My goodness, I don't know what to make of this situation. I think the nurses are handling it very wrong, but since I am only 1st quarter, I will not judge, just ask questions.
I am shadowing in a local hospital. Here is the scenerio.
46 year old female enters the hospital for a two day stay after a complete abdominal hysterectomy. It is my understanding that she is self pay and has paid all bills upfront, this was the gossip at the front desk.
She has one child who is 18 years old. She wakes up, and tells the nurse that she wants the iv as well as the catheter removed. According to her chart, she has issues with being touched, she does not like to be touched due to previous abuse by her spouse.
Anyway, this patient wakes up, request to the nurse that she wants both iv and catheter removed. The nurses response was she could not do that because it was doctors orders. The patient tells the nurse she does not care about doctors orders and again request that these be removed, in addition she told the nurse that she would be going home at 8:00 PM that evening. The nurse told her she was going nowhere, and that she should go to sleep, she was just experiencing "side effects" from the drugs. The woman then told the nurse that she had 30 minutes to remove both, or she would remove them herself and that she was leaving the hospital that evening.
Soon, another nurse came in and asked the woman why she wanted to leave. The woman told her that she was self pay, and that she was unable to pay a large hospital bill and felt that she could take care of herself at home with the help of her family. This nurse explained that complications could happen, bleeding etc.
The woman said she was willing to take her chances. She again told the nurse to remove the iv and catheter. The nurse refused and said she would have to call the doctor. The woman told her she had half an hour to do so, as she wanted to start preparing to leave. The nurse then without asking this woman started to check her pad for bleeding. This woman pushed her away and told her not to touch her, that she would check and give her the results. The nurse then left. In the hallway, they discussed how insane this woman was and what a ***** and if she could not handle the care she should not have had the surgery. I might add that in her chart, she did have two large tumors as well as a 7cm ovarian cyst.
Soon, a social worker came in and started to tell this woman that the hospital was obligated to keep her for 48 hours after a surgery of this nature. The woman told her she wanted no more conversation, to please get whatever needed to be signed and take the iv and catheter out. They left to "speak with the doctor" after she told her that if she left the hospital she would be given no pain meds or prescriptions.
When they came back, this woman had removed (cut the port) the catheter as well as the iv. Her son was there, and they were walking out the door.
The hospital called security, who told her if she left she could be arrested. At that point, I do not know what happened, as the woman was escorted into an office and it was time for me to leave.
Will I encounter this often as a nurse? I sure hope not. This woman seemed, other than extreme pain to be of sound mind to me, but then again, I am a student. I thought, in my own opinion the hospital staff was rude, and I thought that the patient had the right to dictate their own care. Was I wrong?
Yes, indeed I did have a learning experience. I quite honestly hope I never experience learning like this again. It was very sad to see her so angry and so distrusting of others. I hope she stays happy and healthy the rest of her life.
To me this sounds like a potential lawsuit. The patient can sue the hospital for false imprisonment since it was not proven (via court order or POA) that she was mentally incompetent, regardless of how crazy her rationales were. If a pt is able to act on their own free will, they have a right to refuse treatment and leave the hospital even if death is the inevitable outcome. The hospital must document that the patient was educated as to the risks and possible results of leaving, and they must sign an AMA form, but they are well within their rights to leave. It sounds to me like the nursing staff was not used to a patient who refuses treatment, and is determined to leave. They should have had their ClinII notify risk mgt and the MD instead of gossiping about her ability to pay. Even if a pt refuses treatment they deserve to be treated with courtesy and respect regardless of how crazy it seems to us. Just be sure to get the proper forms signed and the right people notified to CYA!
Liebchen
58 Posts
Yes, indeed I did have a learning experience. I quite honestly hope I never experience learning like this again. It was very sad to see her so angry and so distrusting of others. I hope she stays happy and healthy the rest of her life.