You don’t magically fix any sort of mental health or addiction problem with an inpatient stay. Doesn’t work that way.

You cannot fix mental health or drug addictions while a person is in survival mode and fighting to meet their basic physiological needs such as housing and food. It is hard to believe one could say such a thing unironically.

I work with this patient population full time, 365. You have no clue.

I don’t think you understand that EMS was invented here in the Hill district and that is why the center for emergency medicine is in this city at all, not the other way around.

Housing FIRST. Yes, housing is the first step. Until you provide for someone’s basic physiological needs, you cannot hope to move on to the next step. Those are the basics. They are how it works. That’s where all solutions begin, just not where they end.

I will not engage with you any more as you don’t intend to learn anything and think you know it all. ✌🏿

Housing is step 1. It’s not the end of the solution, but it is the necessary beginning.

There are lots of initiatives in Pittsburgh that work to combat this problem, more than most cities. We just began sending out social workers to mental health calls, and we do a lot of innovative things.

Pittsburgh is the first city to create EMS, street medicine, AND trauma-centered neighborhood resilience. We have lots of people doing groundbreaking work that is being replicated all over the country and world. You are pretty clueless about it all, obviously.

PS, all homeless people, sheltered or unsheltered, living with substance use disorder or not, are “legitimate.” There isn’t a bar they need to pass to be “legitimate,” and judgment from people like you is a major part of the problem. Substance use disorders develop alongside mental health disorders, and people with SUD are no less deserving of our help. Shame on you. Seriously disgusting worldview.

I can’t speak to Albuquerque, but shelters here have huge waiting lists. There are not enough supports for them and I seriously commend this business owner for at least trying.

Rehabs don’t take John Does.

At least not right now, no, mostly secondary to staffing and organization. Unless having cancer crisis because they have a cancer doctor or PA there at all times!

The answer, as a nurse in Pittsburgh, entirely is dependent on what is wrong with you.

If I have cancer, I hope I am at Shadyside. If I need to go the ER for anything but a cancer crisis, I pray to God the ambulance isn’t going to Shadyside.

If I have a burn or substance use disorder, I hope I’m at Mercy.

If I am having a CSF leak, it better be fucking Presby.

So and so forth. Every hospital shines (and flops) in different areas.

No, Children’s does not have a burn unit. Only West Penn and Mercy do.

I work at Mercy and if a child is very critically ill with a burn, they will still go to Children’s, and Mercy will send staff there daily for burn care.

Does he go to St Clair? They have free transportation to most surrounding areas for St Clair appointments.

BIl went to sbux

You vastly improved your family’s Christmas in a couple ways. Good for you.

Best of luck. Sounds like a terrible Christmas.

The other option is to die. Some people do that.

Yes, I’m sure, but everyone’s depression is different.

Suggesting a specialized clinic doesn’t mean anything bad. It is a clinic designed for your specific problem that most places don’t have but we are lucky enough to have due to proximity to large medical centers.

I would try a CBT based practitioner, if you haven’t, and work on thought distortions. Good luck!

I mean, they gave you a source for a clinic that specializes in treating treatment resistant depression. That’s a good resource, likely full of therapists and practitioners trained in effectively treating depression.

Downvotes are an algorithm and not even all real people. This is definitely your depression talking.

I hope you find the help you need.

There’s only one Union in Pittsburgh, not plural. Only AGH nurses get a Union.

They have been through all the local staff, treated them like trash, and worked them into the ground until they left.

You don’t really understand the market. They’re staffing hellholes no one wants to work at (ie most of UPMC), but it’s actually much cheaper for facilities and they prefer it. No onboarding, no benefits, short term commitments. The love it.

Mercy ER is overrun and when I was interviewing, as soon as I was alone with the nurses, they told me to run in the opposite direction.

The other comment about the population is not why - I want to work with that population specifically and ended up taking another job at Mercy specifically because of that. I was asked in my interview how I felt about mandatory overtime. You won’t get a proper orientation, period, you just won’t. The techs seem to like it there though if you’re a tech.

Shadyside’s ED had me shadow with a new grad (yikes) and was perfectly open about being exclusively travelers overnight. Pretty clearly a hot mess. Noped out real quick. However, the people at Shadyside seemed pretty nice.

I haven’t been in West Penn’s actually but I spent some time up on the floor and people didn’t have any good things to say.

It really depends on what role you’re performing in an ER, and what you expect out of your work experience. My perspective is mostly from a nursing point of view.

As a patient, there’s lots of different considerations. If you’re withdrawing, definitely go to Mercy. If you’re burnt, go to Mercy or West Penn. If you are leaking spinal fluid out of your nose or having a dental emergency, go to Presby. If you are having a cancer crisis, go to Shadyside. If you’re pregnant, go to Magee or West Penn, etc. Similarly, if you have particular professional issues or interests, that may guide you.

Jefferson. I’ve been inside most of the city’s ERs shadowing and so on, and most are trash. Jefferson is best run and extremely busy.

Them and St Clair, but as far as workplaces go I may rank St Clair second in the ER. Jefferson is run pretty well.

Both are very busy ERs; busier than AGH or Presby, by numbers. They just ship out their traumas after stabilizing instead of admitting them.

Mercy is busier but also not the best place to work.

Kinda depends on whether you want to work in a level 1 or not.

??? I never said anything about hero or reverence. I do deserve basic respect, which you do not display.

I am not saying there are not issues to be addressed, as there definitely are. However, you don’t seem to actually understand how deeply disrespectful you are being to the field, which is a shame.

I’m not saying you cannot study and pass NCLEX. I’m saying that knowledge is required. Also, every “practice” NCLEX test I took was not close to the actual NCLEX (which I did pass easily, I’m just saying they weren’t great approximations). NCLEX has very little to do with actually being a nurse. Nursing school is very regulated. If the schools are approved, there are certain standards they have to meet. Some are better than others, but nursing is largely learned on the job.

Do not belittle a profession you don’t well understand, please. You think you understand a lot more than you do, it is very clear.

I didn’t miss it, just seemed like travelers were getting blamed too. They’re part of the solution, not the problem. But sorry if I misinterpreted!