Hey all. Yesterday for the first time in my career I had a patient drive off after surgery..eye surgery no less. He had general anesthesia and he drove off after I begged him and his family members in the car not to let him drive and legally under the influence. My charge nurse was told me this morning "it happens all the time. People drive around corner and change drivers." I filed incident report immediately afterward but was chastised this morning by charge saying "I shouldn't have stayed on clock to file report and should have filed this morning". My nurse manager advised me to tell dr and document but told me not to call police. Is this the norm like they make it out to be? Because it seems crazy and dangerous for this to happen it seems like there should be better way to handle this.

I would have called the police and filed an incident report.

What would HR do? They deal with employees, not patients.

I would have stayed late to file the report. It would look pretty suspicious if a horrific accident happened and then you filed after the fact.

Yeah that is what I did but found it interesting to be chastised for it. It seemed like a big deal to me.

Legal Obligations to the Dangerous Patient in a Medscape Multispecialty article.

The above is an article from 2009 about patients being a "danger" and nurses reporting it. You should be able to enter it in an Internet search and find it, or similar articles.

It is not a difficult an article to read, not written in "legalese", but still I ended up confused because what you can or should legally do is not real clear, and varies from state to state.

Irregardless your surgery clinic should have a policy manual, it should cover patients driving themselves home after surgery.

Your charge nurse is not a good charge nurse. She should take your concerns seriously. The issue of you using over time was stupid to bring up.

You need to get a clear understanding of your surgery clinics discharge policy. Look for the procedure and policy manual yourself....or tell the charge nurse you are confused about what the policy is, can she find it for you. Don't let her tell you what the policy is, say you want to have a copy of it. If she can't or won't help you tell her you will ask her boss, or the head of anesthesia, or someone (up the chain of command) what the policy is.

Yes it can be dangerous for a patient to drive their selves home.

When this happens in my facility, and it happens from time to time, I instruct my staff to call 911 to report an impaired driver, and we give the identifying information of the driver; and then an incident report is filed timely reflecting our actions.

I have had outpatient procedures myself & so has my wife. The pre-procedure instructions generally say "responsible person has to come with you, stay during procedure, then drive you home. No person with you = we don't do the procedure".

No this person had two other family members with him in the car with him. And got out of drivers seat to let him drive í ½í±Ží ¼í¿»

The police should have been called. How would you feel if he had an accident and killed someone? I think you open yourself up to liability. Not because he drove, because you can't physically stop him. But because you knew that an impaired driver left your facility and no further attempt was made to protect the people who were sharing the road with him. JMO.

Has your Risk management been apprised of this situation? I think they might be interested.

Yeah I found it odd that my boss suggested not to call police. Also got upset that I didn't wait until next day to do report because I was eating up time on the clock. I was more worried about patient and everyone else on the road. I can honestly say I have never had this happen to me.

Interesting thread. My first thought is how impaired is the driver post surgery? Is it maybe equal to a drink to two, or is it more? I mean, a bartender certainly doesn't alert the police about a possible impaired driver for every person that gets behind the wheel after leaving a bar. Then my next thought is who is responsible for determining that the driver is too impaired to safely drive? In the case of the mythical before mentioned bartender there is plenty of case law that supports the bartender and/or bar being held responsible in the case of an impaired driver leaving and causing harm but I don't think I've ever heard of this happening in relation to an driver that is impaired due to a surgical procedure. Probably because the patient signed some forms acknowledging that he or she is not going to drive home that would absolve the office of any responsibility should something tragically happen during the drive. I know the few times I've had outpatient procedures one of the forms I had to sign clearly stated I had to have a driver with me when I left and this was also verbally addressed during pre-op.