How much are we supposed to care when the patient doesn’t care?

Interested to see people’s thoughts and opinions on dealing with non-compliant patients who are abusive to staff, taking up a valuable hospital bed (bed on subspecialty unit) taking up hours of medial and AH teams day that could be spent on patients who are willing to engage and will benefit from our time. Disappear for hours at a time to smoke and use substances (admits to this daily). Patient has been deemed competent by neuropsychology. Understands that medical non-compliance will result in a very early death yet still refuses to take meds and comply with medical advice (specific details intentionally left out for anonymity).

Hours of everyday are spend negotiating with the patient, having MDT’s with AH to find and fund solutions for a patient who in return verbally abuses and berates everyone involved in their care. There are many other patients on the team who would benefit greatly from the time and energy of all involved. Apart from the time of everyone they cost the system a LUDICROUS amount of money on the care that they are receiving (I know money isn’t the point but it could towards other patients care).

At what point do you stop trying to fix a problem that they clearly could care less about and discharge them home. Is it not wrong to waste all these resources (time and money) on someone who just abuses people and ignores the simple advice that they are given).

Interested to hear people’s thoughts.

TLDR: pt deemed competent, completely non-compliant with care, very abusive, takes up more time from all clinicians than remaining 20 or so patients under the team. Can you will a clear conscious stop trying to help