What do you do if a patient needs to go to the hospital?

[Malina9559]

Im new to home health. Visited a pt that was clearly sick, exacerbation of his renal problems and chf. He couldn't breathe. I told the family that he is very sick and he should go to the hospital. I offered to call 911 for them, they told me they want some alone time to ask the patient what he wants. I didn't call the doctor b/c my preceptor told me he would say the same thing to me, to send him to hospital. Anyway, I charted in my notes that I advised family to take him to ER immediately and offered to call 911.

Is this what you normally do in home health, should I have stayed with the family and called 911? Thanks

[jmn126]

You should still,call the MD, you would let him/her know what is going on, that u want the pt to go to the hospital but family wanting to wait, etc.... I have actually had the MD office get on the phone and tell them the exact thing i just did and they agree to fo. But regardless, you need to call the MD.

[paradiseboundRN]

If they absolutely refused to go now, then I would call the doctor to let him know about the refusal and the possibility of the patient going later. ALWAYS call the doctor in these situations! Then, I would chart my butt off about it. In my note, I would use the exact wording that the patient and/or family said in quotes. I would chart that I notified the dr and my manager (if appropriate). I would chart that I explained to the patient and family the possible outcome if he does not go to the hospital and they verbalized that they understood.

[KelRN215, BSN, RN]

I tell the child's parent "you need to take your child to the ER" and then call the MD's office and say "I'm sending this patient in." If the parent doesn't bring the child in, the MD knows it was my recommendation for them to be seen and they should follow-up with the family.

In your case, you're talking about an adult. If he doesn't want to go, he doesn't want to go. I would still document your recommendations and notify the MD.

[84RN]

According to my clinical manager, we are supposed to go ahead and call 911, and if the patient and family refuse to go to the hospital, they can refuse the EMS themselves. But to cover ourselves, and what if they change their minds and it ends up being too late and we didn't call? You also need to call the MD asap.

[Malina9559]

Thank you all so much that was very helpful I appreciate you all

[Isabelle49]

No matter what, always call the MD. If you really feel this patient needs emergency care, call 911 and let them refuse care when EMT's arrive. You can document this. Remember anything not documented/not done!