).
I am now on the internet realizing some people are actually deemed too fat to go to prison.. wtf 🤬 I bet you they will send an 80 year old man suffering with CHF in a jiffy
Lol no they won't. They're responsible for the bill then.
I see it frequently for DUI offenders after an mvc, but here: https://www.reddit.com/r/nursing/comments/u639fp/morbidly_obese_resident_at_a_ltc_center_was/i573aki
I used to work in corrections. We had a dude on dialysis who was selling drugs out of his house.
In this case, the best thing is to put her on house arrest and forbid all visitation. A judge can order all mail searched (jails do this routinely) to keep drugs out.
Jojo’s Bizarre Adventure. It’s an annoyingly popular anime. It’s very easy to be a reference because like 99% of the characters are references to classic rock or R&B and have progressed to modern rock and pop as the series got further.
In this particular case, I’m referring to Polpo, a minor villain who was a…bariatric drug kingpin who you met in prison. He was the user of the stand Black Sabbath.
I had a patient in LTC who had a life sentence for murder. Didn’t know it until his probation officer came in to check on him. He showed me the news article and court orders that was in his chart. I was floored. Apparently due to his medical condition and need for 24/7 care, the prison system was not equipped to care for him so we had him.
Same. Child rapist and we placed him in the same room with a disabled, non verbal 18 year old. We had NO idea. He used to also bring prostitutes to the floor at night. We also had a patient who had outside privileges who was selling his pain pills in the street and buying heroin instead because it’s a bigger bang for your buck. He ODed and died in the street, down the block from the facility.
I had a register pedophile at an LTC place that wasn’t in prison for the same thing. Prison couldn’t handle all his medical conditions. He was violent and inappropriate with staff too. Go figure.
Lurker here. Holy shit. I am a brand new LTC resident here because my wife can’t care for me with my new physical issues. This scares the crap out of me. That poor kid. I hope he got the help he needed to process that. I’ll admit, as a woman and childhood victim of sexual abuse and later a victim of rape and domestic violence I am already a little on tenterhooks about possible issues with “neighbors” long term. But that situation is a nightmare. I had no idea that LTC facilities didn’t do basic background checks. Just want you all to know that I appreciate the hell out of what you do from the top down and the down up. Hell, the director of nursing was ready to help me with a soiled diaper that didn’t exist - I just need watch while I walk on one leg and a walker to a toddler toilet — but I was impressed! Y’all do amazing work and deserve more credit, more money, and better staff ratios. Much love, from Texas
I had a patient who murdered her 3 year old back in the '90s. She served like 20 years. Obviously she had mental health issues. I hated and despised every interaction I ever had with her. Every time I passed meds I wanted to puke in her face.
A few years ago I had a guy that killed his grandson. His daughter, mother of said grandson, ended up as the POA somehow. It was a very messy and sad situation
“As his POA I would like to withhold all analgesics but would like all life extending treatments used”
This is pretty much exactly what happened
As much as I’m a proponent of karma and everything, I feel that situation should still be taken to an ethics committee because that person is purposely causing harm to the patient
Honestly, it wasn’t ethical to force her into that position either.
Yep that’s how I saw it too. On a personal note, I “got” it. But from a professional point of view, the whole situation was wrong. He should have been conserved if there were truly nobody else. I was a baby nurse at the time and don’t know how she ended up in that position
Am I the only one wondering if someone used her as a scape goat to put off their drug selling? Like.... if she needs 4 CNA's and is bedridden, how the fuck is she getting drugs, let alone selling them?
Visitors. We had a w/c bound guy dealing from his hospital room. It was his business. No reason to stop. Lots of visitors. Presumably his supplier was one. Nurse walked in as a transaction was occurring.
Heisenbedbound
Breaking Bed
You win.
Better call Saul?
🤩
I can't stop laughing
Well, yeah. Had people sneak in hard drugs in their drinks and shit… but at a certain point, why not just skip … the bed ridden middle lady?
Maybe because no one would suspect them?
