do staffs have a right not to send pt to hospital?

[Ms.RN]

My patient is alert and oriented X3 and is her own responsible person. She insisted on sending her to the hospital despite the fact that there is nothing medically wrong with her and no reason to send her to the hospital. She just wanted to get more drugs at the hospital. So do staffs have a right not to send her to the hospital or are we putting ourself in liability for keeping her and not sending her out?

[Nurse_Smith]

# 1. Welcome to Allnurses.

# 2. The pt does indeed have the right to seek medical attention. Throw this up the chain of command as per your institutions P & P.

# 3. Yes some nurses eat thier young as evidenced by some of the previous post. Personally I like mine w/ a little mango salsa and time to age.:rotfl:

[CoffeeRTC, BSN, RN]

Yes, you need a docs order for everything in LTC, but if the resident wants to go and demands to go, I'd be calling that doc back and letting him know, I would also involve the DON and ADM in this. Residents of nursing home have the right to make their own decisions about medical care. Period. They can refuse care all the time or request a certain procedure or med. Yes it might be a PITA and you might feel stupid, but once again, this pt would take thier self to the hospital if they were at home. Make your you are totally doing CYA and assessing and charting everything.

I'm sure you, your facility would get into more trouble for not sending them.

[CapeCodMermaid, RN]

...just curious...how does one get to be a "super moderator"??

[traumaRUs, MSN, APRN]

To the OP - I have not worked LTC in many years. However, just from a general perspective, yes, I would definitely send this resident.

[LoriAlabamaRN]

I have come across this problem before, and yes, you have to send. I do call the MD first and make sure he knows. Anytime the resident requests to be transferred to the ER for eval, we document that it is based upon her request and off she goes.

[jodyangel, RN]

Wait til you work at a hospital and have to deal with the people who are drug seekers.

We have a few "regulars" who pop into the ER every few weeks, c/o chest pain and they are always admitted. So they live it up for a few days on Dilaudid and then are discharged. All the tests are run and nothing is ever found.

I agree....never get calloused or assuming about someones pain. BUT, when you know the person and you know all the history, its hard not to have conflicting feelings about the person. Of course, one day, when they cry wolf it Might be the real deal.........difficult situation all around.

[BBFRN, BSN, PhD]

Yikes!

Why not bite her head off while you're at it, ms moderator? It sounds to me like wantobeRN asked her question because she truly wanted to learn something, not because she wanted to be raked over the coals. Did it occur to you that the patient insisted " I have to go to the hospital because I want more drugs and you won't give them to me!" ? We weren't there, so please don't be so quick to judge OP. I give her credit for asking for guidance from more experienced nurses about what to do the next time. I guess you taught HER not to bother us important people here at this forum with her stupid questions!

I didn't see anything in MJLRN97's post that would warrant this kind of nasty response. She posted answers to the question...sheesh.

[txspadequeenRN, BSN, RN]

I have been in the situation when I felt the patient being way too overdramatic about his/her conditioning requiring medical care. However, I send them anyway. But it does burn me, cause I have been at the ER with a child with a unbreakable fever of 104 or when I was losing my baby and bleeding everywhere I still had to wait 30 min. Now there are alot of factors that play into the time factors at the ER, but you get my point.

Wait til you work at a hospital and have to deal with the people who are drug seekers.

We have a few "regulars" who pop into the ER every few weeks, c/o chest pain and they are always admitted. So they live it up for a few days on Dilaudid and then are discharged. All the tests are run and nothing is ever found.

I agree....never get calloused or assuming about someones pain. BUT, when you know the person and you know all the history, its hard not to have conflicting feelings about the person. Of course, one day, when they cry wolf it Might be the real deal.........difficult situation all around.

[mysticwater]

Definately send her out! I had a resident who wanted to go because she liked the attention! If it had turned out that something was the matter you can be personally be held accountable! Remember nursing school told you to protect your license. No matter what the facility tells you - if it goes to court it's your license not the facility!!!

Mysticwater