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Patients who stick around after discharge/legal risks

Emergency   (9,822 Views | 20 Replies)
by JKL33 JKL33 Member Nurse

13 Followers; 31,597 Profile Views; 4,056 Posts

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Larry77 has 10 years experience as a RN and specializes in Trauma/ED.

1,158 Posts; 8,558 Profile Views

We do give some cab vouchers but we also escort some off our campus by security. If they refuse to leave the campus after they are discharged and are loitering the police may be involved with threats of trespassing.

In my opinion anybody treated and released should not be in or around our hospital. If they are homeless there are shelters if they are high they need to be high at home and not around other "sick" patients.

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497 Posts; 5,292 Profile Views

We've had issues with patients needing cab vouchers frequently. It's normally the same patients and the ones who come by ems to boot. They abuse the system of course. I guess it happens everywhere and is a by-product of a learned behavior. It's a bummer, but what can you do?

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33 Posts; 4,088 Profile Views

It is sad not having hospital deal with this issue...they just pass it on to their front line workers(nurses)....our security at work is not the greatest, and they are quite old.

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Altra is a BSN, RN and specializes in Emergency & Trauma/Adult ICU.

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The only times we put someone in a cab is if we have secured a bed for them at a women's shelter or in the event of really unusual extenuating circumstances. We make very judicious use of bus tickets too.

I completely agree that the patient's medical chart should be closed out once they are discharged. Anything that happens after that which needs to be documented needs to be communicated in some other format, such as incident report.

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Roy Fokker is a BSN, RN and specializes in ER/Trauma.

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Mini rant:

I am so SICK and TIRED of docs promising patients cab vouchers.

"Oh don't worry. The nurses here will get you a cab voucher". Like it's a magic pill or something.

Unless you were incapacitated, how did it become the hospital's responsibility as to how you got home?

Cab vouchers are scarcer than hens teeth around here. On average, our ED gets about 3/month (and this is an ED that sees over 6000 patients a month!)

To all those who 'promise' cab vouchers to patients, please, please, please consult a nurse before opening your big mouth!!!

The End.

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mmutk has 11 years experience as a BSN, RN, EMT-I and specializes in Emergency Dept, ICU.

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Our security has no problem kicking people out onto the street. And those who panhandle for rides and money in the parking lot too. Once Discharged off property you are too exit the property.

Sleeping is not allowed.

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Pat_Pat RN has 8 years experience and specializes in ER, Med/Surg.

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This is assuming you have cab vouchers...or cabs for that matter...or security! *I* was security in our ER when I was a unit clerk, just because I was the only guy (besides the docs, who all weighed about 100 pounds..hmm) in the department.

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13 Followers; 4,056 Posts; 31,597 Profile Views

Thanks everyone.

No security here.... and we use cab vouchers judiciously, for special/extenuating circumstances (rare); this pt already had his chance at a very expensive voucher for cab ride home (d/t distance from the hospital) and it did nothing but enable the behavior. Totally abused. This is someone who in the past has gotten a ride home from the hospital and walked into the house and called 9-1-1 again for a free ride to another hospital. This particular case is so frustrating as I believe Risk Management has taken this to both local authorities and the court system to no avail.

As advised here, I will not chart on this pt post-discharge. Since my original post, I've been told to let the house supervisor handle this patient after discharge, so that's what i plan to do, and if I ever document anything, it will be that I have notified the supervisor of the patient's discharge and lack of means to leave the facility.

Thx!

JKL

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17 Posts; 1,296 Profile Views

Our ED too has this problem with many pts who abuse the system and never have a ride home. We give cab vouchers but only if all possiblities have been attempted. We tell them all that we no longer do this but we do give these out as quietly as possible. These pts quickly catch on to this as I'm sure you know. We have pts who will go to the ED just for something to do (kind of sad, really). We have the frequent flyers who have shown up to the ED for the same complaint 3 times in a 24 hr period! By this time the ED docs end up admitting them probably because they fear legal action. If they are harrassing others in the waiting room we have our security call the local police. The more times you can get it documented the better I think. Once these guys are discharged they are discharged. There is no reason we as nurses should be held responsible for them at that point. If anyone should be it should be the hospital for not coming up with an action plan for these instances. :banghead:

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