Pts away from hospital

[perfectbluebuildings, BSN, RN]

OK I don't want to be too specific... but have any of you had a situation where a patient, long-term and close to d/c anyway, left the hospital and came back an hour later? How was it reacted to? It wasn't really talked about at the time d/t other things going on but then in report, the next shift was horrified and the NM had to be told and all that jazz. and later on thinking maybe it wasn't that big a deal in this case, hard to explain, and also wish I would have said something to the pt/family at the time but for some reason didn't realize it was such a huge thing (charge nurse and on-call for pt's physician group were aware at the time it happened)... and then they were going to have this big huge deal suddenly when nothing much was made of it on the previous shift when it actually happened, as i said d/t a lot of other things going on... and the pt is very conscientious and may have been persuaded by a fam member to do this, so it doesn't seem to be their fault... I know I sound ridiculous, but I would appreciate perspective. Feel free to say whatever you think- I fully understand that this sounds crazy.

EDIT: And, if you think this is too revealing and should be deleted, let me know please

[TazziRN, RN]

Yes, it's a big deal, because if something had happened to the pt during the elopement, the facility could be held liable. That's why, in the ER, if a pt elopes s/he is logged out as though discharge had happened. If s/he returns an hour later and wants to be seen, s/he has to sign in again and start from scratch.

[vloho]

I thing the reason everybody freaked is d/t the liability of the Pt leaving and an accident should happen .the first person to mention a lawsuit would be the family that talked said Pt into leaving.

[texas_lvn]

but have any of you had a situation where a patient, long-term and close to d/c anyway, left the hospital and came back an hour later? How was it reacted to? It wasn't really talked about at the time d/t other things going on but then in report, the next shift was horrified and the NM had to be told and all that jazz. and later on thinking maybe it wasn't that big a deal in this case, hard to explain, and also wish I would have said something to the pt/family at the time but for some reason didn't realize it was such a huge thing (charge nurse and on-call for pt's physician group were aware at the time it happened)... and then they were going to have this big huge deal suddenly when nothing much was made of it on the previous shift when it actually happened, as i said d/t a lot of other things going on... and the pt is very conscientious and may have been persuaded by a fam member to do this, so it doesn't seem to be their fault... I know I sound ridiculous,

LTC- not that big a deal.

HOSPITAL, BIG DEAL.

1) if, when insurance company finds out about it, they can deny ALL of their monetary responsibility and leave the family/hospital high and dry

2.) of course injury to pt and hospital liability

3.) no Dr order to release pt, no AMA signed

4.) things happen. Don't be to rough on yourself about it and be glad nothing happened, we learn most from mistakes.

5) no you dont sound ridiculous, you sound concerned and upset, that is what we are here for!

WAIT, if I read correctly, you said that on-call group knew about it, and also charge nurse? Is this documented anywhere? If so, the slack should be off you and on them. To sound teachery (is that a word?:chuckle ) Documentation covers your anatomy!!

Good luck with your situation~!

[TazziRN, RN]

LTC- not that big a deal.

HOSPITAL, BIG DEAL.

Even in an LTC it's a big deal if the doc didn't okay it.

[texas_lvn]

Even in an LTC it's a big deal if the doc didn't okay it.

Sorry, that was implied. It is on our standing orders.

Texas

[bagladyrn, RN]

The last time this happened to me with a hospital inpatient, I had to notify: charge nurse, house supervisor, pt.'s MD,security and sherriff's dept (all at 2 a.m.). I also called her home number as listed in her records and wrote the whole thing up in an incident report. When the pt. strolled back in about 2 hours after leaving, I then had to call all these people again to let them know she was back. It's all about liability and CYA.

[NurseLatteDNP, MSN, DNP, RN]

I have seen our patient driving off the hospital property with a IV pole hanging out of the back car window! That was a shocker. That patient was discharged and the security was called. They waited for her to come back and send her back to the ER. She thought that was not fair, so she left the hospital without going there (without the IV).

[perfectbluebuildings, BSN, RN]

Thanks for all your replies.

We didn't know the pt had been out of the hospital till they came back- did have permission to be off the floor w/in the hospital, and there are resource rooms etc. where pts may go- the only reason it came out is b/c pt had issues shortly after coming back to floor and family member let us know where they'd been. I let the on-call person know what had happened and the charge nurse was with me when the family told me. The family had thought they had permission from MD and I haven't been back so I don't know what eventually happened. I am afraid there was some unwritten "code" or something I broke by telling the charge nurse and NM on next shift and people will be upset with me, but I just had questions about documenting it when realized it was such a big deal.

[vampiregirl, BSN, RN]

Ok, I'm just curious. If a patient is allowed off a floor, how would a nurse be aware if the patient also left the hospital?

[perfectbluebuildings, BSN, RN]

They are supposed to notify us when they are going and where, and almost always do. That's a really good question that I never thought of... but it's never been an issue before. Most of these patients have been coming to the hospital for years and are very aware of the importance of the care etc and hasn't occurred to them to leave.