There is a policy in development for our ED that deals with nurses physically detaining patients that want to leave after receiving narcotics. The tentative wording is that nurses are to.....physically detain them. I see this as battery

and/or kidnapping and certainly not legal. What are your ED's doing? There is a degree of liability when an impaired person leaves the ED. The risk of injury when physically restraining someone against their will is a given.

Security on our campus are not to ever touch anyone with the intent to stop them. So why would the nurses?

What do you think?

Our policy....no ride home, no narcotics. Simple as that.

erlissy--we do check if patients have a ride but patients do lie, We ask them to have their rides come into the ED so we can see them.....I am talking about the pt who has lied and then when we insist on a ride they bolt. Do you "detain" them?

There is a policy in development for our ED that deals with nurses physically detaining patients that want to leave after receiving narcotics. The tentative wording is that nurses are to.....physically detain them. I see this as battery

and/or kidnapping and certainly not legal. What are your ED's doing? There is a degree of liability when an impaired person leaves the ED. The risk of injury when physically restraining someone against their will is a given.

Security on our campus are not to ever touch anyone with the intent to stop them. So why would the nurses?

What do you think?

I'm wondering whether the hospital's legal counsel have been consulted about developing this policy, and what their (legal) opinion about this is ...

Great idea elkpark! I will pursue that angle. I just can't imagine it would be legal.

Thanks

Great idea elkpark! I will pursue that angle. I just can't imagine it would be legal.

Thanks

Hospitals pay a lot of money to keep legal counsel on staff or on retainer -- might as well make use of them and let them earn their keep! :)

Patients do not relinquish their civil liberties because they are given a narcotic. If I were the patient and a nurse tried to "detain" me, I would call 911 -- or does your facility want you to confiscate their cell phone and deny them access to other forms of communication? While we're on that subject, how are you expected to hold them? I assume you will have to employ restraints. Are you willing to sign your name to that form (even if you can find an MD who will order it)?

This is a legal and ethical can of worms!

In my experience, nurses have no part in detaining patients unless they are incompetent to make decisions, and there are legal and medical criteria firmly established that define those circumstances. If you feel that the patient is a danger to themselves or the public (which is the only reason "detaining" them would be considered), you should call security or the police and let them handle it.

If they go wouldn't it be considered AMA?

Not policy per say...but a nurse had me follow a patient out to the parking lot, who had told the RN and MD that she had a ride home so she could get narcotics, patient didn't see me follow her, but I watched her get in her car and drive off. I took down the licsene plate # down and gave it to the nurse, which then reported to the police for impaired driving.

erlissy--we do check if patients have a ride but patients do lie, We ask them to have their rides come into the ED so we can see them.....I am talking about the pt who has lied and then when we insist on a ride they bolt. Do you "detain" them?

I would not physically detain them, but I would document very thoroughly.

Not policy per say...but a nurse had me follow a patient out to the parking lot, who had told the RN and MD that she had a ride home so she could get narcotics, patient didn't see me follow her, but I watched her get in her car and drive off. I took down the licsene plate # down and gave it to the nurse, which then reported to the police for impaired driving.

Wow -- ratting out clients to the police is a new one on me. I wonder if, when she goes to parties, she writes down the license plates of everyone who's had a few drinks and reports them to the police?? If she sees someone run a red light or speed?? Once you start down that road, where does it stop?

We don't give narcs unless pt's ride/family is in room. Of course there are those sneaky few who flee out the back door and we just chart our behinds off. We have been known to watch someone get into the car, take down a plate number and call police to report drinving under the influence. Since we have instituted the no ride present in ER, no narc policy we haven't had to report anyone that I am aware of. We also don't "detain" anyone due to narcs, because lets face it...I'm not getting myself hurt because of a patient. Just document, document, document!

ERlissy

Wow -- ratting out clients to the police is a new one on me. I wonder if, when she goes to parties, she writes down the license plates of everyone who's had a few drinks and reports them to the police?? If she sees someone run a red light or speed?? Once you start down that road, where does it stop?

I guess the nurse was being extra cautious, because one of our frequent flyers for pain meds, after she left another area hospital with narcs, hit a woman crossing the street with her son and killed the women, was in several papers and the papers blammed the hospital for letting her go with out a ride.

I used to manage a fast food resturant and when we would get drunk drivers in the drive thru I would call and report them, as someone who has lost a family member to drunk driving, I say YES you report when someon is intoxicated!