Will my license be at risk?

Nurses General Nursing

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I work at a adult day center, I sent someone to the hospital because he demanded it. It was for itching. I didn't call his emergency contact until 3 hours later. The emergency contact called the center and is upset, wanting to sue, call department of aging.

no dementia but forgetful.

Specializes in Critical Care.

Is the patient legally deemed incompetent? Otherwise, it's the patient's discretion as to whom they want contacted.

Is the patient legally deemed incompetent? Otherwise, it's the patient's discretion as to whom they want contacted.

No he's alert x3 and make his needs known.

Specializes in Critical Care.

If the patient is legally competent then you actually can't notify anyone of their admission to a hospital without their expressed consent to do so, patients do need to be asked if there is anyone they want contacted, but the family member in this case appears to have a poor understanding of things work.

Specializes in Case Manager/Administrator.

I do not think you really did anything wrong you should however called the family to let them know. Some family would rush right over to the hospital and your late calling kept a family form being there for their loved one. When people say they are going to sue let them as long as you have done everything you could you should be fine. Even calling 3 hours later. The person was notified. You might catch heck form the stew as most states require "timely notification" . I would not fret over this too much.

Specializes in Critical Care.
I do not think you really did anything wrong you should however called the family to let them know. Some family would rush right over to the hospital and your late calling kept a family form being there for their loved one. When people say they are going to sue let them as long as you have done everything you could you should be fine. Even calling 3 hours later. The person was notified. You might catch heck form the stew as most states require "timely notification" . I would not fret over this too much.

There's an important clarification there, the family can only be notified at the direction of the patient or with consent from the patient. As a nurse who works in an ER, the understanding family seems to get from nursing homes regarding this is a bit of a pet peeve. Family are often under the impression that if they ask to be notified, then they have to be notified, when really it's completely up to the patient, for us to notify someone that a competent patient has been admitted to the hospital without their consent is a HIPAA violation. And often after meeting these family members it becomes clear why the patient didn't ask that they be notified.

Specializes in ICU, LTACH, Internal Medicine.
No he's alert x3 and make his needs known.

This is not about being A, Ox 3 and making needs known. It is about being able to make his or her own medical decisions. Either patient is "competent" to make such decisions, in which case he's free to go anywhere he wants, including ER, for any reason, or he was previously declared "incompetent" by two M.D.s and there was some sort of agreement legally established about who is supposed to make such decisions: DPOA, guardian, patient being Ward of State, etc.

In either case, even if you sent him in ER for non-emergent issue, your license is safe.

Commission of aging can do nothing with it. No one can sue you for that because one of four main components of suit, namely, "harm" or "damage", is absent (well, that emergency contact person can, maybe, claim "emotional damage" but it probably be a good entry for "the most stupid legal claim of the USA, 2018"). And BONs have their hands more than full with bigger fish.

The worst thing that might happen is your DON would fire you. But if he or she couldn't make peace with just one hysterical family member and let those ridiculous allegations even reach your ears, you might want to run out of that place for your life anyway. Your DON should knew all along that all that hulabaloo worth less than the air it moved; if he or she still allowed you to get scared outta your pants, it means that you need a new boss.

Specializes in SICU, trauma, neuro.

The BON has bigger fish to fry.

Specializes in ICU, LTACH, Internal Medicine.
There's an important clarification there, the family can only be notified at the direction of the patient or with consent from the patient. As a nurse who works in an ER, the understanding family seems to get from nursing homes regarding this is a bit of a pet peeve. Family are often under the impression that if they ask to be notified, then they have to be notified, when really it's completely up to the patient, for us to notify someone that a competent patient has been admitted to the hospital without their consent is a HIPAA violation. And often after meeting these family members it becomes clear why the patient didn't ask that they be notified.

Even if family member is DPOA, it doesn't mean that he or she must be notified about every little thing. If an action is covered under "consent for treatment" and doesn't need separate consent, then whoever signs the paperwork consents to it authomatically. If placement of Foley, CT with no contrast, moving from one room or unit to another or med administration are included in general consent, then it is totally up to nurse and her courtesy to call and inform the family. Not doing so implies no liability as long as the action is covered - i.e. doesn't require separate consent.

I faced this situation innumerable number of times and got to telling people rather bluntly that they can either 1) sit there 24/7 and so be able to personally witness everything we do with Dear Mother, in which case I will be happy to answer their questions and even bring them some coffee, or 2) have a nurse hanging on phone with them 24/7 and let Dear Mother, as well as 3 or 4 other people die because the nurse would be too busy updating them. That usually hit the nail.

If a nurse lost his/her license every time a patient or family member was upset about an element of care...we wouldn't have any registered nurses.

Specializes in Clinical Research, Outpt Women's Health.

Your fine.

If they are in adult day care they are probably not competent, but by getting them a higher level of care you took the safest course.

The family is upset because you didn't notify them in a timely manner or give them the option of transporting themselves which may be less costly. I am not going to second guess your decision, but maybe next time consult with your supervisor before calling 911 if the situation seems non-emergent?

The bottom line is they have nothing they can sue for and your license will not be affected.

Specializes in Case manager, float pool, and more.
Your fine.

If they are in adult day care they are probably not competent, but by getting them a higher level of care you took the safest course.

The family is upset because you didn't notify them in a timely manner or give them the option of transporting themselves which may be less costly. I am not going to second guess your decision, but maybe next time consult with your supervisor before calling 911 if the situation seems non-emergent?

The bottom line is they have nothing they can sue for and your license will not be affected.

Agree with all posts here. Nothing here to worry about.

You did not do anything wrong in sending that person out. However, I think you should have called the emergency contact earlier to let them know that so and so was being sent out. The hospital is not behind you for not calling earlier, but your license is fine. You did what you were supposed to do and call earlier next time. People threaten to sue and if you did not send the person out, it could have been worse and condition could have deteriorated more. Normally, it isn't so bad to call emergency contacts, but if you know that they will be nasty... its another story. I had to call an emergency contact before and it didn't matter what it was, she was not pleasant. I dreaded calling because I think she was in denial of how much the family member deteriorated and did not want to hear that he was not doing as well. I hope your facility does not use the fact you did not call earlier as something to use against you.

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