Questions concerning Canadian law

[Mona77]

Hi,

I am going through Canadian law concerning nursing practice, resulting in confusion,

although Canadian law is quite similar to German law.

I have some questions and hope that there is someone out there who can give a detailed

answer.

If a patient refuses treatment, e.g. at the emergency unit and is not willing to stay in the

clinic any longer:

is the patient obliged to sign a form that he is leaving the clinic on his own will and responsibility, against the physician`s advise?

Does this form has a legal name?

Who`s duty is it?

Is a RN obliged to demand clarification, and logically inform the physician?

Or someone else, too?

What course of action is supposed to be taken, if a patient leaves without signing?

What consequences await the nurse and other occupational groups if a life-threatening

situation occurs during way home, and the affected patient has not signed

a (I call it) "leaving" form?

Thanks!

[Fiona59]

I know the form you are asking about. It's a "left against medical advice" form, also known as the "AMA" -- against medical advice.

If you can get your client to sign it good on ya. In my hospital (we're inner city), the patient just usually leaves. I remember one guy who left to carry on with gang obligations. First the staff knew about it was the empty bed, the IV pumping onto the floor, we followed the blood drops to an exit. Just charted along the lines of "patient left unit during time period of x-y after advising staff he wasn' F'n staying in here". He didn't have any warrants outstanding (police were already involved) but we did notify hospital security.

I've never heard of anyone having issues over it. In an ideal world a doctor, or resident would take the form in and discuss it, but nurses have done it. I think in my province it just has to be a licensed healthcare professional.

Usually if they leave against advise, they know the risks and it's entirely their choice.

[Mona77]

I am familiar with such cases, at our emergency unit patients with alcohol intox or drug intox often search their ways out of hospital or violently refuse treatment,

but we are obliged to write a report, in some cases the police has to be informed, too!

There had been issues at the court, patients wanted compensation after having an injury or accident on their way home or life-thraetening consequences, and they turned it as if they were refused a treatment.

People are tricky!

Documentation is getting more important, otherwise you need sufficient witnesses!

[loriangel14, RN]

We had an inpatient in the hospital where I work once once that was difficult to deal with and the family insisted that we give him no sedation.The doctor said "like it or lump it".One day they took him out on a day pass and never brought him back. He was my patient and charted that he was taken out by family and never returned.I notified the doctor and that was the end of it.

I have had others sign an AMA form and leave with family.