Patients who "cheat" and drive home - page 6

I work at an endoscopy center (and a freestanding surgery center). A few times, we've had patients lie to us about how they are getting home, and they've ended up returning to their cars, and driving... Read More

  1. by   brownbook
    Quote from BeachMom65
    I had to get my IUD surgically inserted with 10 minutes under anesthesia; "In office" method was extremely painful and tore me. Dr. said, "The O R then."

    I took a cab there and expected to take one home. Evidentally, free babysitting was what they REQUIRED of the KNOWN PERSON who collected you, charging that person with watching my bleeding and signs of this and that. Crap what if a guy like my father collected me and had to babysit his 50yr old daughter? Riiiiigghhttt.... tall tales.

    I called a cab, told them to say they were Mark, their real name, and to collect me.

    I was so ticked because I lied to get home! GEEEEZ!!!!

    He SIGNED OUT FOR ME, listened to blah blah blah of a stranger (me) and drove me a few blocks home.

    Turned around, tipped him NICELY, got into my car and hauled off to work.

    No time for silly control freak games.
    Honestly I do understand your post and anger over the whole issue. But take a deep breath and count to ten, (or something).

    There have been real life case of patients going home via taxi, a relative comes to check on them later, and finds them "passed out" on a chair, the front door wide open, and they have no memory of what happened after they had their relatively "minor" procedure at an out patient clinic. How they got home, what their discharge instructions are, what the doctor told them or found, etc. The family is justifiably angry.

    It is not a silly control freak game.

    I have occasionally cheated, put my job on the line, and sneaked my patients out the door to a taxi. I will tell you my heart is pitta patting for the next 24 hours as I wait for a phone call from my boss about "the patient you discharged" never made it home, or had a bad reaction at home, was home alone, neighbors found him passed out in the front yard, etc.

    We do have a protocol in place for patients that insist. Notify the doctor, have the patient sign a form (not AMA) that they understand they are going home against our policy, have them wait four hours after anesthesia was given, etc.

    You, nor I, nor the doctor or anesthesiologists, ever know what normal, healthy, patient is going to have a "that's not normal" reaction to even a small amount of anesthesia 4 - 8 - 12 hours after a procedure.

    You should direct your anger towards lawyers and jurys, not the medical establishment.
  2. by   offlabel
    Quote from medresearch2011
    Lots of things were problematic during my last colonoscopy (unauthorized students, srna etc) who were not supposed to participate etc; but everything was straightened out when I went across town to a different for-profit hospital with my endo doc travelling to do my case with an anesthesiologist not a student or a nurse. We specified propofol only and that's what was used; the exam was completer with moderate sedation and 30 minutes later, I was dressed and my endo doc and I left the facility. I made it clear that I was driving myself back to the university hospital; the endo doc could not drive my stick shift car. The endo center had a hissy-fit about my driving until we got the anesthesia doc to explain why I couldn't drive home safely 30 minutes after propofol..and we don't care about policies, only safety. the anesthesia doc told me that driving 1 hr after propofol (about 300mg) was totally safe as I had insisted. my endo doc said that most of the docs got their colonoscopies with no meds or propofol only and returned t work in the endo suite or operating room within 1 hour of their colonoscopy. Why the BS thta patients are given about not driving themselves home? if they go only propofol, driving 1 hr afterwards is fine
    Your physician drove you? And you received 300 mg of diprivan for a colonoscopy? AND you were told you could drive within an hour? Lots to unpack there but I can refer you to the pharmokinetics of diprivan and what is called the "context sensitive" half life of diprivan and point out that the way in which you rec'd that dose you in no way had all of that diprivan cleared in one hour. The CS half life is about 40 minutes. Had an accident occurred, the liability would have been breathtaking.

    There might be some misinformation going on there...