Fix me NOW (but on my terms or I'll leave AMA)

Specialties Emergency

Published

Just a vent, everyone.

Dear patient, I cannot fix your problem of 3+ years in the ER on Sunday evening. I am sorry (but not surprised) that your doctor fired you. I am sorry you have sat in this room for so long but I was tending to my OD who arrested shortly after arrival. I am sorry you are going through this.

HOWEVER, stop telling me you are going to sue me and the doctor. Stop telling me this hospital ****** you up (why do you keep coming back then). And stop cursing, it's getting old. And after all that, you are leaving AMA when we recommend admission????? Really???? After "we didn't do anything???" Going to administration? I think they will be satisfied with my documentation.

I know this scene played out in hundreds of ERs across the country over the weekend. I was polite and professional and feel I expressed empathy. I also urged the patient to stay. But I just had to vent here :(

Specializes in Emergency & Trauma/Adult ICU.

Wait - you know my favorite patient, too?? :sniff:

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Tonight it was we were the best hosp ever cuz we didnt have 6 hour wait times.. ?

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Specializes in ED.

I had a patient recently that presented with belly pain. Glucose >1500, sodium was 113. This patient was in their early 20's. They decided to leave AMA. Counseled them extensively on the risks of leaving, explained the serious risk of death related to their labs, they were adamant about not wanting to be admitted. Discussed the possibility of staying in the ED a few hours longer so we could at least stabilize them a bit more. Nope, insisted on signing out and denied any thoughts of self-harm. THEN WHY WASTE MY TIME?!

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Specializes in HH, Peds, Rehab, Clinical.

I love how they think their threats of leaving will make us BEG them to stay. Um nope, you aren't hurting ME a bit by leaving. In fact....

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Specializes in Emergency/Trauma/Critical Care Nursing.
I had a patient recently that presented with belly pain. Glucose >1500, sodium was 113. This patient was in their early 20's. They decided to leave AMA. Counseled them extensively on the risks of leaving, explained the serious risk of death related to their labs, they were adamant about not wanting to be admitted. Discussed the possibility of staying in the ED a few hours longer so we could at least stabilize them a bit more. Nope, insisted on signing out and denied any thoughts of self-harm. THEN WHY WASTE MY TIME?!

Maybe they were going through candy bar withdrawals like our addicts do lol :p

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Specializes in SICU.

The funnest thing for me was actually handing them the AMA form (in record time i'll have you know) and watching their mouth drop open. and the ensuing phone calls to their friend/ride/family that " they are kicking me out now...come and get me..."

I have no time for idle threats from patients. I am here to help you and if that makes no sense to you since after all you are in a hospital, then the exit signs are pretty clear.

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Specializes in Psych ICU, addictions.

If a patient tells me they want to leave AMA, I reply "fine by me, I'll call the doctor and we'll get the process staretd." More often than not, I've just called their bluff because they change their mind.

And if they still want out...well, if they're AOx4 and competent, then Vaya con Dios. If they don't want to be there and aren't being held, then let's get them out and open up the space for someone who does want treatment.

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Specializes in Emergency/Cath Lab.
If a patient tells me they want to leave AMA, I reply "fine by me, I'll call the doctor and we'll get the process staretd." More often than not, I've just called their bluff because they change their mind.

And if they still want out...well, if they're AOx4 and competent, then Vaya con Dios. If they don't want to be there and aren't being held, then let's get them out and open up the space for someone who does want treatment.

Exactly. Too many other businesses cater to the threats and demands of their customers. Im not one of those people to do that. You say you are leaving and you aren't half dead, later gator, see you in a few weeks I'm sure.

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Maybe they were going through candy bar withdrawals like our addicts do lol :p

When Glucose drops down past the patients 'norm', then yes, the body does respond. The body acts like it is going hypoglycemic and sends out all the warnings so the patient will eat and bring the glucose back up to 'norm.' This is one of the reasons (not the only one) that makes it hard for Patients with really high blood sugar to bring the numbers down on their own. But I am sure you learned all that in nursing school.

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Specializes in Emergency/Trauma/Critical Care Nursing.
When Glucose drops down past the patients 'norm', then yes, the body does respond. The body acts like it is going hypoglycemic and sends out all the warnings so the patient will eat and bring the glucose back up to 'norm.' This is one of the reasons (not the only one) that makes it hard for Patients with really high blood sugar to bring the numbers down on their own. But I am sure you learned all that in nursing school.

I did, I was just making a tongue in cheek comment... Thank you though

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Don't let the door hit you.........

Dang JR you beat me to the punch.

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Specializes in Med Surg.
Exactly. Too many other businesses cater to the threats and demands of their customers. Im not one of those people to do that. You say you are leaving and you aren't half dead, later gator, see you in a few weeks I'm sure.

I work the floor and have the same attitude. We've got plenty of sick patients who really want our care; I don't waste time with people who make threats like this. They're adults and can make their own bad decisions.

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