Pt rights to go to the hospital

[mittels]

I just dont get it! I work in an assisted living facility as a HSD-RN.

We have many residents on hospice. There is one resident who is having terminal agitation mixed with periods alertness to the point of being totally oriented. I know that she has signed a DNR on Monday when she joined hospice and she has since had a significant decline over the past week. Prior to admission to hospice on Saturday this last weekend she was taken to the hospital and had to be coded. At that point is when she joined hospice when she came back to the ALF. She stated during one of her alerted states "I just dont feel right, I feel like I am sinking, I want to go to the hospital, take me to the hospital now." I called S.S. and the on call nurse told them of her rapid decline and terminal agitation and of her statement that she demanded to go to the hopital. Her daughter and son were present at the time by the way. I do know that when I worked for hospice for 2 years that if a pt demanded to go even with a DNR we needed to follow through. Well the nurse - on call came out and the SS worker came. Her wishes were not followed through by the nurse with a simple call to the Dr. Nope she just gives an order for ativan and morphine. I dont get it!!!!!!!!!!! Any one with any thoughts?

[mittels]

Originally posted by mjlrn97

It still amazes me how so many medical professionals, who ought to know better, seem to believe that "do not resuscitate" means "do not TREAT". I used to see this attitude all the time in long-term care, especially among doctors and paramedics, and it just sent me into orbit!! If a patient wants to go to the hospital, he/she should go to the hospital. Period. Not that the MS and Ativan weren't appropriate in this case, but this patient should NOT have had to get some kind of "approval" before being transferred to the hospital. Phooey!!

I totally agree with you. In my assisted living and these laws, it needs to have a hospice nurse present and verified by her/him. I am however going to get to the bottom of it including going to the hopice dns.:imbar