When patients lie about rides.....

Specialties Emergency

Published

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 had him call for a ride. I spoke to the friend, whose wife is a resident in our LTC unit, he said he would be with her and would await our phone call. I medicated. When he was ready for discharge I was off the unit and a coworker discharged him. He told her that he would just walk down to the LTC and get his friend to take him home. When I came back and found that out I cringed. (Coworker is new to ER, was a PACU nurse.) When I explained how it should have been done, she said "But he said he was going to go over to LTC for his ride home."

About a hour later a man knocks on the ER door. It's the friend wondering how much longer it's going to be because he's ready to go home. My cringe was accompanied by a silent moan. When I explained what had happened he shook his head and said "His truck's not in the parking lot and he never came to get me."

I told the friend to "beat up the pt's other side when you find him"!

Specializes in Emergency/Trauma/Education.

I've been fooled once, several years ago...

This guy was ordered IV meds for his migraine. I asked him to call for a ride and then I'd give the meds. He was cooperative and proceeded to use the "white courtesy phone" to call his wife. We all saw him having a conversation while on the phone...

He was reassessed, pain was tolerable and was ready for discharge. He wanted to just "lie on the stretcher until my wife gets here". Sure, no problem...

I turn back around and HE IS GONE! The registration clerk said she saw him go out the door and drive away. :angryfire

I called his home number and spoke with his wife. She was so thankful I called...since she hadn't heard from him since he went to the ER... :uhoh3:

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Specializes in Looking for a career in NICU.

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 , 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.

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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.

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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.:madface:

Is po-po the police?

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Specializes in ER, ICU, L&D, OR.

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

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Is po-po the police?

Yep

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Specializes in ER, ICU, L&D, OR.

why call the police

20 yrs ago we could do that

now its a HIPPA violation

dont take it personal

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um... I actually did this once. :chair:

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!!!

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Specializes in 6 years of ER fun, med/surg, blah, blah.

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!:uhoh3:

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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.

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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.

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um... I actually did this once. :chair:

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.

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