Patient drives off after anesthesia

[sungrl01]

Hey all. Yesterday for the first time in my career I had a patient drive off after surgery..eye surgery no less. He had general anesthesia and he drove off after I begged him and his family members in the car not to let him drive and legally under the influence. My charge nurse was told me this morning "it happens all the time. People drive around corner and change drivers." I filed incident report immediately afterward but was chastised this morning by charge saying "I shouldn't have stayed on clock to file report and should have filed this morning". My nurse manager advised me to tell dr and document but told me not to call police. Is this the norm like they make it out to be? Because it seems crazy and dangerous for this to happen it seems like there should be better way to handle this.

[kbrn2002, ADN, RN]

Interesting thread. My first thought is how impaired is the driver post surgery? Is it maybe equal to a drink to two, or is it more? I mean, a bartender certainly doesn't alert the police about a possible impaired driver for every person that gets behind the wheel after leaving a bar. Then my next thought is who is responsible for determining that the driver is too impaired to safely drive? In the case of the mythical before mentioned bartender there is plenty of case law that supports the bartender and/or bar being held responsible in the case of an impaired driver leaving and causing harm but I don't think I've ever heard of this happening in relation to an driver that is impaired due to a surgical procedure. Probably because the patient signed some forms acknowledging that he or she is not going to drive home that would absolve the office of any responsibility should something tragically happen during the drive. I know the few times I've had outpatient procedures one of the forms I had to sign clearly stated I had to have a driver with me when I left and this was also verbally addressed during pre-op.

[NurseOnAMotorcycle, ASN, RN]

I would have called the police and filed an incident report.

THIS

Sounds like they are trying to cover up so their facility doesn't end up in the news.

[Horseshoe, BSN, RN]

Then my next thought is who is responsible for determining that the driver is too impaired to safely drive?

I work in endo. The patients receive propofol, and frequently also fentanyl (and sometimes additional drugs). There is no need to "determine if they are impaired." They are about 30 minutes out of anesthesia, so they ARE impaired and should not under any circumstances drive a car.

Probably because the patient signed some forms acknowledging that he or she is not going to drive home that would absolve the office of any responsibility should something tragically happen during the drive.

Okay, to me, my concerns go beyond liability. Even if I'm absolved of legal and financial liability, I could not reconcile this with my conscience if I did nothing about a known impaired driver leaving my facility and he or she went on to hurt or kill someone else.

I think about my daughters, who mean everything to me. If something horrible happened to one of them under identical circumstances, I'd be tortured inside to know that a medical professional knew that their patient was violating the agreement to not drive after receiving anesthesia, and they did nothing about it because they didn't feel financially or legally culpable. Not their fault? Not their problem? No. Just no.

[Loracs72]

I had outpatient surgery and I had forms sent to me specifically stating that someone had to come with me to drive, or they would cancel the surgery. The staff does check and speaks to your friend,relative to make sure they are the driver. And the staff escorts you to the door.

I felt fine and really felt that I could drive ( I had Fentanyl and Versed preop) so I probably was impaired for driving ! I think the staff needs to FYI the police that the patient was driving or have security in the hospital refuse to let them leave ( Of course they could sign out AMA).

[FurBabyMom, MSN, RN]

I know our policy is that they need to have a friend/family member 18 or older to help them get home. Otherwise they don't have surgery or we keep them overnight as observation (depending on the situation). Then again we do sometimes have "outpatients" who get admitted to inpatient status too...so there is that. It is my understanding that we escort outpatients to their cars and their family/friend is driving at that time. Now, I can't speak for what happens around the corner from the hospital or our surgery center...

But if I saw it I would be documenting it (and documenting the education the patient/family received) as well as completing an incident report. It is very likely that I would call the police but there is no guarantee that that would do anything.

Also - what is this flack you're getting about staying over to do an incident report? Unless it's an especially crazy set of circumstances I can have most of ours done in about 5 minutes... I think, recently, the longest it's taken me was 15 minutes with interruptions to complete one.

[LadyFree28, BSN, LPN, RN]

I would've stayed and did that incident report.

I think in hindsight you would've done more; this may not be the last time this occurs; if you feel as though you want to call the cops as well if this happens again, do what you feel comfortable doing

[Horseshoe, BSN, RN]

It is very likely that I would call the police but there is no guarantee that that would do anything.

Of course not. But by not calling the police, you are guaranteeing that nothing will be done to stop this person from hurting someone else.