I do think it's going to be hard for the hospital to discharge Vicki if she's making it hard to wean her off of O2 and she has no fixed address. That's not the kind of thing they can do. Can any hospital-experienced Kiwis tell us a little bit about their options here? In my non-hospital-experienced mind, I would think "maybe they can discharge her to some sort of adult protective services group home, or some kind of transitional housing program?" but I have no idea how any of that shit works. Please enlighten us!
It depends what resources are available in her area: sometimes there are homeless camps/shelters specially aimed at post-hospital care, when someone needs a fixed address and running water for home health nurses to do dressing changes. If those are available to her, they'd review and be concerned that there was no discharge plan--Vickie intends to linger.
If it were only the oxygen use, they'd be able to reach out to homeless shelters with a medical hall, but Vickie would be able to refuse. Since she's "falling" and requiring assistance with ADLs, they could try to discharge her to a SNF, but a SNF would look at her homelessness (citation needed) and read through the notes and realize that Vickie doesn't want to rehab and get better.
Long-term care needs a lot of paperwork and time waiting on intake and again, if Vickie doesn't actually want to go to these places (she doesn't) she is capable
for now of becoming "better."
I
suspect that once she starts to get serious discharge planning, people coming in with lists of medically-appropriate shelter options and telling her they're leaving voicemails, she starts improving, Placing a patient on supplemental oxygen who needs butt wiping and mayo-handling isn't an immediate thing; there will be faxes and phone calls and at least a day of warning, which is enough time to remember how to breathe deeply.
And that's assuming any of these hypothetical facilities have an open bed. (Pooner thing likely complicates any room-sharing before Vickie even has to start howling about COVID.) Some patients literally stay in the hospital for a year or more, stable and nonacute, but there's nowhere they can go. It's kind of a "you touched them last lol" problem.
But for now, Vickie's able to get off oxygen and rediscover the spoons to wipe her butt, once she gets credibly threatened with an unglamorous discharge.
n.b. I'm nowhere near NY and available resources vary by location. I'd think they had options for the decrepit homeless problem by virtue of volume, though.
(I would also like to add to the bank of STEM larper sign warnings, though this stretches across any and all disciplines; they'll be a first year undergrad but confidently title themsleves a Physicist/Economist/Biologist etc etc etc at like 18 yo.
I see you've met savant syndrome statistician and former anal athlete
Zinnia Jones.
But having said as much, if that's not the case and she really is in the hospital going on week two, on oxygen, and is also telling the truth about the latest results showing weakness in her diaphragm, Vicky may be closer than she realizes to achieving her ultimate goal. Depending on what level of "help" she is getting, she may be about to cook her breathing apparatus the same way she cooked her mobility. The longer it goes on, the stronger the possibility becomes that she will be truly incapacitated and need significant assistance building back up to normal strength. BiPAP and high flow for sure can cause this after longish spans, and of course a vent would.
I wonder, and this is based on vibes, if they discharged her in a boring way and she's just not going to post about it now that she's no longer inpatient.
Vickie doesn't care about blueballing her readers, and does sometimes abandon a story arc to pick up a new one; as people have said before, asking questions is forbidden. If she were still inpatient and trying to get intubated, she'd be posting about that, or she'd be posting about the unjust and oppressive discharge planning.
Even with a dozen posts about her death from Lung Disabled, if she were inpatient she'd still be bitching about hospital-specific things like infection control or Dietary not having enough variety as they meet her multiple allergies and intolerances.