Signing out AMA

[CapeCodMermaid]

OKAY here's the question....a patient signed out AMA 2 days ago...all well documented that we told her she wasn't ready to go and was at risk....she left anyway. She is now back in the ER wanting to come back. I said NO. I've never worked in a place that took someone back after signing out against medical advice. My administrator wants to take her to make nice with the docs. I am outraged and know I will be over ruled (another story altogether)..what do all y'all think.?

[Noryn]

It depends on the "complex need" however the sad face of reality is this, most nursing homes have 1 lpn for about 25-30 patients. Depending on the shift they may have anywhere between 1-5 aides and that is it. So you are limited in how much care you can provide to a patient. Most long term care facilities are not equipped to handle acute alcohol withdrawal and ultimately the patients needs will not be met there. Administrators dont care about this though. They see the money the pt will bring in, if they really had the best interests of the patient in mind they would decline the pt and have the ER or hospital refer the patient to a center that can address alcohol abuse.