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Ask Auntie Aggie: Caring for undocumented immigrants

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Auntie Aggie answers two questions this month, both dealing with undocumented immigrants.

Anne writes:

I heard that if parents have a child in the U.S. but are not legal citizens, they are not allowed to visit the baby in the NICU. How does that work? It sounds horrid to me, but a lot of the things we do are just by necessity.

Golly! I have no idea. It seems to me that it would be difficult, if not impossible, to keep parents out of a hospital while their child was there. There’s also the question of undocumented immigrants versus parents who are here on various types of visas—if a tourist, student or work visa expires while the visa-holder’s baby is in the NICU, are they then barred from entering?

I asked Mister Google about this and could only figure that different hospitals must have different ways of dealing with this question. NICU and well-baby nurses out there, what do you do? Peds ICU nurses, regular peds nurses, what about you guys?

Julie asks:

What are your feelings on providing non-emergency care for illegal immigrants?

We have to define what we mean by “non-emergency care.” If a patient is admitted through the ED to my unit for care after a stroke or traumatic brain injury, am I good with that? Yep. Though it’s technically non-emergency care—and likely not to be paid for by anything but the hospital’s coffers (and you can say that about a lot of other, legal citizens, too)—I’m all for it. If we can prevent another stroke or get a person back to his family and working again, I’m good.

Likewise, if we can provide a basic level of preventive non-emergency care for everyone in the country—and I include dental care in this—we would see significantly fewer emergency room visits for things like diabetic reactions, stroke and heart disease.

And don’t forget that there’s a compelling reason to provide care, especially to children: Contagious diseases, like measles and mumps and whooping cough, are coming back. True, the vast majority of those aren’t showing up in immigrants; rather, they’re the product of anti-vaccination thinking in what could be broadly termed Rich White Google MDs…but it’s still vitally important that we vaccinate everybody we can when we can.

The trouble, as it usually is, is money. The other trouble that goes hand in hand with that is access. I hear a lot of politicians bleating that we should take care of our own first, but those guys don’t seem very interested in improving Native Americans’ access to care, or the quality of the very rare community clinics in predominantly minority areas. If I ran the world and had unlimited access to cash, I’d set up a web of clinics hither and yon to provide basic health and dental care to all comers. If undocumented immigrants showed up at the door, I’d let ’em in.

The point of all this rambling is this: A nation’s health depends on its weakest links. If you don’t take care of everybody at some point, you’re going to end up with either an epidemic or a healthcare system that’s overwhelmed with uninsured people with preventable conditions.

Personally? I don’t ask, I don’t care where you’re from and I provide care to everybody.

Agatha Lellis
Agatha Lellis is a nurse whose coffee is brought to her every morning by a chipmunk. Bluebirds help her to dress, and small woodland creatures sing her to sleep each night. She writes a monthly advice column, "Ask Aunt Agatha," here on Scrubs; you can send her questions to be answered at askauntieaggie@gmail.com.

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