There is a policy in development for our ED that deals with nurses physically detaining patients that want to leave after receiving narcotics. The tentative wording is that nurses are to.....physically detain them. I see this as battery
and/or kidnapping and certainly not legal. What are your ED's doing? There is a degree of liability when an impaired person leaves the ED. The risk of injury when physically restraining someone against their will is a given.
Security on our campus are not to ever touch anyone with the intent to stop them. So why would the nurses?
When feeling better, most patients want to leave the ED. But what they don't understand is that they are feeling better because they have been medicated. To possibly, decrease some of this, inform the patient prior to medicating that you are obligated to observe them for a reaction for at least an hour and they are not permitted to drive. Having them sign a legal statement of understanding might cover you and the hospital if the patient is non-compliant If the patient is persistent in leaving, I would get the physician involved and document his orders for restraint and be sure he/she orders the restraint for the safety of the patient. Just my opinion.
The ED I work in generally asks the pt if they have transportation arrangements prior to narcs. Albeit, some do lie. Once the ride arrives we require that the driver come into the ED, show the whites of their eyes and the pt is dc'd. This policy that states "detaining the pt" is not been enacted at this time and most ED staff are smart enough to ignore this!! Personally I will NEVER put a hand on a pt that wants to leave. The ED staff does not have the right to detain a narcotically impaired (by the staff) person. Would everyone like to have them have a ride home, you bet. Does it always happen? No. Who has the time to watch the elopers or will stand in their way???
CrunchRN, ADN, RN
4,556 Posts
"But because we refuse to hold people responsible for their own behavior, we get ourselves in this quandry"
I so agree. Drives me nuts.