Ama-

[verock]

Hi everyone! I am a L&D RN that works in a small community hosp. which doesn't have a psych. floor. Well today I had a pt. who came from the ER during the night shift w/ a hx of schizophrenia (according to a relative who called) and waiting to be transferred. She was having illusions, was combative and the night staff applied restraints. Well this morning, as I started my shift her parents arrived and were insisting on taking their daughter out of the hosp. at this time she was calm but restless, and disoriented. The charge nurse was notified, the doc. was at the bedside and the director of the dept. The director was fine w/ having the pt. leave as long the parents signed AMA. The doc. witnessed the AMA, the charge was upset and was against having the parents signed- in the end the pt. left w/ parents. No psych. evaluation was done, because The psychiatrist couldn't make it this early but was aware that we had a psych. pt in our dept. My big ? is -can the parents sign AMA under this situation? This pt. is 26y/o.- parents were told of risks, and so on. Thanks-

[Noney]

I don't know the legalities, but if the young woman harms herself or someone else shortly after the AMA my guess is that there is going to be trouble.

Noney

[PMHNP10]

For someone of that age, it would seem the parents would have to have med power of attorney, or some sort of documentations stating they can legally make decisions about a person's care.

[laurenkst]

I can't for any reason understand why the L&D was used to house a schizophrenic patient. I used to work in a NICU and the L&D was right beside the unit. I don't know whether the patient was having delusions or hallucinations. But if she's already hearing and or seeing things that are not there, I am not sure she could filter out the screams from the mother's before, during and after the delivery.

The parents were correct. They were very wise to take their daughter to a more appropriate facility that could handle her

needs more effectively.

As for the psychiatrist, why couldn't he see the patient so early. Unless he was on call at another facility at that time, or circumstances prevented him from getting to your hospital, he should have been there--asap. If your facility does not have a psych unit, the patient should have been transferred to a facility that does have one-asap and that would have been his respon-sibility.

Please cover your __ __S_ ___, no one else will.