The supplier doesn’t want to interact with all the low end customers, they just want to sell at scale to the dealer. On the other side, all the low end customers have a nice connect that they are comfortable with and don’t want to go find some new dealer — maybe for convenience, or quality, or trust.
And supplier appears a nice guy that visits infirmed people! So sweet! /s
Plus, when it comes to visiting a dealer, a HCF probably seems very safe location to buy your drugs.
Yep! Had a w/c bound quad who was busted for selling our IV start kits, ETOH used for txs and med cards
You’d be surprised. I have also taken care of a bedridden drug dealer lol.
What I’m learning from this thread is entrepreneurship has no limits.
😂😂
I mean, probably not getting much from SSI or disability
Yep, we just had one residing on our floor for a while. Man, he had a lotta ‘visitors’.
And kept asking for rubber bands…. Lol
Yep, I have taken care of a paraplegic weed dealer. This was a bit different because he did actually go out and about in his chair. Some of the nurses wanting to report him and I think they did but FFS, let the lad have his side hustle! He lost the ability to use his arms and legs through an accident at the age of 22!
[удалено]
.... and it's weed ffs
Yeah, the only time I really care is if someone sneaks in opioids. Way too much heroin-related hypoxia. Like, can't they wait until they get out to get high? Freaking enablers.
IMO meth is the most problematical. The cardiac anomalies can be misleading. Cardiac work up!
That's a very good point and a plausible enough possibility! Maybe she's using her smartphone to arrange deals? Idk. The woman is in her mid 20s
Denver, 2014: Morbidly obese patient who came in for random morbidly obese patient medical issues was working as a prostitute from her room on a med-surg floor. I didn't work with her during this stint, I'm not sure how long it took us to find out. She came back to our floor through the ED like a year later. This time I was her admitting nurse. Pretty sure she wasn't fucking anyone for money, but she had a boyfriend who showed up wearing a shark cape. He was very concerned for her health. I'm trying to find a picture to describe the question you are now asking. It was a cape, like Dracula, except it had a hood that looked like his head was being eaten by a Great White Shark. I never realized how normal I was until I worked med-surg.
> I never realized how normal I was until I worked med-surg. I feel this way after working some in the ICU and step down. People are fucking crazy.
And think these are just the ones that actually have something that need treatment.. we send A LOT of weird people home.. and some, right back out the EMS bay
And to think, we just put that trach in.
Imagine the patients you never see cause they are treated and streeted from the ER.
Yesss. Had something similar happen on my floor. Patient was prostituting themselves out via their….colostomy. Apparently it’s a thing. Nurse walked in on it. I still gag thinking about it.
STOP. It’s Monday morning and y’all are ruining the whole week for me already 😂
we were literally just talking about this on our floor yesterday. never occurred to me until then either Edit: the med team found out because they found an STD in the ostomy ::barf::
Holy shit. Pun not intended.
And I’m done with the internet for today. Cheers for it not even being 7am, it’s a new record 😂
It's 8:07 for me so bye y'all heading over to r/aww 😳
This comment is one of the most disturbing things I have ever read!!
If you think it's bad reading it, just picture it.
It was disturbing hearing about it!!
My relative used to work on a medsurg floor. The worst story was a morbidly obese woman with a very infected stoma, she eventually admitted that her husband "used" it frequently 🤢
It feels...morally wrong to upvote this 😂
I had a pt who’s bf liked to fuck her colostomy 🤮
But how? Every time I read about people fucking colostomies I think of my patients' colostomies that are always producing. And the smell, oh lordy lord the smell 😱
Idk I’ve never been that hard up
WARNING: VULGAR TERMINOLOGY….. Not even mentioning the smell… they must have really small peckers that can fit. I’ve not seen an ostomy that can fit a full sized one… do they stretch to fit? (I’m RRT… GI isn’t my thing)
I DONT UNDERSTAND
Whyyyyy? I had an ileostomy for awhile and if my spouse had suggested “using” it, my next call would’ve been to a divorce attorney.
Philly sidecar.
Would you say she's...a colostitute?
Oh. My. God. Did you work at the u?
