When patients lie about rides..... - page 2

I had a pt this morning, rib pain after a play wrestling match a few days ago. He drove himself to the ER and rated his pain at 11/10. I got an order for Vicodin #2, and before I let him have it I... Read More

  1. by   BSNtobe2009
    This is an interesting addition....my neice was involved in a car accident last year, that should have been her fault. It did $3K worth of damage to her car.

    The woman driving the other car, get this, had a HEART BYPASS 3 weeks prior to the accident and was driving! We found this out because she requested an ambulance after the accident, not because she felt she was hurt, but she wanted someone to check her out because she "had just had surgery". She was admitted to the hospital overnight for observation.

    The woman sued my neice, who only had liability insurance, for $25,000. That is frightening to a 20-year old.

    Well, our family got my neice an attorney, and it turned out that the woman not only didn't collect $25K from my neice, but she ended up having to pay for my neices car, rental, and her attorney because medical records showed she was not to drive for 6 weeks and was currently prescribed very heavy pain killers.

    In other words, the woman lost her right to be on the road, so the accident was said to be automatically her fault.
  2. by   TrudyRN
    Quote from Quickbeam
    I'm a community health nurse with a state DOT and I oversee health and driving issues. I'm the first person the newspapers call when one of the above examples occurs. Or when someone with diabetes crashes. Or when someone on OxyContin runs a pedestrian over. You get the idea.


    In my state (and this can vary a lot), you the driver are responsible for what you do behind the wheel. That includes responsibility for your state of health. Even the most basic notation in an ER chart would be enough to prevent civil liability here.

    I hear all the time "but it wasn't ME that caused the accident, it was my diabetes!!!". Sorry, you own it. Today's laws are much kinder than the ones in the 40's and 50's that prohibited entire classes of people from driving (seizure disorders, in some state, those with diabetes....). The watchwords today are individual function and individual responsibility.
    Why is diabetes a reason not to drive? Thanks.
  3. by   TrudyRN
    Quote from Mr. Grumpy
    My policy is to see the whites of eyes of person that is giving the ride. Of course people do ask to go smoke, sneak out, etc. Those are the ones that I call the po-po and advise of. You can't adult-sit these people. However, you can inform them of their illegal activities and endangerment of others. Most people that have a vehicle will wait for a ride when you remind them that you worry more about the "others" that they could harm. Especially, when you mention children.
    Is po-po the police?
  4. by   teeituptom
    One just accept that drug seekers will lie to you if its in their best interest

    then document document document

    outside of that there aint nothing you can do except shake your head
  5. by   TazziRN
    Quote from TrudyRN
    Is po-po the police?

    Yep
  6. by   teeituptom
    why call the police

    20 yrs ago we could do that

    now its a HIPPA violation

    dont take it personal
  7. by   LoriAlabamaRN
    um... I actually did this once.

    Before everyone gets mad at me, let me explain. I was working at the hospital as a CNA while in nursing school, and injured my back near the end of my shift when a large patient passed out while I was walking him to the bathroom. I couldn't straighten up, so as per policy I went down to the ER. I would not accept anything stronger than a shot of Toradol, since I know from experience that Toradol works much better for my pain than morphine or demerol, and since it is an NSAID it doesn't make me loopy. After the shot had taken effect and I was discharged, the nurse told me that I was not allowed to drive myself home. I had NOONE else to get me, and all I had been given was one shot of Toradol. So I told her that my husband was already in the waiting room, and I left and drove home. If I had taken ANY narcotic, I never would have done that. However, I was single and had lived in the area for about five months so I literally had noone to call. I had been given IM Toradol on numerous other occasions so I knew that it would have no effect on me as far as impairment.

    Don't hate me!!!
  8. by   Victoriakem
    Toradol is NOT a narc so you should have easily been able to drive yourself home. I don't understand why the nurse would have told you that!
  9. by   TazziRN
    Quote from teeituptom
    why call the police

    20 yrs ago we could do that

    now its a HIPPA violation

    dont take it personal
    Nope. The pt now has become a danger to him/herself and others by operating dangerous machinery under the influence.
  10. by   bethin
    Being an aide on a busy med/surg floor I've d/c alot of pts. When I started, no one told me what, if any policy there was concerning rides. I decided to cover my butt and wheel the pt (or walk them out) no matter how much they protest by claiming it's hospital rule. That shuts them up. Then I wait for the ride to pull up and I make sure they are seat belted in before I walk away. There have been times that a pt has sneaked out after being d/c while waiting for a ride. I make sure it is well documented on the chart so if there is an accident and drugs were involved that I, the hospital or the nurse do not get sued.

    It sounds like your co worker acted on good faith. She spoke with the friend so you have a witness if it comes to that.
  11. by   bethin
    Quote from LoriAlabamaRN
    um... I actually did this once.

    Before everyone gets mad at me, let me explain. I was working at the hospital as a CNA while in nursing school, and injured my back near the end of my shift when a large patient passed out while I was walking him to the bathroom. I couldn't straighten up, so as per policy I went down to the ER. I would not accept anything stronger than a shot of Toradol, since I know from experience that Toradol works much better for my pain than morphine or demerol, and since it is an NSAID it doesn't make me loopy. After the shot had taken effect and I was discharged, the nurse told me that I was not allowed to drive myself home. I had NOONE else to get me, and all I had been given was one shot of Toradol. So I told her that my husband was already in the waiting room, and I left and drove home. If I had taken ANY narcotic, I never would have done that. However, I was single and had lived in the area for about five months so I literally had noone to call. I had been given IM Toradol on numerous other occasions so I knew that it would have no effect on me as far as impairment.

    Don't hate me!!!

    Don't hate you. I would have done the same thing. Toradol does not make me sleepy, loopy, drowsy, etc.

    The best we can do is educate our pts, explain to them why they cannot drive, explain the consequences to them and you and document. If they leave without you knowing it, at least you have done all that you can.
  12. by   Kinky Slinky RN
    Oh, all the wonderful experience I will receive by signing on to a busy, busy ER here... Can't wait =)
  13. by   Medic/Nurse
    I, too, document very, very well.

    If concerned, I also have them call a ride (if necessary) and sign (prior to narc administration) that they understand the "No operation of motor vehicle due to potential for impairment x 12 hours....etc" part of the d/c instructions.

    I will also keep 'em until I see the ride and then the ride can sign too.

    As to the civil liability issue, I know that juries have held bartenders "liable" - so what would make me think that I could be less so. Defending a "lawsuit" that may not have a basis - can sure ruin your day! Oh, there are a LOT of hungry lawyers out there! Practice SAFE!

    If I have given you narcotics and you have LIED to me and proceed to operate a motor vehicle - I will call the police. No question. I think it may be my only mitigation defense if ever questioned. "Protecting the patient is one thing (they can hurt themselves) - protecting the public is another!"

    Anyway, its gotten to be a pretty big deal with me. I practice the same way, every time. I also will not allow "patients" to drive that I have given medication to that, may not be a narc, but is otherwise very sedating.



    OH, I saw an above post that Toradol is not a narcotic, TRUE- but it is a C5 in some areas (news to me too) so... and it can be minimally sedating - so I guess that was it.....
    Last edit by Medic/Nurse on Oct 12, '06

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