OOh I got another one..
So heres a trick for ya,
Our hospital used to let our nicotine-loving patients go downstairs to take smoke breaks. Now they sign a form upon admission explaining that to do so, you will have to sign yourself out AMA.
Well now I was faced with a tall, large, schizophrenic, homeless, blind patient with no fingers...only thumbs (he said he lost them due to frostbite). Well he was agitated and beligerant as all get-out and by golly he wanted a cigarette! (We wanted him to have one too, trust me!) But rules were rules and we explained that he'd have to go AMA to leave and that I didn't advise it, he would probably be discharged in the next couple days, it wasn't worth it. Well he threw every name in the book at us, said we were keeping him there and that we had ****** all over his sheets to make him mad, he said the whole place smelled like ****, that we were holding him hostage, he knows his rights, etc. and proceeded to spit at us, pull out his IV, told us to get the hell away, etc..
He was clearly having paranoid ideation. However, he was oriented x 3 so was technically (according to my nursing supervisor) allowed to make decisions for himself and signed the AMA form.
Alright. Fine. One less patient.
After all that name calling and spitting at us, telling us to leave him alone, could you believe he'd have the nerve to come up to me and ask me to help him undo a knot in the drawstring of his sweatpants!!
With a deep sigh, rolling of the eyes, and mustering up some compassion as I looked at his fingerless hands, I did.
He then walked out of his room and started wandering down the hall...the wrong way.
I did mention he was blind right?? Well, legally blind. He could make out very rough shapes/shadows.
He cursed and spit his way down the hall... got to the elevators. I don't know how but somehow found the "down" arrow. Theres 4 elevator doors.
*ding* one of them opened
He couldn't see which one though!
Okay this is just cruel... I know.
He hit the arrow again... this time the "up" one (oops)
Lucky for him the door in front of him opened. I felt sorry for the people he got on board with...haha
Rumor had it that the supervisor found him somewhere in the hospital, and ended up giving him a cab voucher.
Don't know where they took him... but watching the blind schizophrenic with only thumbs leave AMA was very humorous
On the subject of cigarettes....
For my confused patients, I found that giving them a thermometer probe cover to puff on worked for longer than you'd think.