ER policy/unresponsive pts

[gonzo1]

What is your ERs policy on unresponsive patients. In the last 3 weeks we have had female patients being brought in unresponsive from local bars and a couple of times the people who came with them and stayed with them turned out to not be friends or family after patient was lucky enough to respond to treatment and recover. In the meantime we are giving them updates on patient and letting them sit with patient (if they are sober and behaving). So far we didn't even think to call police when amb brings patient in, but now I'm thinking we need to call police when patient comes in. Maybe they could do something to verify people with patient actually have a right to be with patient or at least start to keep track of how many times this is happening.

Thanks in advance for your help with this matter. My ER needs to develop some quidelines and we don't have a clue.

[pkapple]

If you want to get nutso crazy...When i was in a neuro icu - we allowed only immediate family, exceptions were made for some so's, more distant relatives, etc. But the fun part came when "Mamma" made a list of who was acceptable! Poor 23yo in a coma - now step-mom and boyfriend aren't on the list, but of course "mamma" hasn't been around for the last 5 years.!!

Even had a case where current wife of a patient wouldn't allow stepchild patient has raised from infancy!

Finally got a policy, we are not the POLICE, we can't id everyone, so in icu, we ask if visitor is family and use our judgement on visiting by anyone. The rule change was really beneficial for the floors. I recall one family that had 23 names allowed to visit, forgot poor sister from out of state, so floor ever so vigilant said sorry you are not allowed, of course family who made list pitched a fit...of course sister Sue can visit....on and on and on. So we are not the police, every nurse has the right to prohibit visitation by anyone for patient care,agitation,etc. This can get hairy when one nurse is willing to walk around 75 assorted visitors, and another prefers to change dressings privately or whatever....anyway no policy is fool-proof and some are just crazy!

[Ruby Vee, BSN]

in icu, we ask if visitor is family and use our judgement on visiting by anyone.

i always ask "are you a friend of hers?" if they're family, they'll respond with "i'm her step-mother" or "i'm her sister." if they're friends, they'll say "yes," so then you know they're not family.

if you start out by asking "are you family?" a great many of them will answer in the affirmative even though they're merely this week's greeter from church. boyfriends will say "yes," even though she's also dating 3 other guys.

[TazziRN, RN]

We do not call the police in alcohol- or drug-related cases because we don't want people to be afraid to come in for help. There are times when I have felt they needed to be called and I was told I couldn't, that it was against ER policy.

[Altra, BSN, RN]

traumarus, we are going to start notifying the police when these cases come in. I like your idea about asking for info. You're right, if "friends" can't answer simple questions they probably shouldn't be allowed in room. Especially if intoxicated like this guy was.

Thanks to everyone for the helpful hints. We are going to start using every idea listed so far. Still looking for more if anyone else has some ideas.

Just want to make sure all bases are covered and the safest care provided for our patients.

Just to be clear ... you're going to be calling the police for every drunk that fell off the barstool, every college kid that drank until he/she passed out, and anyone else who used what ever combination of drugs was available?

Here, we'd be tying up significant police manpower from midnight to 4am just about every night ... Don't think it would fly here.

[gonzo1, ASN, RN]

Thanks for all the info. All great ideas to take into consideration. You're right about tying up the police. Fortunately we don't get that many unresponsive patients, it is a fairly rare thing for us. And we don't want to do anything that would scare people that need help away. We have had more than one stabbing victim and gunshots victims dropped at the door. It would be sad if people were afraid to at least do that much.