when patients go off the floor... - Page 2

Our patients (guests? clients?) have to sign themselves out. Plus, they are told that if anything happens to them while outside, they must go back thru the ER instead of back to whatever department they were in. For instance, if they should get SOB or have chest pain, they must go directly to the ER. We are a non-smoking facility, so they can't go out to smoke, anyway.

Haha nice. There was a pt on out floor who had gotten a pass signed by the MD to leave the hospital. Don't know WHAT reason for leaving he told the MD. He left wearing baggy clothes and came back with 2 brown grocery bags of expensive steaks he had to keep in our refrigerator. Hmmm....

That's an awesome idea! Unfortunately hard to enforce here since everyone just walks out to the sidewalk in front of the hospital to smoke.I'm a former smoker (I quit when it changed to a non-smoking campus 3 yrs ago) but find it extremely tacky to see hospital employees smoking in front of the hospital on the sidewalk.

Before I started working ICU, we simply had to get a dr's order if a pt wanted to go off the unit without staff. That way, it's up to them, not you. If the dr decided they weren't stable enough and they insisted on going anyway, they had to leave AMA. They would usually end up in the ER later that night or the next day.

This all sounds crazy to me! At our facility the pts can't leave the floor at all unless it is for testing taken via escort. Even the ones who are not a fall risk, and in my hospital that is only about 10% of the population. Our fall risk policy is so unbelievably strict that if you are even a slight fall risk, you get a yellow "fall risk" band, yellow socks and a bed alarm. No getting up to use the bathroom by yourself unless you call us. If you're not a fall risk pts need an order to walk the unit. Then administration wonders why we have so many complications. We are too short staffed to ambulate everyone like they should. (only 1 aid to 20 pts and 3 nurses with no charge) I work on a med-surg/oncology floor. I have been there for two years and this is my first nursing job. I just thought this was the norm, I guess I was wrong.

Policy, Policy, Policy......it depends on the facility and the usual standards of practice. Some areas, of course, you can't leave .....like a locked psych unit...... but I have worked at facilities that have dunkin donuts or starbucks that patients and families may take out to the court yard (restrictions permitting) but this facility also had pet visiting hours. The patients had to sign out an alert disc (like at the restaurants) and return when beeped.

I really miss that place.....sigh.

[QUOTE=noyesno;6295894]Our patients aren't allowed to leave the floor. Most of them are hooked up to PCA's or loaded up on pain medication. We had an interesting patient escape the floor/hospital for a few hours. He had a bullet lodged near his aorta and had a chest tube. He was scheduled to have surgery in the morning. Apparently, he went walking around town, chest tube and all. I guess this all occurred because he wanted to have a cigarette. Glad I wasn't his nurse.[/QUOTEWe have PCAs that come in a portable pouch so the patient can ambulate or go out in a wheelchair easily.

If our stable patients want to go to the little snack place, library etc they get a visitor pass sticker that states when they left. To come back on the floor, they have to have the sticker on (they can only be gone 30 minutes, only exception are moms coming to the NICU to care for their babies, they can have unlimited time, but the nurses do check to make sure they are still with us after 30 minutes). If they want to go out to smoke, they are told they have to sign an AMA form and they can't come back, they have to go thru ER. If they leave and we don't know it, we call a missing person thing and after 15-20 minutes we pack their belongings, say they are AWOL and they have to go thru ER to be readmitted.

When it is nice out, the patients that do not have IV's or hospital equipment attatched to them can go outside, but only with a family member, once again, the stickers come into play and they have 30 minutes.

This has cut down on those...where is my patient???

At my facility, we only get patients to sign an AMA form is if they're going out on a pass approved by their attending physician....or if they decided to sign themselves out.

If we had patients sign the AMA form everytime they went out for a smoke break or a walk to the cafeteria, my days would be filled with nothing BUT making the more independent patients sign themselves out everytime they fancied a smoke break or some snacks from the cafeteria!