Does your hospital give DC instructions to AMA patients - page 2

Just wondering what your hospital policy is. Does hospital policy assure that the patient leaving AMA (Against Medical Advice) gets discharge instructions of some kind or not?... Read More

  1. by   rn undisclosed name
    No discharge instructions but I do tell them to make sure they follow up with their doctor asap in the office. I also document that while explaining the risks of leaving AMA. Luckily I haven't had anyone leave AMA in awhile. I've found it's usually the ones who want to get their methadone cause they ran out.
  2. by   jojotoo
    Quote from Emmanuel Goldstein
    Because it's outside the norm and risk management needs to be aware of the occurrence. Liability issues, I'm sure.

    We don't file incident reports for AMAs, LWBS, or elopements any more (unless it's a psych hold). We have so many of these, they are no longer considered outside our norm.

    And not only do we give written ACI, we also give prescriptions (including narcotics), and bus tokens - on request. Though I do draw the line at taxi vouchers.
  3. by   EmmaG
    Quote from jojotoo
    We don't file incident reports for AMAs, LWBS, or elopements any more (unless it's a psych hold). We have so many of these, they are no longer considered outside our norm.

    And not only do we give written ACI, we also give prescriptions (including narcotics), and bus tokens - on request. Though I do draw the line at taxi vouchers.
    No doubt lol.



    I didn't work ER, so we didn't get that many AMAs. I had a patient who threatened to go AMA (I don't remember why). I had a long talk with him and he decided to stay. In report, I told the oncoming nurse what happened and that I'd convinced him not to leave, and she responded, "What did you go and do THAT for???"


    One of the hospitals I worked for as a traveler made patients sign an AMA form before being allowed off the floor to go smoke; not only were they relieving the hospital and staff of liability, but it also included that staff was not responsible for taking them out or seeing that they returned to their room. I thought that was a great idea
  4. by   big-chicken
    I was recently an overnight patient in a hospital. I was eating at a restaurant with my wife and had a sharp pain in my stomach. I went to the Mens room and fainted, hitting my head,neck, and shoulder on a hard surface. I was brought to the hospital in an ambulance. After being checked out in the ER (EKG, cardiac enzymes, CAT scan of head, and chest xray), I was admitted to a cardiac telemetry ward for monitoring.

    I spent a sleepless night in the cardiac telemetry ward while they monitored my heart, drew additional labs, and ran fluids into my IV. I had a lot of pain in my head, neck and shoulders but was only given 600 Moltron which was totally inaffective. In the morning, I had 3 differant doctors come and check on me. I was given nothing more for pain even though I requested something to make me more comfortable. The last doctor I spoke to said he wanted to keep me for another 24 hours to continue monitoring me. At that point all EKGs and labs were normal. I was eating, and drinking sufficiently. I felt that the the continued monitoring was a waste of time and I was frustrated that I was recieving nothing for pain, so I told the doctor I would not agree to staying any longer and requested that I be released.

    My DC instructions said to call my PCP and get checked out further. I did so and was sent for a 5 -hr glucose tolerance test (miserable) and a cardiac stress test (passed with flying colors).

    This incident occured 3 weeks ago and we never determined why I fainted and fell as I did. I have a strong suspicion that I may have a problem with gall-stones and may have passed a stone that night, causing me the pain which doubled me over and made me pass out. I don't understand why the doctors didn't suspect this and investigate further. They seemed to have tunnel-vision only caring about my cardiac function and nothing else, including my comfort level.

    I'm normally a very healthy person. This is the first time in 30 years I've seen the inside of a hospital. I'm 53 yo male.


    big-chicken
  5. by   blondy2061h
    I left AMA from the hospital once and was given discharge instructions. They pretty much included, "You need to be in the hospital and could die, so please come back if you don't feel better."
  6. by   The_Squid
    From the ER I definitely give them instructions, basic ones to follow up with pcp and return if worse, watch for s/s of infection, etc.. Honestly can anyone say they just silently have them sign the AMA form? I can identify with half of the people that leave AMA from the ER, they're certainly not critical and they can follow up if they need to.

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