incentive rehab

What better way to get a former drug abuser to talk status post stroke than to deny controlled substances? One of our patients suffered a stroke a month ago and has been starting to speak for the past 3 weeks. In the past few days, however, her speech has improved and she has now become more adamant about getting vicodin, benzodiazepines, and codeine. She refused to eat or take any other medications unless she got the above substances. She, however, describes no pain.

I feel sorry for her for regarding her stroke, but I'm beginning to see her true colors. The weird thing is that none of her next-of-kin or friends have come to visit her during her stay at the hospital. I'm wondering what type of person she was before this stroke.

rocks

A "rock," is a patient who is practically impossible to discharge from the hospital for various reasons. We have 4 rocks on our service. One has been there for 2 years! It's all about funding. Rocks usually do not have insurance, Medicaid, Medicare, or don't qualify for our county sliding scale health service. We can not discharge these people because they have no where to go. No family, nursing home, or rehab center will take them. This is yet another "frustration" of the "system."