Nurse faces challenge with undocumented residents

LAWRENCEVILLE - Trauma nurse Deb Battle is trained to care for the sick and wounded, but another obstacle she faces is caring for undocumented residents.

"Some other challenges that can make (cultural diversity) more of a challenge are undocumented citizens," said Battle, the trauma program manager at Gwinnett Medical Center.

A seasoned nurse, Battle knows what her patients will need after they receive treatment at the hospital. Some will go to nursing homes, others will have home care and some will be entitled to bring home specific medical equipment, such as an IV drip, paid for by Medicaid.

"But a lot of these people, if they're undocumented, have no health insurance and aren't qualified for some benefits," Battle said. "I tell them up front, 'I'm not the INS or the police, but I need to know your legal status because it impacts what (help) I can get you.'"

Although defining a patient's residency status is not part of the admissions process and is not required by the hospital, Battle said it helps to know up front. She then tailors her course of action according to what type of benefits the patient may receive once released from the hospital.

"There's this fear among some people, and they're not honest; so then we go down the path to get benefit A, B and C, and then they're not qualified and if (they) would have told me that up front ..."

Financial resources and IV nutrition are just some of the components American citizens have access to. Battle said finding resources for undocumented citizens can be frustrating, especially when the time comes to be released.

"If you're American, I can get you some resources. ... But now I'm sitting here with the same patient (who is undocumented), but I can't get them to a rehab center or I can't get them to a nursing home or home health care because they are not an American citizen," Battle said. "So the discharge plan becomes more challenging."

One of the resulting scenarios is taking up limited hospital bed space. Once Battle realizes a patient can't receive benefits but is ready to be released from the hospital, the patient waits in limbo in a bed that other patients may need.

"This is the subcategory of being undocumented that presents even more of a challenge in trying to provide health care," she said.

"We don't ask (patients their legal status), and it's not a policy to not ask; it's just not part of our admission process," said Paula Martin, Gwinnett Medical Center spokeswoman.

However, after a patient's stay is completed the level of care offered post-hospitalization hinges on the patient's residency status.