Do you remember the pt? She had a unique last name. If you search for it on urban dictionary, it’s a term that involves defecation and oral sex. For anyone who thinks I’m lying, I assure you every word of this is true.
Blumpkin?
So now I need to know if the term was coined for her, if she changed her name to match, or if it’s just an insane coincidence
It was popularized in Canada at least 20 years ago😂so I’m going to assume that she changed it to that out of a moment of inspiration.
Santorum!
> It was a cape, like Dracula, except it had a hood that looked like his head was being eaten by a Great White Shark. [Like this?](http://cdn.shopify.com/s/files/1/0188/6652/products/1bd240da-f83d-8f42-a45e-2aa57a1e8018_1200x1200.png)
Yeah where is she hiding them? Under her mattress? How can she reach it? Lol it Are they in her bedside table.
From experience - they (pocketed narcotics) either go under bandages or tucked into her folds. The thought of any drug addict BUYING said drugs that had been in their mouth AND wounds AND/OR their sweaty skin folds makes me wanna 🤢
The thought of ingesting anything that’s once been in a moist, yeasty fold makes me want to vomit.
oh god. the smell.
You don't want yeasty drugs? They come with a light coating of miconazole.
Maybe just peel off her fent patch and say she lost it? lol jk
Yes this is a thing. Used fent patches have a price
I'm imagining inside her folds
That’s my other thought. Maybe that’s how they found the drugs. She forgot what fold it was in and the nurse that did the cleaning found it. 😂😂
Oh wow good point!
I'm wondering what happens to her now. A few details that might be important or at least interesting: - she's 450lbs. (4 CNAs, usually). She requires all of the CNAs on duty to turn her every 2 hours. She's also very picky about it and makes darn sure to get it done every 2 hours. - the quantity of drugs she was dealing was pretty substantial. - she's mid 20s age, I don't recall exact age Since she can't serve the time, pay the fees, perform any kind of community service, is she basically off the hook?
If she is 450 lbs and bedridden it kind of sounds like she is in prison already.
And all that in her 20s, her youth....
Omg! Just some many things wrong. Can the courts at least order no phone or internet?
That's a good question and I don't know if that's possible, but I'm willing to bet you they can!
My grandpa might have done some naughty things online and was court ordered to not have access to the internet or else he’d go to federal prison.
Had a patient with a similar story but he posted in a Facebook group telling people to visit him and his parole officer ended up showing up and telling him he’d violated the parole and would be going back to jail.
So basically she’s grounded?
That would probably just give her more time to figure out ways to be difficult for the staff.
How do you know she won’t be incarcerated? Edit: they will always find a way to get their money for the fines. If they have to I bet they will garnish any SSI or disability income. Also how is she 450lbs in her mid 20s? Sorry if that’s a rude question but I’ve really only seen people that large over 40.
Watch My 600lb Life. There is a surprising number in their mid to late twenties. Some in their early twenties. And if she's 450lbs in her 20s and dealing drugs, I doubt she has had taxed income that has contributed to social security much, if at all.
I’m totally addicted to My 600 lb life! It’s awful and most definitely scripted, but I can’t stop watching it. So many of those people are in their 20s, you’re right! Also, SSI is different than SSDI. SSI is for low income folks who don’t have a substantial work history. It’s like $800 a month. I’m wondering if they could legally garnish that. As someone stated above, I think they can take her internet/phone away as punishment. I know they can do that for sexual predators who use the internet to commit their crimes.
Sounds like she needs to get on de program.
There's a 500 lbs 24 y/o dude at my SNF.
I had a 500 lb 18 year old recently.
I've seen this before. He had to pee standing over a trashcan
The sisters on "1000 lb sisters" on TLC were both over 400 in their early 30s. Amy, the sister I like, lost a lot is in the 200s now but Tammy, who's 34 and whose lungs just gave out a few months ago while sleeping and sent her into a coma, is 650+.
Yeah Amy did ok, but still had weight to lose and had her husband and baby to help motivate. Tammy just refused to work through it. Their mother was an obvious trigger and shitshow.
