call the ambulance?

[babs1963]

Hasn't happened. What if pt needs ambulance but doesn't want to go bc of the cost, or whatever? Can I still call if I feel it is warranted? Bc the pt can refuse the ambulance, therefore I covered my A, along with documentation. Or should I just call supervisor, and Dr, and document.

[caliotter3]

I recently had an episode in which a Home Health client was experiencing SOB, tachycardia and abnormal lung sounds. I instructed him that he needed to go to the ER related to his s/s and wanted to call 911 but he refused. He agreed for me to call his daughter, which I did and she arrived shortly. I explained and instructed the daughter regarding her father's condition and she ensured me she would take him in to the hospital. I learned he did go to the ER by ambulance which the daughter had called. The daughter is now threatening to sue because I did not call 911. Per my supervisor, whether or not to call 911 is a nursing call, however; I am now wondering whether that is correct. This client has recovered fully and is home but we are no longer seeing him due to the obvious issues. Any advice would be appreciated.

From my experiences, you are wrong either way. If you called the ambulance, someone will say you were out of line. If you didn't call the ambulance, someone will say you are out of line. That is how the agency supervisors treat the field nurse, and that is how the client and/or client family treats the field nurse. So you make your decision and expect the worst. You won't be disappointed.

[amoLucia]

From my experiences, you are wrong either way. If you called the ambulance, someone will say you were out of line. If you didn't call the ambulance, someone will say you are out of line. That is how the agency supervisors treat the field nurse, and that is how the client and/or client family treats the field nurse. So you make your decision and expect the worst. You won't be disappointed.

How sad!

[toomuchbaloney]

If the patient is capable of making informed choices and clearly states that he/she does NOT want EMS to transport to the hospital I do not call EMS. I do call the MD and the agency to advise them. I do have the patient sign my note which says that they refused EMS (even my electronic document allows a patient signature that I can add to ANY document).

If the patient would rather travel to the ED by personal car or taxi that is their choice.

I have never had a problem utilizing this approach.

I have had a family member call EMS for a dying patient who refused the EMS after they arrived. They got a bill.

I was present once when EMS was called or a hospice patient who had a DNR posted on the wall above his bed. That created quite a problem for the EMS when the daughter wanted them to resusitate. She did not have a MDPOA to show them. I was standing there decidedly NOT doing CPR as that was the wish of the patient and the EMS were obviously feeling VERY stressed.

The daughter was distraught and threatened to sue me and the EMS, but of course, that did not happen and she learned to have peace with her father's wishes for his EOL experience.

[nicki52731]

That certainly is the truth!