What do you do if a patient needs to call 911 but they are refusing

akulahawkRN, ADN, RN, EMT-P · Jan 2, 2015

If you think the patient should be at the hospital, you call 911. Let the patient go through them for refusing care. Among the things that will accomplish is 3rd party documentation that the patient refused 911 and not just refusing your suggestion that they'll need to go to the ER. If the patient isn't competent to refuse, the Paramedics or Law Enforcement can deal with that. Sometimes you may have to do something like that to protect your own license and/or the patient at the same time and shift some liability over to the 911 service.

Trauma Columnist · Jan 2, 2015

What kind of facility or situation are you talking about? This is posted in critical care - is this an inpt already?

Altra, BSN, RN · Jan 2, 2015

This may not be a new topic, but I am pretty desperate...! First it was the holiday, with the GP away, then the hospital with an inconclusive diagnosis, and it doesn't look any better, but pretty bad...

Are you saying that a person was a patient at a hospital, but (you?) wanted to call EMS?

*IF* this is what you are saying ... what was the goal? The individual is already hospitalized. The 911 / EMS system is activated to get medical attention for someone who does not have it currently. EMS cannot under normal circumstances respond to an acute care hospital.

If you were concerned about the patient's condition, or dissatisfied with care, these are the appropriate avenues to take:

1. COMMUNICATE with the patient's physicians, nurses and other clinicians. Ask questions: what is the diagnosis? What other info are you awaiting to formulate a diagnosis? What has been ruled out so far? When do you expect to see improvement? What is the current plan of care and what symptoms is it intended to alleviate?

2. Ask to speak to (in order): the charge nurse or supervisor, the unit manager, a case manager, the hospital patient advocate or ombudsman.

3. The patient can exercise his/her right to request discharge or take the responsibility to sign out AMA.