Hello friends
I need some serious help here....
I have a serius and ethic delemia to figure out fast.
I have an ethical delemia and need some good advice. In my 120 bed LTC facility (I am a DON) I was MANDATED and instructed by my corporate office that I MUST discharge a lady to the hospital tody...because she owes 56, 000to the facility. Ok.. I ordered stat labs, to include a CBC, BMP, UA, dig level and an EKG.. (in hopes to find a reason to send her out.. tests were uneventful.. EKG Sinus brady with S-T elevations and HR 57, labs good except for low dig level at 0.53 (has no meds for a week, pharmacy cut off her orders because she owes them 10,000, the CBC - RBC is a little low at 3.56 (I asked if the doc could admit for anemia)
Long story short: MD ran a bunch of tests probably did a 10,000 work up. and NO DICE>. She has nothing that warrents a hospital stay.
Primary MD was willing to do a direct admit as long if something justified could be found.. well, 7 hours later she is ready to come back:
I have a direct order from corporate that she is NOT to return back under no circumstances. but there is no case for an admit. In fact she is alert and keeps telling the ER that "I have nothing wrong with me" I asked if she could stay because of the finacial debt, they said it is not their problem (understandable) Now if I bring her back, I, the DON and the administrator get fired..:angryfire
I have to go with my gut feelings on this and do what is ethically correct, I do not want to be facing the board of nursing for failure to take her back from an unneccessary ER send out.
Choices:
1) do not take her back per corporate mandate and face AHCA tomorrow with a possible big fine and a big tag, and possibly have personal charges brought against me by the board of nursing
2) accept her, and face getting fired tomorrow for allowing her to return to the faciltiy.
I want to call the hospital and have her sent back because it is the ethical and legal thing to do, regardless if I get canned tomorrow..
What are your thoughts on this. We are under Florida laws.
Thanks in advance to anyone who can offer help.