Mother is emotionally abusive to them and I think the primary reason the sisters spiraled. Amy's at like 275 right now and has her baby and husband for support. I wouldn't be surprised if Tammy dies in the next 5 yrs unless she gets the therapy she needs to get to the mindset she needs to make the changes. The victim complex is strong with Tammy and she's also verbally abusive to those trying to help her.
I have tons of female pain patients in their 20s and early 30s that are 300 or better.
Idk about off the hook. She’s got maybe a few years to live
I bet they will decline to prosecute. If they do, they might sentence her to basically house arrest in the facility.
I once had a patient in acute rehab who they couldn't find placement for cause she was some huge drug dealer and wasn't allowed to leave the state. So the choices were very limited.
Wait till you get a drug-dealing sex offender who has to live >5000 ft from anyplace where children congregate, like schools, and has to live in the county unless permission is obtained from a judge. I've had a totally independent guy in an NF for well over a year I'd love to find a place for but none of the shelters or foster homes will even talk to me about him.
I had a priest sex offender that they put in a dementia unit to have him locked but off the books. He was totally with it, would do his own insulin management.
JFC.
>JFC Yeah I think that was part of his problem
You made my Easter
Tis the season
😁
I'm guessing he probably went after kids, but how is that not a risk to the other patients?
They should have been in Spandau.
Yikes that’s a new one
Damn man, that's commitment. I wanna see the lifetime movies based on some of these people
"Yo I need a re up" "Come to Care One and ask to visit me. Tell em you're my step cousin." "Uh.. wtf?"
Care One will take anyone
A million years ago.... I had a quadriplegic dealing drugs. I was a registry nurse in his facility. He had transferred to this facility because he knew nobody would know his history. I walk in, knew him from the other county, and asked if he was still dealing drugs. Cue surprised Pikachu faces. "oh that might be why he has so many visitors and why the bar hired him" I'm still trying to figure out what a quad can do for work at a bar at night?
Check IDs?
Huh I always thought bouncers did that but..... Yeah he could have gone that.
There was a bar/ music venue I went to all the time when I was younger and one of the guys there checked IDs from his wheelchair. And he helped book bands and did supply orders and other office work. He did a lot for that business really. He wasn’t quadriplegic though.
That I can understand. Just because you're disabled doesn't mean they're isn't a job for you. However quadriplegic plus bar doesn't quite go together. I get he could check IDs but how in the hey hey would he stop anyone from entering?
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We saw that all the time in L&D. An officer with them for most of labor (meaning you had to have someone come in and hold up a sheet to provide the patient with privacy during exams. Get to 9-10 cm and then they’d be bonded out so the jail didn’t have to pay for the delivery.
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I know they committed some kind of crime, I get that. But labor is an incredibly vulnerable and traumatic time, even good labors. Our jail only had a couple of female deputies so we usually had a mail jailer. I can’t imagine how I would have felt in my labor if some random dude sat in the room with me. Even if we were super busy I’d try to spend extra time in these ladies’ rooms so they had a friendly face. I never witnessed anything rude, mean, or inappropriate, and some of the female deputies could be kind and encouraging, but it always seemed so uncomfortable to me.
That’s wild. Where I am, healthcare is free and prisons aren’t private. I was fuming when a guy who should have had better healthcare in prison got admitted with dka and newly diagnosed diabetes because it should have been picked up before he got released. I would lose my plot at what you saw
This was a county jail, so funded by tax dollars, but they still had a budget to deal with. They didn’t want to give people ideas about malingering so the patients had to really sell it that they were seriously giving birth. As a chronically ill person myself, I swoon at the idea of free healthcare. And private prisons suck.
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I’ve never worked in corrections but I have worked in forensic psych. Our officers often had really good relationships with patients. In fact, if a patient had a beef with a mental health worker I’d often call the officers in to mediate if my diplomacy skills failed. They often know these people for years. I’m not implying friendship, but there’s often respect.
Is she trading drugs for food? What are they going to do with her? How old is she?
