Misunderstanding in ER

Nurses General Nursing

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Will a nurse get in trouble if their patient leaves hospital without having IV taken out of arm? I am a current NEW nursing student, I am still taking my A&P's. I went to the ER due to pain I was having and had to leave to go and get my son from school. I admit, I was a bit frazzled and rushing and told the nurse I needed to step outside to go and get my son and come back.  She said that it was fine as long as I came right back. I Did not realize that the IV was still in my arm until after I left. Hospital called within minutes and said that if I do not return, the police will be called to my house. I returned to the hospital within minutes of course, as it was a genuine accident. But the RN said that as a healthcare worker it was very suspicious to her and called me a liar. After having the IV removed, I left and returned to the hospital after getting my son. Upon being taken back to my room,  another nurse mentioned that I had just been there. And I told her that I had to leave to get my son, and she said "yes but you lied to us". After I was discharged, I walked past the nurses station and heard them talking about how "she lied to us.” I'm a little embarrassed and frustrated, and wondering if I should file a complaint, however, I feel bad that I may have gotten someone in trouble. Is that why they were acting like that? 

Specializes in Tele, ICU, Staff Development.
JKL33 said:

Safety issues are within their purview

Correct. But obviously the hospital would not enjoy putting on a OD defense by saying, "they would've killed themselves anyway"

 

**I have no idea what just happened with the separate posts and the quotes being attributed to Tweety.

Sorry.

That's strange! (the attribution error). Tweety may well not like this-is allnurses liable? haha

@JKL33 I enjoy your posts and exchange of thoughts.

Calling law enforcement for an IV is not in any hospital policy I've seen; it seems an urban myth. I could be wrong.

When I have told staff nurses not to call the police, the reaction is, "They might use it to inject drugs!" Yes, and they also might inject between their toes.

Yes, it's an error to allow a patient to go home with an IV, yes, there is a liability, and yes, everything should be done to retrieve the IV. 

But not the police. Is the expectation the police will remove it themselves? Forcibly put the patient in a police car and escort them to the hospital. Does anyone know?

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Specializes in Med-Surg, Trauma, Ortho, Neuro, Cardiac.
Nurse Beth said:

That's strange! (the attribution error). Tweety may well not like this-is allnurses liable? haha

@JKL33 I enjoy your posts and exchange of thoughts.

Calling law enforcement for an IV is not in any hospital policy I've seen; it seems an urban myth. I could be wrong.

When I have told staff nurses not to call the police, the reaction is, "They might use it to inject drugs!" Yes, and they also might inject between their toes.

Yes, it's an error to allow a patient to go home with an IV, yes, there is a liability, and yes, everything should be done to retrieve the IV. 

But not the police. Is the expectation the police will remove it themselves? Forcibly put the patient in a police car and escort them to the hospital. Does anyone know?

I think it's more like a wellness check if the hospital can't reach the patient.  The police might be able to find them and inform them it's in their best interests to return to the hospital and have it removed or perhaps check if the patient took it out themselves.  It's not a criminal investigation I wouldn't think, but I certainly don't know.  Doubtful the police would put a high priority on it if there are emergent things for them to do with their time.

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Nurse Beth said:

But not the police. Is the expectation the police will remove it themselves? Forcibly put the patient in a police car and escort them to the hospital. Does anyone know?

Simply notify the patient that we are trying to reach them to correct what may be a safety issue and to please give us a call.

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@traumaRUs Hi, no narcotics were given. I was having pelvic pain. They drew blood for Labs. And the IV was still in my arm after being flushed. She thought I was going right outside, as I told her that I needed to step out to go get my son. But I left the hospital. I feel silly now, and bad.  Had I been less vague the whole thing could've been avoided. Their frustration was that the nurse I spoke with thought I was going outside to get my son and coming back in. My frustration was that when I came back within minutes of them calling and had the IV removed I got an earful from multiple nurses. None of them were the original nurse that I spoke with before leaving. I apologized to both and said that I was rushing to get my son from the bus. Both said that I lied, and one told me that as a healthcare worker I should know better, and other patients could see/hear it so it was a little embarrassing. I'm not a healthcare worker I'm a first semester nursing student. I had my school scrubs on. But I'm aware now, I was in a rush and of course it'll never happen again. 

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I will say I suspect there is a lot of local variability in how things like this are handled, as well as what the rationales are. And I agree they are often not in writing.

There have been occasions where I've been told to handle something a certain way and even on the very surface of it what I was being told to do seemed like a bad idea, sometimes even flat out against the law. We collectively/on the whole seem to have a bad grasp of medicolegal issues and are prone to doing whatever an employer (or one of their representatives/employees) tells us to do. I have had a number of occasions where I flat out said, "Ah...no. I am not doing that."

