Please do not let altered old ladies covered in urine sign out AMA

[MikeyBSN]

So the police brought an elderly lady in the other day after they stopped her for erratic driving. She smelled of urine, she was dirty, and wearing a hospital robe. Although she knew some of her medical history and could answer some questions, she did not know what year it was and she did not know who the president was. She was wearing a hospital band so I thought maybe she wandered off. So I call the hospital on the band and talked to one of the nurses so I could find out the patient's story. The charged nurse told me, "Yeah she was here, but she signed out AMA".

[anonymurse]

Hey, don't question the pt's former nurse's actions. She managed to skilfully transfer her pt to your care, didn't she?

[PAERRN20]

Perhaps a 302 was in order?

[Pepper The Cat, BSN, RN]

How much time elapsed between her discharge from the other hospital and admittance to you?

could she have been fine on d/c and the hit the booze/drugs etc?

[MikeyBSN]

How much time elapsed between her discharge from the other hospital and admittance to you?

could she have been fine on d/c and the hit the booze/drugs etc?

Not much, she was driving home from the other hospital when she was stopped. She didn't seem like the boozer/drug type.

[oramar]

That is a tricky call, false imprisonment is a pretty heavy charge. It is a damned if you do and damned if you don't situation. In ideal situation you would have an army of mental health workers at you beck and call and they could do a quick eval. and you could hold the patient for a day or two. It is not like that in real world. It is hard enough to get a hold people to do mental health eval. in a life and death situation and when it is sort of ify it is next to impossible. By the way, many years ago when I was a student and mental health care was a lot better than it is now. I sat in on 72 hour hearings for several days as was required by my nursing programs. In ever case the judge released everyone of these early dementia patients that were held for 72 hours. You see our society puts a great premium on personal liberty.

[Kyrshamarks, BSN, RN]

Unless they have a court order holding them there, they are free to sign out and not a thing you can do about it.

[dulcemorena]

I understand not forcing her to stay, but if their orientation is altered then at least try to make sure they have on clean clothes or clean pajamas. Maybe thats just my ltc cna experience talking. Or how about contacting a social worker, can they enforce some type of temp custody? At least to keep her from driving and possibly injuring herself or someone else?

[Whispera, MSN, RN]

As a side note, I wonder if this lady had a UTI? Apparently she was used to driving and had access to a car. Disorientation and the evidence of incontinence lead me to believe this might be the case. A UTI is one of the leading causes of acute onset disorientation, confusion, and delirium in the elderly....