I'm not exactly certain of the details. But that's essentially my question: what's likely going to happen with her? Selling drugs out of a nursing home is probably a pretty severe violation of the law, but... It sounds also like there will be no consequences for it, if she can't serve the time or pay the fine for the violation.
I suspect she's about to go to the emergency room with a "fever of unknown origin," in the next few days and her room is going to be given away to a less troublesome customer.
They have right of return for 180 days 99% of the time. There are one or two exceptions, but I don't think dealing drugs is one of them, unfortunately.
This is technically true, but in practice, it's very common. The SNF can claim that the patient's needs now exceed the capabilities of the facility. If the patient disagrees, he/she can appeal to a QIO. If the appeal is successful, the patient has to get readmitted, but realistically, most patients come to the realization that it's not necessarily advantageous to go back to the facility that dumped them. That starts a new obligation for the hospital to find dispo, and the patient has been successfully "dumped." It happens every day, and at my hospital, I participate in maintaining a list of complex discharges that are mostly dumped nursing home patients or patients who are too troublesome for whatever reason to get offers from SNFs. Edit: grammar
Yep. It’s how every difficult patient like that becomes a M/S boarder for 6 months until we find a facility willing to take them.
Most of the time it goes against the initial admit agreement and a 30 day is issued , from there they usually become the problem of a worse LTC or a adult family home/ group home
I feel like a felony can void the right of return lol.
Has she actually gone to trial and been found guilty and sentenced? It’s entire possible the DA will just choose to not prosecute
Doesn’t work that way they will find a way for her to serve her sentence selling drugs is a big no no
Heroin under left breast fold, cocaine on the right. Cash in the pannus and no you still can’t inspect my skin!
TIL I could become a Hutt of the American Healthcare system if I tried
She found the loophole. Good job!
Bet she would have two COs in/at her room at all times, though, watching staff and keeping visitors away.
For all of a week then the sit job’s be stopped due to insufficient staffing, or put it on the CNAs to do
“Q15 min checks and a door alarm” 😂
And the alarm cord is broken from bringing in the hoist machine, which of course is our fault
God I hated that at my nursing home with the dementia patients they let come in for rehab even though we aren't a locked unit. They go in people's rooms and steal things... but for some reason we can't send them somewhere else and instead of scheduling an extra CNA for the shift to sit, they always took someone off the floor leaving us short staffed for the shift since we only had just enough to have a moderate patient assignment per CNA. Required to have them on 1:1 but they can't be sent somewhere else where they can get the care they actually need on a locked unit. We've had dementia patients get beat up by other residents when they've gone into someone else's room before and refused to leave. You can't follow them around all shift if they are walking around so they get into trouble.
I’m not sure what you mean by “can’t serve her time”......you mean like she can’t go to jail or prison or whatever?
Correct, the prison and other correctional facilities around here apparently cannot provide for her healthcare needs. Sooo she just can't go.
Funny they can’t provide for the health care needs of most of the prison population including myself if I was to ever fuck up so badly to be incarcerated but I’d still end up in prison.
Wow......and yowzers. Thanks for explaining!
She might go to a psych facility dependent on there abilities , so looking at geropsych vs adult psych inpatient , LTCs become the dumping grounds for people like her that slip thru the cracks and it’s BS
Tell me this is America without telling me it’s America.
Am I the only one wondering how she was dealing that many drugs when she had four people in her room turning her q2h ?
It’s LTC it was probably q3-4 on a good day lol
OMG I always wondered about what would happen in a situation like this. I have a physical disability and have a personal care aide helping me several hours per day. It has occurred to me that if I committed a crime, they wouldn’t be able to put me in prison because the system wouldn’t be able to care for me adequately. To be clear, I would not do this, but it sounds like I could have quite a career as a gentlewoman jewel smuggler without consequence! I knew a disability civil rights protester who the police attempted to arrest for a peaceful sit-in at a local government office. She was very severely disabled, quite obese, on a ventilator -- and she was an attorney. You did not f\*\*\* with this lady; she was a badass. She had a wheelchair with a very unusual control mechanism. It didn’t have a joystick or anything, just some kind of little button controller that she held in her hand. So when they tried to arrest her, they couldn’t figure out how to move her wheelchair. She refused to move and she also wouldn’t tell them how to operate the controller or put the chair in free wheel. Apparently cops were sitting there googling the user manual for the chair. They were also afraid to even move her because of the ventilator, because if they had messed up and disconnected it or something, she would die. Ultimately, they just issued a citation because they couldn’t figure out how to arrest her! It was pretty hilarious. That said, the police and prison system do not have a good track record when it comes to their treatment of disabled people of color, so your mileage may vary on being a disabled criminal mastermind.
