Drunk paitents

locolorenzo22, BSN, RN · Dec 6, 2009

Patients always have the right to sign out AMA, unless they are not their own guardian/poa. I work detox, we get quite a few who decide they don't want treatment. You can not restrain someone to give them tx...false imprisionment, assult, and battery come to mind.

**canoehead, BSN, RN** · Dec 6, 2009

You can let them go- if they are with a responsible adult usually we have no issues. If they are alone and so drunk they may walk into traffic or otherwise hurt themselves we call the police. Police either take them to the drunk tank, or return them to us in custody, depending on their medical condition.

A drunk that is in custody and is uncooperative usually has a whole new outlook on life if we can put them to sleep for a few hours. I loved the thorazine shot one of the docs used to order, and their vitals stayed rock steady while they slept.

elkpark · Dec 6, 2009

Patients always have the right to sign out AMA, unless they are not their own guardian/poa. I work detox, we get quite a few who decide they don't want treatment. You can not restrain someone to give them tx...false imprisionment, assult, and battery come to mind.

That's not necessarily true -- if the person is acutely dangerous to himself or others, there is always the possibility of a psychiatric involuntary hold (depending on the specific definitions/standards of the law in your state). It's up to the responsible treating professional to decide whether that's appropriate/warranted.

I used to do CD evals in a big, urban ED (I'm a psych CNS), and the ED physicians used to get great results getting acutely intoxicated people to stay voluntarily for a few hours to sober up by informing them that, if they tried to leave right away, the physician would commit them. Offering them the choice of a bed, a meal, and a few hours' nap vs. spending several days on the psych unit gave them a whole new outlook on things ...

Alternator81 · Dec 7, 2009

It doesn't make a difference in any state you are in, you can only restrain a patient if it is believed that they are an immediate threat to themselves or someone else. So if the drunk guy says he doesn't want a specific treatment & wants to leave you let him go and he is signed out AMA.

I did have a wasted pt in the ED who wanted out, but he wasn't going anywhere-- he was cuffed to the bed and accompanied by 2 officers in the Trauma bay. Once he sobered up enough to figure out that he was going to jail, he kept trying to throw himself on the floor to keep him in the hospital.

Meriwhen, ASN, BSN, MSN, RN · Dec 7, 2009

OP: you can't hold the patient in the hospital for treatment unless they are an immediate danger to themselves or others...and like Elkpark said, it'd be a psychiatric hold, not a medical one.

Also, he could still refuse medical/psychiatric treatment even as an involuntary psych hold. It might not work in his favor when it comes time to review his case...but until a court-orders it, you can't force treatment on him.