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How does your hospital address patients who refuse all care

Nurses   (1,125 Views | 25 Replies)

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The patient who does not want any vitals, labs, tests, or even an IV but they demand to be treated.  Does it matter if it is a private, state, or single payer system?

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Sour Lemon has 9 years experience.

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That varies greatly depending on the circumstances and the staff involved. We do psych evals, involve family, discharge them "broken", wait for them to have a good day and change their minds, discontinue their narcotics, etc. I have no idea about the financial side of things.

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Tenebrae has 8 years experience as a BSN, RN and specializes in Mental Health, Gerontology, Palliative.

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Give them the forms for signing out AMA? encourage them to change their minds, however if they are refusing treatment no doctor would chart narcs or any other meds without a clear clinical reason

If there is a clear clinical need eg patient taking a paracetamol overdose and needing the n-acetyl systine infusion then it can be forced

 

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

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Homework?

 

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Nurse SMS has 9 years experience as a MSN, RN and specializes in Critical Care; Cardiac; Professional Development.

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Document, educate, discharge.

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839 Posts; 13,173 Profile Views

I agree that this sounds like a homework question. In my experience patients who refuse all care do so because they've exhausted all efforts to harass the MD into giving them their particular drug of choice. Document, educate and discharge like SMS said. When they sign the AMA they're agreeing to accept whatever consequences come their way as a result of refusing care, be they financial or otherwise.

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181 Posts; 4,748 Profile Views

On 5/13/2020 at 2:42 AM, TriciaJ said:

Homework?

Ha ha. Nope, is that really a question? Thanks I'll be looking for that one. I'm sure when I get that far, patient refusal, will be the LEAST of my problems.

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181 Posts; 4,748 Profile Views

It is not a homework question. I doubt some will believe me. I have to ask, why would it matter anyway on a forum for Nurses?  Unless it is an eat your young type of situation.

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Tenebrae has 8 years experience as a BSN, RN and specializes in Mental Health, Gerontology, Palliative.

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1 hour ago, DesiDani said:

It is not a homework question. I doubt some will believe me. I have to ask, why would it matter anyway on a forum for Nurses?  Unless it is an eat your young type of situation.

Na its more of a not wanting to do a students home work for them. 

Happy to help out with those questions once the student has put their ideas across 

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

14 Followers; 3,782 Posts; 40,784 Profile Views

2 hours ago, Tenebrae said:

Na its more of a not wanting to do a students home work for them. 

Happy to help out with those questions once the student has put their ideas across 

Exactly.  If not homework, what made you think to ask this question, especially regarding private, state or single payer system?  It smells like a homework question.  If you tell us what your thinking was, we may be able to help you.

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TriciaJ has 39 years experience as a RN and specializes in Psych, Corrections, Med-Surg, Ambulatory.

14 Followers; 3,782 Posts; 40,784 Profile Views

Interesting how the same thing always happens. 

"No of course this isn't homework."

"Then give us more information so we can continue this conversation."

*crickets*

Yup.  It was homework.

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181 Posts; 4,748 Profile Views

Was just bored at work pondering why these people arent just discharged, especially if they are alert and can walk.

Yes, the why is irrelevant, but there you go. Every question could be interpreted as a homework question.

On 5/17/2020 at 12:17 AM, TriciaJ said:

Interesting how the same thing always happens. 

"No of course this isn't homework."

"Then give us more information so we can continue this conversation."

*crickets*

Yup.  It was homework.

Um no. I have a life.

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