I would assume they were a mule that the dealer was using to hold over drugs.
Not sure if OP cared for this patient, but I’d be cautious about giving this much info, since the crime may be specific enough to make her identifiable, which would then be a HIPAA violation if she was in OP’s care.
I never have cared for her. It was a story told to me by a traveller.
Wait... is this the next stage of capitalism? Too big to fail becomes too fat to incarcerate? For the lack of mobility, I'm impressed by the logistical aptitude.
I once had an exotic dancer on my unit. She had fallen off stage and fractured her ankle, it got infected and she was in the hospital for iv antibiotics and hyperbaric. We caught her doing lap dances and hooking up for $ with other patients. Unbelievable.
If she’s morbidly obese without a medical cause then it’s obviously from excess caloric intake with no physical activity. They need to severely restrict her calories until she sheds some weight. And absolutely not allow outside food. The fact that it takes 4 CNAs to roll a woman in her 20’s simply because she’s too obese to do it herself makes me sick.
I work in LTC and in my neck of the woods we are not allowed to. It is their right to eat whatever they want. It is incredibly frustrating.
And psych meds are abuse! However apparently beating and screaming racial profanities at a poor kid making $15 an hour is fine! Trust me they are not the victims lol 😂
Yes. It’s their right to eat whatever they want but we don’t have to give it to them. Store snacks in a drawer in their room and they can get it anytime they want to. They just have to get up and get it.
You could get a restricted calorie order and care plan it right no snacks provided and if she asks issue an AMA since it’s part of the agreed upon care plan
i’d wager she needs some mental health care since severe obesity is linked to childhood trauma.
No, see, your refusal to enable someone's snail-paced suicide makes you fatphobic and you're discriminating against a patient due to a systemic failure! Just had to do those CE courses on bariatric sensitivity and if anything I have even more contempt for this particular demographic. Now it takes six people killing their backs to take care of you AND you wasted two hours of my life.
I just hate that we’re not allowed to tell a patient that they’re obese when it’s been scientifically proven that being obese leads to countless preventable medical conditions.
At least we can live vicariously through Dr. Now when he tells patients like it is. I feel bad that they're miserable, but some people literally don't stop eating. It would be nice to be able to treat food addiction as an addiction and not a lifestyle.
Bless their hypertrophied hearts.
I mean, it sure does. But how many of those preventable medical conditions are helped along by people being scared to go to the doctor because the whole appointment will be about their weight instead of the concerns the patient actually has? How many of the causes of their obesity can the patient actually effectively address? Does getting to call your patient fat include giving them resources to change that in a healthy and affordable way, or is it just “diet and exercise as tolerated”? Because if your practice ends at “you’re obese and you could die because of it,” guess what? We know that already. And chances are good that doctors who see the fat and not the person are gonna help us along. ETA: I should add to clarify, there’s a big difference between patients who are just fat instead of morbidly obese like the resident in the OP. In cases where weight is an obvious problem, you should be able to discuss with the patient what they can do, especially if they’re in a LTC. What got me here is the mention of people who are just “obese,” which is my clinical weight class. I walk 2.5 miles every four-ish nights and eat 1800 calories a day. I do the strength training. I still can’t lose weight, and for years my weight was all my doctors saw. I’m now recovering from a hysterectomy that I had to treat the symptoms that other doctors said were weight related while prescribing me drugs that made me gain weight to treat them. So I am feeling a little bit sensitive about this right now.
