AMA Discharges

Wow, no. That is scary!

At my facility this tends to be directly related to the discontinuation of IV pain meds for pts with mysterious conditions for which the docs can find no cause. It also tends to be related to our refusal to allow pts on pain meds to go off property to smoke.

We see our fair share of them on the floor I work on. It's usually related to them not being able to leave the floor to go smoke. It insane how mad a person who was admitted with chest pain r/o ACS can get when you tell them that they cannot leave the floor to smoke.

fellow posters please note, this is in the nicu forum....

Haven't heard anything lately, but that's pretty odd!

well not in the nicu, but I had a mother in the picu threaten to leave with her elementary school aged child (who had not yet stood up since OPEN HEART surgery), who still had bilateral chest tubes, oxygen, a morphine PCA and who had just been extubated a mere 12 hours previous all because they were going to a semi private room on our step down unit. Now there are 6 semi private rooms on this particular acute care unit, the whole hospital was busting at the seams, and this mother was upset that her child was the ONLY sick child who was going to have to share a room. Because we keep all our healthy kids inpatient and in private rooms

This escalated past the attending, social work & clinical supervisors to the AD & security.

Outcome? Kid went to the floor and had a roommate. (but mom did have all the AMA paperwork brought to her and discussed)

and in any case now that I think about it, I did have a family in the nicu threaten to leave AMA. Kid wouldn't have made it down the hall w/o her nitric & inotropes though so not sure what mom thought she was going to do

We've had several in my NICU threaten to move their baby to a competing hospital. They always change their mind when told that Medicare/aid won't pay the $10000 it'll cost to transport the baby on a voluntary transport and that it'll come out of pocket prior to transport.

Isn't a shame they have to pay for something out of pocket that is completely unnecessary?! *eye roll* I have never seen them go through with it either.

Only a few have had their kids transferred. If they hate it in our unit so much, let them go so all of us aren't miserable.

Quick question.....is it possible that checking a child out AMA would not be reported to child protection?? Sorry my past is coming in, but I worked for child protection, and for a sickly child who needed medical care, going AMA might classifiy as medical neglect....Have any of you seen it go that far? Just curious.

We would get an emergency custody thru the court.

We've had a couple parents threaten and our charge RN let me know that the police would arrest the parents the minute they left the hospital and the child would be brought back immediately to the NICU. The arrest is for child endangerment/neglect and it would immediately become a CPS as well as a criminal issue. I've never had parents actually go through with it though.

Has anyone noticed an uptick in parents seeking discharge Against Medical Advice?