Has anyone seen a pt involuntarily discharged???

[traumaRUs, MSN, APRN]

okay, i work in an area where there are only fmc hdus. has anyone ever seen a pts involuntarily discharged? what were the circumstances?

thanks.

[blueheaven]

Yes, there was a patient that continually was non-compliant and was a very"frequent flyer" to our nursing unit. The nephro doc eventually took him off HD for complete and total noncompliance. This was only after suggesting that this person get some mental help and the doc did try everything to avoid discharging him.

[traumaRUs, MSN, APRN]

Thanks....we've had two pts moved to other FMC units in the area due to assaulting staff but no one discharged.

[Onekidneynurse]

Thanks....we've had two pts moved to other FMC units in the area due to assaulting staff but no one discharged.

They were discharged from your unit and eventually they will act up there and get the boot there too.

[Tish88]

I have discharged 2 patients from my unit for abusive / disruptive behavior. We had our department meeting with them and gave them their 30 day notice paperwork.

I don't put up with patients being abusive to my staff. One of them ended up in a psych ward and I do not know what happened to the other, since NO center in the area would take either one of them.

[sissib]

Yes, we had one pt that kept messing with her needles while on tx causing her to bleed all over, we documented verrrryyyyy well and the doc had her sent to psych for 96 hr hold and then she was not allowed to come back. She went to the other unit in town and they made her husband sit with her all during tx and she eventually was booted out there, reasons unknown. Pt # 2 was doing cocaine and became violent with staff and other pts, police called x2 and sent to psych x2 and now he is in an nursing home and has to take court ordered risperdal and he still comes to us but is no longer agitated.

[sherilyn321]

The new CMS requirements are stricter on the reasons for involuntary discharges. A physician can do it easier, but facilities have to notify the ESRD Network. Are you just looking for what you can discharge a patient for, or the process on how to discharge them?

[Valerie Salva, BSN, RN]

I have never seen a pt discharged. I've seen pts threaten and assault staff. One even threatened a sec'y with a knife. As long as pts are making money for a unit they don't get discharged in my experience.

[GeauxNursing]

our MD has d/c'ed a couple patients over my 5 years of experience. Continual noncompliance, refusing to let us do our job, refusing to remove anywhere NEAR enough fluid q tx, etc. Basically, if you won't do what I suggest for your care, you can go somewhere else.

[NDXUFan]

Yes, there was a patient that continually was non-compliant and was a very"frequent flyer" to our nursing unit. The nephro doc eventually took him off HD for complete and total noncompliance. This was only after suggesting that this person get some mental help and the doc did try everything to avoid discharging him.

I am curious, you make the clinic sound like a jail?

[NDXUFan]

our MD has d/c'ed a couple patients over my 5 years of experience. Continual noncompliance, refusing to let us do our job, refusing to remove anywhere NEAR enough fluid q tx, etc. Basically, if you won't do what I suggest for your care, you can go somewhere else.

In other words, if you do not let me run your life, you will be discharged. If you ever had a taste of your own medicine, you would sing a vastly different tune.

[NDXUFan]

Thanks....we've had two pts moved to other FMC units in the area due to assaulting staff but no one discharged.

I agree, but what about staff assaulting and insulting the patient who is paying thousands upon thousands of dollars per year to FMC or Davita? Great consumer service skills.