when patients go off the floor...

Nurses General Nursing

Published

Specializes in ER, progressive care.

...To go outside for a "walk," do you have them sign an AMA form?

I've never thought about it until yesterday when I received report on a patient who likes to go downstairs a lot with a family member for a walk. The dayshift RN had the patient sign an AMA form just in case and told me that you're supposed to do that, but I'm not sure if that is an actual policy that we have.

Specializes in Gerontology.

Our pts go off the floor all the time. Out to the coffee shop with their family. Outside in nice weather for some fresh air. In fact, we encourage it as it gets them out of bed even if they are in a wheelchair. I have never heard of calling the AMA , that is for people that leave and don't come back.

Specializes in ER, progressive care.
Our pts go off the floor all the time. Out to the coffee shop with their family. Outside in nice weather for some fresh air. In fact, we encourage it as it gets them out of bed even if they are in a wheelchair. I have never heard of calling the AMA , that is for people that leave and don't come back.

That is my thought, too...I have patients leave all of the time. This was just the first time I have ever heard of a nurse making a patient sign an AMA just to go off the floor for a little bit.

Specializes in Pedi.

My patients go off the floor all the time. All I do is inform the family that they must remain on hospital grounds. I have never once had someone sign an AMA form for that... they aren't leaving against medical advice, they're stable enough to go off the floor for a while.

Specializes in Critical Care.

AMA forms are for anything the patient wants to do that goes against recommendations; exceeding a fluid restriction, going off tele to go outside, etc.

Specializes in Acute Care, Rehab, Palliative.

We have a clipboard where our patients or the family member signs them out.Quite often we have patients leave the hospital propety.They have to have a doctors order staing they can go out and they sign a release of responsibility in case something happens while they are out.AMA forms are for if they are doing something the MD has advised against.

I guess you should refer to your policy. On our gyno/postpartum floor the patients are required to sign an AMA form when they walk off the floor so the hospital is not responsible if anything were to happen while downstairs. However, on the floor I work on now, they don't have to sign anything because we love for family members to wheel them downstairs or go outside on the patio for some fresh air. It can be depressing sitting in a hospital room all day. I am not sure how many other floors require the AMA form at our hospital.

Specializes in ER, progressive care.
I guess you should refer to your policy. On our gyno/postpartum floor the patients are required to sign an AMA form when they walk off the floor so the hospital is not responsible if anything were to happen while downstairs. However, on the floor I work on now, they don't have to sign anything because we love for family members to wheel them downstairs or go outside on the patio for some fresh air. It can be depressing sitting in a hospital room all day. I am not sure how many other floors require the AMA form at our hospital.

The only policy I can find is leaving AMA...for a patient actually leaving prior to discharge. I do not see anything regarding signing an AMA form to go outside. I work on a tele floor so when patients leave they get disconnected. I remember during a staff meeting several months ago, they mentioned that we cannot hold a patient hostage in their room. If they want to go downstairs, they are allowed to, providing that they are stable. Our manager at the time just stated to disconnect the patient from the monitor and explain to them that while they are downstairs we cannot properly monitor them, and then document that in the nurses notes ("patient requesting to go downstairs; explained risks of being off the monitor, patient verbalized understanding" etc). Nothing about an AMA form. But that was also several months ago. :confused:

Specializes in Family Medicine.

Our patients aren't allowed to leave the floor. Most of them are hooked up to PCA's or loaded up on pain medication.

We had an interesting patient escape the floor/hospital for a few hours. He had a bullet lodged near his aorta and had a chest tube. He was scheduled to have surgery in the morning. Apparently, he went walking around town, chest tube and all. I guess this all occurred because he wanted to have a cigarette.

Glad I wasn't his nurse.

Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.

The only reason our pts want to go off the floor is to smoke. They try and get sneaky by saying "I need to get some fresh air", " I want to go down to the gift shop", "I want to go down to visit with my family down in the cafeteria while they eat dinner". No, no and no. If you're that well you need to go home. The sneaky ones I fib and say they can't leave the unit because of their cardiac monitor, it's against hospital policy.

I had one pt whose room was right next to the elevator. She stumbled outside with her PCA, tripped, tipped over the whole IV pole all before she had even lit up. Security found her and hauled her back upstairs. That night she was crying over her skinned knees.

Boo stinking' Hoo.

The stable, honest, long timers I let off the unit with responsible family.The others can sign an AMA form.

Specializes in ICU.

Our patients (guests? clients?) have to sign themselves out. Plus, they are told that if anything happens to them while outside, they must go back thru the ER instead of back to whatever department they were in. For instance, if they should get SOB or have chest pain, they must go directly to the ER. We are a non-smoking facility, so they can't go out to smoke, anyway.

Specializes in Cardiac, PCU, Surg/Onc, LTC, Peds.
Our patients aren't allowed to leave the floor. Most of them are hooked up to PCA's or loaded up on pain medication. We had an interesting patient escape the floor/hospital for a few hours. He had a bullet lodged near his aorta and had a chest tube. He was scheduled to have surgery in the morning. Apparently, he went walking around town, chest tube and all. I guess this all occurred because he wanted to have a cigarette. Glad I wasn't his nurse.
Haha nice. There was a pt on out floor who had gotten a pass signed by the MD to leave the hospital. Don't know WHAT reason for leaving he told the MD. He left wearing baggy clothes and came back with 2 brown grocery bags of expensive steaks he had to keep in our refrigerator. Hmmm....
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