[Answered]: I just got a consult regarding a veteran that…

I just got a consult regarding a veteran that needs psych placement. Why can’t the VA take care of this? Psych placements are so hard to find. And I know how this physician works, he will want to get this patient discharged ASAP so that he can keep his length of stay average down. I’m pretty sure the hospital administration provides incentives for the docs to keep their LOS numbers as low as possible. Well, let me tell you, this doctor must be winning that lottery. He’s always discharging patients before anyone else on the team (RN, PT, OT, etc.) thinks the patient is ready. He just says, “We’re not babysitters. The patient can do this stuff at home, on his own dime.” I’ve tried reporting my concerns to the nurse manager and the hospital administration, but I never get much of a response. Anyway, now I’m stuck spending hours on the phone begging for help for this guy only to get shot down when they find out he doesn’t have insurance. 1. Lou has clear concerns about the discharge practices of this physician – how might he best address them? 2. What is Lou’s ethical obligation to the patient in this case? 3. What resources could help Lou with this issue? 4. What are the ethical ramifications of his action or inaction? 5. What social injustices are present in this situation? How could he address them?