 

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Specializes in Tele, ICU, Staff Development.
JKL33 said:

I will say I suspect there is a lot of local variability in how things like this are handled, as well as what the rationales are. And I agree they are often not in writing.

There have been occasions where I've been told to handle something a certain way and even on the very surface of it what I was being told to do seemed like a bad idea, sometimes even flat out against the law. We collectively/on the whole seem to have a bad grasp of medicolegal issues and are prone to doing whatever an employer (or one of their representatives/employees) tells us to do. I have had a number of occasions where I flat out said, "Ah...no. I am not doing that."

 

I agree. I always say " Show me the policy"

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Nurse Beth said:

I agree. I always say " Show me the policy"

I just say um no. ? "knock yourself out but you are wrong and I'm not doing that."

But really, as to the topic at hand, these do get handled different ways due to no malice whatsoever, just that every weird thing that crops up in an ED (daily occurrence)  isn't going to be covered in writing somewhere. So...various supervisors or admins on call have to make judgment calls. I have little doubt that a police call for an intact IV could easily come about by a well-meaning admin saying, "hmmm....well....let's call the non-emergency line and see if anyone is in the area and could drop by and let them know we are trying to reach them."

Next thing you know, someone who wasn't part of that situation has a similar situation and are advised by their peers, "oh, you have to call the police if that happens!" ?

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Specializes in OB-Gyn/Primary Care/Ambulatory Leadership.

In that topic, as the new manager of a n OB unit in a small community, I had to re-educate the staff that they cannot/should not tell people that if they leave AMA, their insurance will not pay for their hospital stay. Not only is that totally untrue, but might even be viewed as coercive. It's amazing and appalling how pervasive that myth is!

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Specializes in New Critical care NP, Critical care, Med-surg, LTC.
klone said:

In that topic, as the new manager of a n OB unit in a small community, I had to re-educate the staff that they cannot/should not tell people that if they leave AMA, their insurance will not pay for their hospital stay. Not only is that totally untrue, but might even be viewed as coercive. It's amazing and appalling how pervasive that myth is!

Yes! As a new provider, I have told SO MANY people that this myth is not true and can definitely be considered a threat to patients. Even attending physicians that have been at my hospital for years have said this. If anyone is suspicious, here's a reference:

J Gen Intern Med. 2012 Jul; 27(7): 825–830.Published online 2012 Jan 31. doi: 10.1007/s11606-012-1984-x PMCID: PMC3378751 PMID: 22331399

Financial Responsibility of Hospitalized Patients Who Left Against Medical Advice: Medical Urban Legend?

Gabrielle R. Schaefer, BA,1 Heidi Matus, MD,2 John H. Schumann, MD,3 Keith Sauter, BA,4 Benjamin Vekhter, PhD,5 David O. Meltzer, MD, PhD,5 and Vineet M. Arora, MD

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Specializes in Critical Care.

Interesting discussion. To the OP, sorry for the bad experience. Going to a hospital for any reason, is already stressful enough, without adding feeling like a child who did something wrong.  I don't know about you guys; I do know I would have requested to speak to a supervisor (or even addressed it, right then and there myself) if I overheard the nurses in the nurse station gossiping about me. Let this be a learning lesson for all of us and strongly suggest everyone take the time to review their hospital policy regarding this type of situations. 

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Many people, of all ages, leave a hospital setting (outpatient and inpatient) with a functional IV access. There are many IVs in the home setting. That in and of itself is not a cause for alarm.

If a patient is in the Emergency Department being seen as a patient, they are there for an emergent need, and everything else outside is on "hold". If the patient is well enough to leave to pick up a child (a phone call to someone else or to the day care to tell them you will be late could have resolved that issue quickly), then you have to question the need for the ED visit...was there truly an emergent need for an ED visit?

Just my two cents after reading this post.

 

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Specializes in Supervisor.

As an ED nurse and a House Sup, ED should have offered to "get" your son, this would have clarified where he was.... If their concern was you using illicit drugs, letting you leave the ED for any reason is an issue.  You could literally shoot up in the bathroom.  
As a house supervisor, call the patient, ask them to come back, I have also had them go to a local fire station or EMS quarters and have the IV pulled.  I've admitted home health patients who still has their line in because someone forgot to take it out at discharge.   
IV drug users don't need your IV to use people. They don't need to leave the hospital either. They just need the motivation and availability. 
 

Also nurses openly discussing a patient at the desk is a great way to get written up for privacy violations.  Seen it happen.  Expensive and never ends well. 

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