leaving with iv lock in

HappyNurse2005, RN · Mar 13, 2006

How do they leave with it still in? ARe they leaving AMA? or just refusing to let you take it out after giving them discharge instructions?

My only left AMA pt ripped his out on his own.

BittyBabyGrower, MSN, RN · Mar 13, 2006

I agree, how are they getting out? When someone goes in with d/c instructions how hard would it be to take it out? And why ask...liability wise I would think letting someone leave with one is asking for trouble.

zacarias, ASN, RN · Mar 13, 2006

Let me ask you this, do doctors round and say "Guess what you're outta here. Take care."? Of course the patient doesn't know that nursing still has to do the paperwork, get the patient to sign, remove IV etc. The patient, if he is set to go may be upset and leave thinking, "hey the Dr said I can go. I'm not staying here any longer."

If they leave despite you talking to them, there is nothing you can do. The only thing would be to take it out the first time you see them and talk to them about d/c. The only problem with this is they might even leave quicker this way.

ellencrn · Mar 13, 2006

i meant people who leave with the IV lock in and we usually know that they are drug abusers. some will sneak out after it has been put it and some just want to have a straight access. these are people who know it is there and leave anyway.

neneRN, BSN, RN · Mar 13, 2006

We attempt to contact the pt at home and inform them that they need to return to the ER to have it removed. If we are unable to contact them, or if they refuse to come back, then we send law enforcement to the home. Problem is when they are homeless or have given incorrect contact info. Happened just the other day, and it wasn't your typical frequent flier/drug seeking type, just an angry pt that decided he couldn't wait 30 sec to have the nurse remove it. The charge nurse contacted the pt at home, and the pt stated he had taken it out himself and would not return. Still sent out law enforcement as a CYA.

puddlesrn · Mar 13, 2006

I would not endanger myself or others when insisting to take out the IV but have you ever considered letting the police know about the patient. Have them go by the patients home to have it removed? I also live in a area where there are lots of drug abuse and we have patients leave with IV sites in. Can't help but be suspicious.

meownsmile, BSN, RN · Mar 13, 2006

I havent ever had an abuser leave with one in. Ive had people discharged and someone forget or not get in to get it out and have made a home visit after working hours to take them out. But those folks are usually just one who left with it inadvertently.

If you have someone who is a known abuser, maybe question the doctor before he goes in the room if he is planning discharge on that patient. If he says yes, someone needs to get in there right behind the doctor and take it out. Just another reason to be aware of which doctors are on your unit, making rounds with the doctor and being aware of and participating in discharge planning.

LandDRN · Mar 13, 2006

You legally can't physically force a pt to do anything. I'd write an incident report describing pt refusal/ sudden sneak out/ AMA /whatever, report it to your charge nurse and supervisor and document, document, document!!!

gypsy nurse · Mar 13, 2006

We usually try calling the patient at home first and tell him/her that they need to come back in and have the IV removed by personnel or come back and physically show us that the IV has been taken out by them. We tell them if they don't we will send the police out to their house, and we do send them out if needed. The police if not too busy, usually attempt to help. If it truely was an accident and the pt can't get back into the ER, I have instructed them over the phone how to take it out and apply pressure, and have them do it while I am listening to make sure the bleeding stops.

I guess it just depends on the situation.

ERNurse752, RN · Mar 13, 2006

We call the police. Haven't ever seen someone inadvertently leave it in or forget about it. Usually it's intentional.

Jabramac · Mar 13, 2006

For those pts who are not drug abusers but the IV was accidentally left in because nursing forgot to take it out or they left with out nursing d/c, would any of you call on the phone and give step by step verbal instuct to the pt or family to remove the IV them selves?