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...
  3. by   aa915
    I live in a large city and I literally know no one who owns a car (except for a few far out in the 'burbs) even if they were willing to lose a day's work and come get me. If this were really about my "welfare" the hospital/dr would weigh the risk of my taking a cab home against the risk posed by the consequences of their refusal to treat me at all (which they have); it seems to me if they were so concerned about my well-being there'd be no contest. The fact that there is tells me all I need to know, which is that this is all about lawyers. If I die from something that was never diagnosed or treated that's my problem; I can't sue THEM for it, and that's all that matters. And it's not just me: see How Hospitals Do Us Wrong | Psychology Today
  4. by   Kooky Korky
    Quote from coneil
    I have this same problem from a patient point of view. I haven't scheduled an endoscopy procedure for over 1 year because I have no one to drive me home. What are people supposed to do in this case?
    While possibly difficult or awkward, this could be a good time to meet your neighbors or get some help from a local religious organization or Older Adult Services from your town or county. It's hard for me to believe that a friend or relative can't take off a few hours once in a blue moon to help you, though. Same comment is directed to the single nurse who commented above.

    It is not a nurse's duty to keep anyone in the facility after the procedure is done and the patient has returned to stable VS, neuromuscular, GU, and LOC status, I wouldn't think. Where is your facility lawyer?

    I had a "small" procedure the other day. General anesthesia. The minute I was awake, my son was handed my clothes and directed to help me dress, use the toilet. I was given no juice or cracker or any other form of nourishment, which used to be routine for outpatient things like this. I was dizzy, nauseated, and just not ready to turn cartwheels, but here came the transporter anyway. I felt basically thrown out and that I was a bother, even though I know I was not the problem - the problem was $$$$$ and the way medicine is practiced in America these days and poor training of overwhelmed nurses. I was sick as a dead warthog all next day, until relieved by vomiting, then weak, achy, febrile, SOB. Scary stuff. Kind of off point, sorry. Yeah, I know, a dead warthog would no longer be suffering. LOL
  5. by   Kooky Korky
    Quote from brownbook
    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.
    I hope you never again risk your job and your license, your income, and your own family's wellbeing to help a patient in a non-emergent situation. I understand why you did it, but it was really foolish.
  6. by   Kooky Korky
    Quote from morte
    the bottom line, to me, is that if these patients require this much attention after the fact of the procedure, the procedure should not be done on an outpatient basis. Problem solved.
    Yes, except you have to have the blessing of the insurer.

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