question about discharge from Outpatient Surgery

not you again · Oct 22, 2002

Hey, all of you great OPS nurses, I have a question for ya'll.

What is your hospital's or freestanding clinic's policy on discharging OPS pts. who have had general anesthesia when the patient makes it known that they have NO ONE at home to care for them? They have a RIDE, but no one to stay with them for the first 24 hours?

In the past 8 years that I have been in PACU/OPS, we have either refused to do their surgery until they came up with a "responsible adult" to stay with them, or else kept them in the hospital on "extended stay day surgery" status. But today both the CRNA and the MD insisted that the patient could go home without some one to be with them or to check in on them. The CRNA & I even discussed it with the QA person, and they agreed that we "couldn't expect the patient to alter their normal living arrangements just because they had surgery."

However, I did point out that our IV CONCSIOUS SEDATION discharge instructions state right on them that the patient needs to have a responsible adult with them for the first 24 hours. HMMM, IVC sedation, yes, but GENERAL ANESTHESIA??? No, we'll send them home.

On top of it all, the patient was so unable to care for himself adequately, that the doctor's office draws up his insulin in several syringes at a time for him and he takes them home and gives himself "one a day", and the other pills he is on is a "blue one and a white one". Gooooooood, this is a person that should be going home to an empty house after general anesthesia! :eek:

Am I the only one who sees something wrong with this picture?

I would really like to know what your hospital policy is about having an adult to stay with the patient.

A co-worker brought up the fact that many people probably go home "with an adult", but then may send that person home and ultimately stay by themselves. I pointed out the difference is that this is not known to us and that we are not legally responsible as long as we have told the person that they need adult supervision. However, today's situation is "fore-knowledge" and I believe that we could be held responsible if anything happens if this is not "standard of care". I always thought having an adult with a person who has had day surgery was "standard of care", but if it is not, please let me know.