I work at a large hospital in a metropolitan area. I am a nurse case manager meaning I work with patients to arrange the services they need when they leave the hospital.
The nursing process that I was taught and have used for over 35 years is: assess, plan, implement and evaluate. One of the questions I ask almost every patient is: Have you or anyone living in your household in the past year been unable to afford rent/mortgage, food, medicine, utilities, transportation?
There is research that backs up asking this question. The research on social determinants shows the you have improved health outcomes if the basic needs of the person who is unhealthy or experiencing an illness are met.
So, I ask that question and I sincerely want to hear their answer. However, if they tell me they can’t afford their rent this month because they have been sick and unable to work..all I can tell them is, “Here is a resource you can call 2-1-1 and they might have a program that will help you.”
I want to be able to do more than just tell them to call 2-1-1. If I had a $100,000 to use for patients who have what I judge to be legitimate financial needs how would I distribute that money? How do I follow up and see if it truly made a difference? If people found out they could get their rent paid when they are sick does that incentivize illness? What are the ethics of paying for people’s immediate financial needs when they are so vulnerable?
These are difficult questions for sure with no easy answers but I want to keep grappling with the issues and not just let the idea go because it sounds difficult to execute.