Leaving facility AMA...

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Specializes in PERI OPERATIVE.

So, I had a patient sign herself out AMA yesterday 4 HOURS after delivery! She was strongly encouraged to stay, but nothing I did short of putting handcuffs on her would make her stay.

What is the shortest time after delivery you have seen a patient sign out?

Oh, and I could rant and rave about this person, but I'm sure it would be breaking HIPAA laws.

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Specializes in Certified Med/Surg tele, and other stuff.

Ob? 2 hrs later. Med/surg ....an hour after arriving to the floor.

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Did she take her baby with her??? My son and I were packed up and loaded in the car exactly 5 hours after giving birth. But I had him at a freestanding birth center, so that was routine for their typical, uncomplicated delivery.

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Specializes in Hospice / Psych / RNAC.

I didn't go out AMA but I left with the OB nurses practically having conniption fits. It was my second birth and I had moved to a place where I knew no one. I went to the hospital to give birth with my then 12 year old son.

When I was all packed up and they escorted me and my new baby down to the parking lot they were stunned to find out I was going to drive myself home. I told them I drove there and I was going to drive myself home. I felt perfectly fine and had already stayed 3 days in the hospital. They were telling me I couldn't so I got in my car and put my baby in the seat that I had in there for him and told my other son to get in and left.

I really didn't realize what the big deal was. Now that I'm a nurse I probably would have listened to the nurses but I just wanted to get home. I guess everyone dropped the ball on discharge planning because the subject never came up until we were in the hospital parking lot.

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Specializes in PERI OPERATIVE.

Nope, baby is still a patient. She did visit him for 4 hours today, how nice. Also, she asked what time she could 'pick him up' tomorrow. I must be the highest paid babysitter ever!

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Specializes in Nurse Leader specializing in Labor & Delivery.

I don't think there's anything wrong with that, in a healthy woman who had an uncomplicated labor and recovery. Women who have homebirths are at home at 4 hours after delivery, too. :)

Even at FSBCs, they generally only stay 4-6 hours after delivery before going home.

I left approximately 8 hours after my last delivery. My baby had to be transported to a higher acuity NICU which was 90 minutes away, so I made my OB discharge me.

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Specializes in Emergency Medicine.

I so thought this was going to cover "Advanced Maternal Age".

Darn...

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I had my babies at a freestanding birth center, and we went home 3-5 hours after delivery. I was well educated about potential complications, had the phone number of the midwife in case of problems/questions, made an appointment with the pediatrician for the next day, and had a home visit by a nurse three days after.

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I had an emergency C-section at 34 weeks pregnant. My daughter was transferred to another hospital not too far away and put on a oxygen hood. A day and a half later, I found out they were taking the hood off and that she was able to be held, I told my OB he better let me leave lol. Not two hours later, I was discharged. Although, he did make me go to his office the following Monday to have the staples removed and to check on my healing. I could barely walk, but there was nothing that was keeping me from holding her the first time!

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Specializes in psych, addictions, hospice, education.

Where's the anger coming from? Was she a pain in the neck about it all? Are you intensely worried about her because she didn't have a "normal" birth and needed to be there longer than she chose to stay? It seems like there's more to this than her just leaving sooner than recommended...

Does she have other children at home that need care? If she doesn't go to work, might there be no money to buy food? Is she an addict and has to go get her next fix? What else is up here?

I do empathize with your feelings. I've had them about AMA patients too. Sometimes it's hard to keep in mind that we can only do what we can do...

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Specializes in NICU, Psych, Education.

In Houston a few years ago, there was a firefighter who delivered her baby at 9 pm and had to take a departmental exam for a promotion the next morning at 9 am. I'm not sure how long she stayed hospitalized, but she took - and aced - the exam on two hours of sleep only 12 hours after delivery.

http://www.firerescue1.com/fire-news/15198/

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Specializes in Community, OB, Nursery.

We had a patient who left AMA about 8 hours after delivering, but I can't remember exactly why she left. This was her 4th or 5th baby. I do remember that she pretty much told us she wasn't coming back for her baby, though, and she didn't.

I didn't have a problem with her leaving, but it broke my heart that her baby was starting life with the deck stacked against him.

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