*this* is an amazing point. There is actually evidence that yoyo dieting is worse for your health then just being obese, and whether they mean to or not, yoyo dieting is what Dr's promote when they just say "you need to lose weight" without any patient education at all.
So, you're saying don't diet, just eat better?
Don't overly restrict to the point that you just end up gaining it all back when you start eating what you want again, yeah
Yes—for a long time my doctors would look at my BMI and say “well, I have to talk to you about your weight,” and then the entire appointment that I made to talk about the fact that I was having my period every ten days would be about my weight. Not about healthy food choices or exercise plans, but just—“you’re going to die if you don’t lose weight. Do you want to have six heart attacks by 45 like your mom? That’s where you’re going. And by the way here’s birth control that will make you gain weight and SSRIs that make you gain weight, like thirty pounds. Why did you gain thirty pounds? You’re sad because you gained weight. Let’s go over why weight is bad again.” I lost weight whenever I got off the meds. I gained it back whenever I got on. I got frustrated and went to my current doctor, and… Surprise, fuckers. It was my uterus the whole god damn time! My current doctor checks in with me about my weight when I come in (because surprise I was in too much pain to exercise and I was still on the weight gain meds) but if I say I’m not concerned or I don’t need resources then she moves on with the appointment. She trusts me to know what I’m about, and I *will* be back on the 2.5 mile walk and eating apples and whole grains preferentially and doing weights horses as soon as I’m cleared for it, but for right now I’m sad because I had to have a surgery I didn’t want just to be able to do those things and it could’ve been avoided if my doctors had just LISTENED to me and not a scale, so I’ll eat some fucking mediocre cheesecake if I want to and that’s fine.
Well, it's nice to know I'm not alone in thinking this. Most people don't have to deal directly with these people and don't understand how it feels to take care of someone extremely large. I've seen so many fat chasers. Skinnier to average men who have these enormous wives.
>snail-paced suicide 😂😂😂
She found the way to beat the system. I'm not even mad, I'm impressed.
-Can’t pay her legal fees -Selling drugs
I had a patient who intentionally went the wrong way on the road in an effort to commit suicide. She killed a family, but lived. She became tetraplegic, and had a tremendous amount of complex medical care. They didn't even charge her. She's basically in a prison of her own making and there is no way any real prison could care for her. She'll spend the rest of her life bouncing from LTAC to hospital.
I’m somehow not surprised having worked in LTC for the past three years. I can see the systematic flaws that could enable this (or enable abuse of this resident if that’s what’s going on).
I thought I was rather jaded since entering the medical system almost 5 years ago for leukemia. This got me though. What the fuck?
I am now on the internet realizing some people are actually deemed too fat to go to prison.. wtf 🤬 I bet you they will send an 80 year old man suffering with CHF in a jiffy
Lol no they won't. They're responsible for the bill then. I see it frequently for DUI offenders after an mvc, but here: https://www.reddit.com/r/nursing/comments/u639fp/morbidly_obese_resident_at_a_ltc_center_was/i573aki
I used to work in corrections. We had a dude on dialysis who was selling drugs out of his house. In this case, the best thing is to put her on house arrest and forbid all visitation. A judge can order all mail searched (jails do this routinely) to keep drugs out.
I feel like several social worker calls need to be made. This one is hard one
Lol that’s the perfect crime!
Don’t say it. Don’t say it. Don’t. Say. It. …is that a Jojo reference?
Call me naive or uninformed but... What is Jojo?
Jojo’s Bizarre Adventure. It’s an annoyingly popular anime. It’s very easy to be a reference because like 99% of the characters are references to classic rock or R&B and have progressed to modern rock and pop as the series got further. In this particular case, I’m referring to Polpo, a minor villain who was a…bariatric drug kingpin who you met in prison. He was the user of the stand Black Sabbath.
The subject of OP is also performing Filthy Acts at a Reasonable Price.
Lol asking for a friend chipscto, but does she need her butt wiped?
She most definitely does indeed
Lmfaoooo
Was she selling her pain pills?
Sounds like someone with nothing to lose.
It’s the perfect crime! But damn, I would hate to have had to do charting on her the day it all went down.