ER policy/unresponsive pts - page 2

What is your ERs policy on unresponsive patients. In the last 3 weeks we have had female patients being brought in unresponsive from local bars and a couple of times the people who came with them... Read More

  1. by   TazziRN
    No, but friends who are true friends know the pt's first and last names and how to get in touch with at least one relative. I should have clarified more: if someone claims s/he is a friend but can't give me even basic info, s/he stays in the WR.

    And yes, steps are family. Our facility will allow stepparents to sign consents.
  2. by   TazziRN
    Oh wow....I just read my original post......I did NOT say what I meant to say!! Read my second one, that was my intended message!
  3. by   gonzo1
    I like the DNA idea, but then I would be in trouble because I was adopted, so my DNA doesn't match my family.
    The above postings are all thoughtful ideas, hope there are some more ideas out there too.
  4. by   flashpoint
    The HIPAA law actually allows disclosure of information to people that the patient presents to a healthcare entity with. So...if Tazzi and I were out shopping and I had an allergic reaction to the shrimp I was eating and Tazzi called 911, the ambulance personel and ER personel can assume that I would want Tazzi to know what is going on with me. They can't reveal information not pertinent to the current hospitalization (like that I came in with a Dulcolax OD three months ago), but they can tell her that they are giving me epi and starting me on a steroid and keeping me overnight just in case. The basic logic behind this is that ideally, I would want my family there, but for whatever reason they aren't there, so I turned to Tazzi for help...Tazzi is the best I have until my family shows up...and I think Tazzi is wonderful, so...
  5. by   TinyNurse
    To the OP, good question! Honestly, I've never really thought about it, but also haven't encountered your situation.

    In my ED we do not list assault victims names on the white board. Also, in any assault type of trauma when the patient is awake and alert the patient may name 2 people that are allowed to visit, and that is included in their chart. I know this is not "really" what you are asking for, but.......it's something.
  6. by   TazziRN
    Quote from cotjockey
    The HIPAA law actually allows disclosure of information to people that the patient presents to a healthcare entity with. So...if Tazzi and I were out shopping and I had an allergic reaction to the shrimp I was eating and Tazzi called 911, the ambulance personel and ER personel can assume that I would want Tazzi to know what is going on with me. They can't reveal information not pertinent to the current hospitalization (like that I came in with a Dulcolax OD three months ago), but they can tell her that they are giving me epi and starting me on a steroid and keeping me overnight just in case. The basic logic behind this is that ideally, I would want my family there, but for whatever reason they aren't there, so I turned to Tazzi for help...Tazzi is the best I have until my family shows up...and I think Tazzi is wonderful, so...
    :kiss Love you too, Mac! :biere:



    Um.......Dulcolax OD.....?
  7. by   BabyRN2Be
    Quote from gonzo1
    I like the DNA idea, but then I would be in trouble because I was adopted, so my DNA doesn't match my family.
    The above postings are all thoughtful ideas, hope there are some more ideas out there too.
    Gonzo, my comment about DNA tests for everyone was really tongue in cheek. I mean, from what I last heard, DNA test take about 48 hours and time may be of the essence in some cases. And you are right, I'm sorry if I came across insensitive as there are adoptions in families.

    I was sort of thinking about L&D, when the mom makes all these demands, one of which is a DNA test to prove to whoever that he's the baby's father.
  8. by   traumaRUs
    I worked at a level one inner city, college town for 10 years as a staff nurse and than as a case manager. It was routine that when the ambulances went to the scene of an "unresponsive" person, our police go with them. If the patient arrives by car, then the police are called upon the patient's arrival to the ER.

    We have had several GHB (date rape) drug cases and most came in with friends. I always asked about past medical history, allergies (a biggie), etc. My feeling was that if they didn't know the basics such as name, date of birth and how to contact family, they didn't come back to the room. Once the police showed up it was always amazing how our waiting room cleared out.

    Another way to find relatives is via the patient's cell phone or wallet (if they have one). As a case manager, it was often my job to try to find out who was who and these are the clues I used.

    Excellent thread.
  9. by   gonzo1
    Babyrn2be, no offense taken, I thought it was a cute comment.
  10. by   gonzo1
    traumarus, we are going to start notifying the police when these cases come in. I like your idea about asking for info. You're right, if "friends" can't answer simple questions they probably shouldn't be allowed in room. Especially if intoxicated like this guy was.
    Thanks to everyone for the helpful hints. We are going to start using every idea listed so far. Still looking for more if anyone else has some ideas.
    Just want to make sure all bases are covered and the safest care provided for our patients.
  11. by   BSNtobe2009
    Quote from gonzo1
    What is your ERs policy on unresponsive patients. In the last 3 weeks we have had female patients being brought in unresponsive from local bars and a couple of times the people who came with them and stayed with them turned out to not be friends or family after patient was lucky enough to respond to treatment and recover. In the meantime we are giving them updates on patient and letting them sit with patient (if they are sober and behaving). So far we didn't even think to call police when amb brings patient in, but now I'm thinking we need to call police when patient comes in. Maybe they could do something to verify people with patient actually have a right to be with patient or at least start to keep track of how many times this is happening.
    Thanks in advance for your help with this matter. My ER needs to develop some quidelines and we don't have a clue.
    I am not a nurse, but when someone brings a patient in that is non-responsive, I would probably ask for a driver's license from the person that brough them in and write down their information before I permitted them to stay...and here is why: You are absolutly right when you say you have no idea what the relationship is between an unresponsive patient and the person that brought them in.

    If a crime was committed or the patient later dies...and the person that was with them bolts, this could prove to be very valuable information to the police later, should an autopsy reveal something odd.

    My undergrad is in criminology so that is why I was thinking of that.
  12. by   pkapple
    If you want to get nutso crazy...When i was in a neuro icu - we allowed only immediate family, exceptions were made for some so's, more distant relatives, etc. But the fun part came when "Mamma" made a list of who was acceptable! Poor 23yo in a coma - now step-mom and boyfriend aren't on the list, but of course "mamma" hasn't been around for the last 5 years.!!
    Even had a case where current wife of a patient wouldn't allow stepchild patient has raised from infancy!
    Finally got a policy, we are not the POLICE, we can't id everyone, so in icu, we ask if visitor is family and use our judgement on visiting by anyone. The rule change was really beneficial for the floors. I recall one family that had 23 names allowed to visit, forgot poor sister from out of state, so floor ever so vigilant said sorry you are not allowed, of course family who made list pitched a fit...of course sister Sue can visit....on and on and on. So we are not the police, every nurse has the right to prohibit visitation by anyone for patient care,agitation,etc. This can get hairy when one nurse is willing to walk around 75 assorted visitors, and another prefers to change dressings privately or whatever....anyway no policy is fool-proof and some are just crazy!
  13. by   Ruby Vee
    Quote from pkapple
    in icu, we ask if visitor is family and use our judgement on visiting by anyone.
    [font="comic sans ms"]i always ask "are you a friend of hers?" if they're family, they'll respond with "i'm her step-mother" or "i'm her sister." if they're friends, they'll say "yes," so then you know they're not family.

    if you start out by asking "are you family?" a great many of them will answer in the affirmative even though they're merely this week's greeter from church. boyfriends will say "yes," even though she's also dating 3 other guys.

close