Naturally, we have all had to deal with phone calls from alleged relatives. If the patient is in the department, I generally have them or whomever is with them call the caller back to avoid any Hippa violation.
Last night I had a strange situation. I'm varying some details to not completely identify the patient.
68 yr old female comes in, pacing and quite nervous. Does not relate very much history to triage RN. She does take "Methadone" for "ongoing pains" She is alert and oriented, c/o being unable to sleep, coughing, and joint pain. After an exam, and CXR etc etc. the physician decides to give an antibiotic for URI, and also some Percocet to take home for her pain. She requests sleep aid, we recommend OTC Benadryl. Since she was a little odd, I reasses her LOC and find she is alert and oriented to time place, year, situation. She states good understanding of the teaching,by saying, "Ill go to the drug store for my antibiotic, and I'll take it until the course is complete, I won't take any percocet till I get to my home, and I'll go see my doctor on Tuesday. If I get worse, I'll come back here."
I then did her vital signs and she ambulated out on her own power. The only medication she recieved was a PO dose of antibiotic.
ABout a half hour later, her "Daughter" calls. Daughter is in another state and claims to be Health Care POA. Daughter does not reveal why she has POA, but does reveal she is quite alarmed that her mother is driving about by herself. Daughter proceeds to scream at me and tell me I am somehow responsbile for her mother arriving alone in the ED in a car, and being discharged home. Of course, I am only releasing the info of "Treated and released" which is what we are "supposed" to say at this hospital.
Now, I did note that the patient was a bit strange, but I am wondering, considering that she was alert and oriented, and acting reasonable, even if she was a bit strange, Should I have been asking her, and every patient if someone else has a Health Care Power of Attorney???
Jan 1, '06
All of your actions seem appropriate to me. POA's need to be actively involved in their charges care, not verbally critical after the fact.
Jan 1, '06
I agree with SFCardiac,, maybe the daughter should be around a bit more to find out what her mother is actually doing.
Jan 2, '06
Not only should the POA be more actively involved and closer, the fact that the pt has a POA does NOT mean the pt cannot consent.
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