As in lost, not expired... Well, this just happened to me a few days ago, and I'm still shaken up about it. I had just started my shift and the craziness they call bedside report (which was just implemented in the med-surg units). His room was my first stop, and he was sitting on his bed wearing street clothes instead of the hospital gown. Odd? Maybe, but he has an extensive Hx of CVAs and dementia, so some things he does are not considered "normal" anyway. So, the outgoing nurse doesn't like bedside reporting and stood at the doorway while giving report. We moved on to the next rooms and all is well. A few mins. later (still doing report), I see my PCA and another nurse escort him back into the room, as he was wondering the hall. When the PCA went back to do VS, he was gone, and she immediately came to tell me. To say I panicked is an understatement! I searched the entire unit (pretty big) and couldn't find him... Stairwells, elevators, even outside, and nothing! I informed the charge nurse who, in turn, called security and the nursing supervisor. Everyone was mobilized, but he was still nowhere to be found!
I was so mad because it seemed that security and the police weren't doing enough! The investigator looked like he was on his first day at the job! I spent most of my shift shuffling back and forth between my other patients and the security office looking at the tapes trying to figure out if he had, in fact, left the hospital. The family was informed, but they didn't seem concerned as "he does this all the time." All I could think of was that if this was my parent, I'd be hightailing it to the hospital trying to find him! All the big wigs were telling me everything would be all right, that I didn't need to worry, that my bases were covered, and that there was nothing I could've done differently. After all, it's not like we can physically prevent anyone from leaving if they so desire! Rationally, I understood what they were saying, but that didn't keep me from worrying that this confused, elderly man may have been wandering outside and possibly gotten hurt, or worse.
It seemed no one understood that I wasn't worrying about my behind, but about him! Screw the job, this is a person we're talking about! By the time I left after my shift, he was still missing, even though they had "searched everywhere" in the hospital. My coworkers and managers were very supportive, which made me feel very grateful and made me remember that I'm lucky to work with such wonderful staff, even though this job is less than ideal. Thankfully, they found him unharmed, 24 hours later, hiding in plain sight. They took him to ER to get him checked out, and I haven't heard anything else from this ordeal. I'm just extremely thankful that they found him and that he never left the grounds. I can only imagine what could've happened. So my question is, has anything like this happened to you, or on your unit?
I've "misplaced" a few pregnant patients over the years. One labor check who was instructed to ambulate for an hour then be rechecked apparently got bored doing laps of the hall and wandered off down the road to a convenience store in her gown for a quick snack! We spotted her hiking back up the hill.
Another, an antepartum patient admitted on total bedrest took off, got in her car and went looking for her significant other who apparently wasn't where he was supposed to be.... She went driving around town checking out the residences of his other women! No question - she told me this when she came back
I'll break this up with a little humor. I THOUGHT I lost a patient once. Couldn't find him. Checked in the bathroom, saw nothing, the light was off. Called a code gray.....I was panicking (I was new and a float nurse) checked the room again... the bathroom again. Turned on the light this time. There he was on the bowl.
Hospitals are responsible for their patients. There is protocol to follow when a patient elopes. Physician, police, family must be notified. However, if the patient is mentally alert and oriented, not under legal or medical restraints, a hospital is not a prison. We can, must, do all we can but they are free to leave.
Specializes in Early Intervention, Nsg. Education.
I had an interesting experience as a relatively new nurse, maybe just short of 2 yrs. experience, while working in LTC on a head injury floor...
I was driving in town, a little less than a mile from the facility, and who do I see staggering along the sidewalk in house slippers, but one of the residents! Not just any resident, but a head injury pt with a history of violence. :uhoh21: A bit of history: this was "supposedly" an alarmed, but not locked unit with monitored exits, and was very proud of its restraint-free behavior management protocol...which worked quite well when the unit was staffed with trained nurses and aides at low staff:resident ratios, but after the facility was bought out...you get the picture.
I rolled down my window and chatted with him while my friend ran into a nearby elementary school (!) to call the facility. (This was before everyone had a cell phone, and there was NO WAY I was inviting this guy into my car!) A short time later, a nurse from the facility came over and lured him into her car with a snickers bar. I drove back to the facility and filled out an incident report, the nurse who picked him up said she'd document in his chart...next time I worked, I discovered that there was NO record of the incident! I asked the supervisor if I should document on "John Smith's" elopement yesterday and was told..."I don't know what you're talking about, John went for a walk with Nurse X, that's all."
Needless to say, I left shortly after that!
Safety tip: If you ever find a violent resident wandering the streets, call the police!:redlight:
One incident sticks out firmly in my mind. It was YEARS ago, when I worked at a NH, but it was unreal.
This gentleman had dementia. He also had mobility issues; we needed to use a sit-to-stand to get him from bed to chair, etc. Had one of those "standing" recliners. We had made attempts at time in the past to stand him just with staff, and they didn't go well....he wouldn't stand up straight, would barely bear weight...so the lifts were definitely necessary.
One afternoon, his W/C was in the hallway, in it's usual place outside his door....empty. WTH? Looked everywhere, could not find him. Mind you, he should NOT have been able to get up and walk ANYWHERE.
Eventually, he was found way out in the parking lot. In the driver's seat of a coworker's car, trying to close the door on his legs (he was very tall, she was about 4 foot 8, so the seat was too far forward for him to fit). Not sure why her car was unlocked; the keys weren't in it, though, so he couldn't have gotten any farther. We're guessing he tried car doors until he found one that was open.
He was not able to tell us what he was doing, too confused. I can't picture him walking all the way out there, it was amazing.
The confused pts are one thing, but the completely oriented ones are another. I can honestly say I've misplaced :uhoh21: a confused pt a time or two.
I've had an assortment of pts leave AMA.
But for a pt to be so callous as to torture their nurse by just leaving is something I have not experienceD ....yet.
I just left a thread about nursing and "caring". I can't imagine anything that would short circuit the caring area of my brain quicker, than to have a pt dismiss me and my job so completely.
In the hospital where I work at, we had a pt escape through the window. He actually made a rope out of the bed sheets and climbed out the 2nd floor window. Luckily police was able to find him and bring him back
This happened to a co-worker of mine. Pt. left with a family member to "go get lunch". Nurse and NM were outside looking for her when she pulled back into the parking lot in a family members car (I work at a small facility). They let her come back (I had her that night)-but the doctor ordered a drug test on her and she was discharged early on my days off. She had a central line too.
I realize this is two different settings, but as a PP stated...if this happened in LTC the place would have been closed down.
I believe UPMC has a big old policy in place for wanderers. At the start, they assess on admit and when they are id'd as being at risk or have a history of this then things are initiated.
He actually made a rope out of the bed sheets and climbed out the 2nd floor window. Luckily police was able to find him and bring him back
bagladyrn, RN
2,286 Posts
I've "misplaced" a few pregnant patients over the years. One labor check who was instructed to ambulate for an hour then be rechecked apparently got bored doing laps of the hall and wandered off down the road to a convenience store in her gown for a quick snack! We spotted her hiking back up the hill.
Another, an antepartum patient admitted on total bedrest took off, got in her car and went looking for her significant other who apparently wasn't where he was supposed to be.... She went driving around town checking out the residences of his other women! No question - she told me this when she came back