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/Cath Lab.
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.

There is always that ONE person...

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Me : Sir, you can absolutely sign out AMA. But please be aware that the Narcan we gave you when you were dropped of in the parking lot will wear off and you may stop breathing again. You were not breathing when you came in, we had to use a bag to breath for you.

Patient: I got stuff I gotta do today.

Me: Okie Dokie, as long as you understand that leaving now may result in your death.

Patient: I do. Is there medicine that you could give me so I don't stop breathing while I am at my probation officer meeting. I cant mess that up.

Me: Um, what? ** Gets AMA form**

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Specializes in cardiac, ICU, education.

True Story - Christmas 2007

Patient in IMCU: "I am getting out of this ******* place. You people are all idiots. Like you know what the **** is going on."

Me: "Sir, it is quite clear by your lab results and your EKG that your heart is not healthy. We really need to keep you overnight and do some testing on you to make sure you are not, in fact, having a heart attack."

Patient: "What the **** do you know, you are just a ******* nurse. Here, clean out my bedpan (As he throws his urinal at me an soaks me in his urine). Isn't that what you are paid to do? I am getting the **** out of here."

Leaves AMA

2 days later - dead in the ER

Not that I wished for this man's demise, but karma is an ******* you-know-what

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Does anybody know for a fact whether or not if its true that when a patient leaves AMA that insurance won't pay the bill?

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Specializes in Emergency Room, Trauma ICU.
Does anybody know for a fact whether or not if its true that when a patient leaves AMA that insurance won't pay the bill?

You think any of these people have insurance?? Not that there aren't jerks with insurance but the majority of the frequent fliers we get in the ER who act like this have no ins. That's also why the use the ambulance like a taxi cause they don't pay the 2 grand it costs each time.

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Specializes in Telemetry, IMCU.
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.

Agreed. Im a type 1 who had a rebellious phase of DKA 4x in my teen years. Lowering it from the usual highs caused massive panic from me because I felt hypo. Worst part is sitting down and trying to tell yourself you won't pass out from hypo just because it went from 500 to 240 and it feels like I'm 40. :confused:

Thankfully I'm over that phase. :D

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Specializes in Telemetry, IMCU.
Does anybody know for a fact whether or not if its true that when a patient leaves AMA that insurance won't pay the bill?

I asked my insurance company and they said that they do pay even if the patient leaves AMA.

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Specializes in Telemetry, IMCU.
There is always that ONE person...

That one person what?

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Well...Medicare/Medicaid.

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Specializes in ER, TRAUMA, MED-SURG.
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....

I know- most of the time I'm thinking "and if u go now I can pee or squeeze in a few minutes to actually EAT!"

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Well the flip side is I have been that patient lol I was a new nurse and it was a Sunday, I was having shortness of breath and and blood in my sputum. I went to the ER. The Triage nurse was like what are you doing at my ER you need to go to your PCP.... I left came back a few hours later because i was feeling worse and crawling to the bathroom. The triage nurses ends up being my charge nurse and when he sees me he tells me I told you to go to your pcp. long story short I had pneumonia. Well the nurse was on the other side of the curtain attending to another patient and I was on the phone with a friend telling them about the whole ordeal... I MEAN my DOCTOR was more caring and compassionate than my nurse....that never happens.... long story short the nurse must of overhead my conversation because he came in to give my discharge instructions and and sat down trying to be all buddie buddie. I looked at him said thanks I know what to do I'm a nurse... lol he just kinda back peddled after that....I mean I know all of us have bad days and I know most of us don't go to the doctors unless were absolutely dying but I want to tell you after that experience I went home and was crying in the fetal position... I mean he actually made me feel ashamed for going to the hospital....as a patient I hated the experience as a nurse I learned a valuable lesson that day.

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Specializes in Emergency Department; Neonatal ICU.

Kcwestportboy, I'm so sorry that happened to you. I hope you recovered well. Just as a reminder to those from the general public who might be reading this, it is a vent thread. Sometimes, the verbal abuse we take gets to us and we have to let it out to our fellow professionals who understand. One of the main reasons I was compelled to write this was that after I spent 2+ hours in one room trying to save someone's life (a young person who died in the ICU several hours later), I walked back into that patient's room and was subjected to multiple f-bombs, threats to sue me and was told I wasn't doing my job. Very ironic that this patient then left AMA.

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