Will not take your advice - page 2

What do you do when the caller will not take your nursing advice? i.e to make an appointment or .. to go to the Er Do you every call 911 against the patient request? Share with us your... Read More

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    I hear it all the time. I don't want to go sit in an ER for 6 hours, they say. Well, okay, don't then. But I can't just wave my magic wand and make it all go away. I actually had someone call me from the hospital ER lobby one time to say they felt like they were about to have a grand mal. I still can't quite believe that one.

    I only call 911 against someone's wishes if they've given me a reason to believe they could be a threat to themselves or others.

    Oh, then there was the gal who called me from her car phone to inform me she was driving home after just having passed out several times in an hour while at work... she had a headache, blurred vision and a recent hx of increased ICP. She did not want to stop her car and go to the ED. I finally convinced her to stop, call 911 etc.. then I called 911 to make sure she did it. At that point she was a danger to everyone else on the road and I was calling for their sake.

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  2. 0
    "As a Nurse I don't diagnose" Based on your symptoms my reccomendation is for you to...........................

    Just read them the AMA statement

    Patients tend to screw with your head allot. The make like they are in such horrible distress and achieve a high acuity on your assesment then when you make your reccomendation to go to ED "Oh do you really think I am that bad? I'm not really that sick! Then why the **** did you play this drama queen **** on me about how deathly ill you were?

    I never force nor coerce anyone to go in . I just read them the AMA statement.
  3. 1
    Once, when I was the house supervisor at a psychiatric hospital on the noc shift, I received a crisis call from a distraught individual with serious mental health issues. She was delusional, paranoid, and by her own admission, suicidal. Because she was in another city, I ended up having a coworker call 911 on another line and having her ask them to trace the call. Our PD contacted her PD, and I believe they were able to get her some help. Her agitated mental state and self-harm statements trumped privacy issues.

    Some other thoughts to consider:

    It's advice, not orders.

    You may just be standing in for the part of themselves that wants to do the sensible thing. It's just so darn difficult to argue with yourself.

    You can only do so much. The presenting problem might be heart attack s/s, but the chief complaint may be chronic stupidity. An MI doesn't improve the IQ.

    You never know what seeds you might be planting. Even though the response may not be as timely as it could have been, going in an hour later (after the wisdom of this idea has had time to germinate) can still be helpful.

    Sometimes it's good to let go of the tug-of-war rope and appeal to their better nature. "You're a good mom. I'm sure you'll do the right thing." It may be whistling in the wind, but it just might turn an argument into an affirmation of their love for their child.

    Document. Then let go. Otherwise you'll burn yourself out.
    Ruthiegal likes this.
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    As far as calling 911 for pt. the closest I hve cvome to that was alerting PD while suicidal pt. was on the line or calling for a wellfare check for cops to stop by and check on soimeone who just wasn't sounding right but not in need of 911. If someone I was triaging was to week to call 911 or out of it I would first consult with supervisor before doing so.
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    Quote from eltrip
    I get frustrated when the patient truly needs to call 911 but insists upon having someone drive him/her to the ED.

    For the family members who call & want to know how to "make" their loved one go to the hospital, I have to inform them of that person's right to refuse treatment until he/she loses consiousness. I further inform them that once that person has lost consiousness, they can no longer refuse treatment.

    I don't let it bother me anymore. You do the best you can to explain your rational it is on tape any your butt is covered!
  6. 0
    So many times I have told the pt. or family to take the pt. to the hospital now. Plus given a laymens level explanation of why it is imperative to do so now. Do you understand this plan of care, do you have any questions?

    And yet get the response-
    "OK so what your saying is that I can take her to urgent care tomorrow right?"

  7. 0
    I have called 911 several times, usually it is for the elderly pt who is confused or trying to do something for their spouse. I mostly do it with approval from the caller. I have called the Police a couple of times on Suicide calls, I have withheld the truth from the pt and called. I am not competely sure of my legal footing but ethically I know I am right on tract. You never know what some lawyer might say, but if someone has taken pills and is talking to me if I get an address out of them I will call in a heart beat to save them. I am taking the phone call as their cry for help, even if they tell me they don't want help. If they really didn't why call the nurse??

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