When patients keep calling 911

No advice, but sympathy. Apparently someone in my faciity called 911 last night too ... had to tell a dispatcher that I didn't know of any problem. We had someone call in a bomb threat - TWICE - quite a ways back, and another shift had to evacuate the building. I also had a resident several months ago who called 911, claimed he knew the governor, FBI, and oh yeah - another unit told me that when he was there, he called 911 and said "I was brought IN to this place in a helicopter, and I want to be picked UP by a helicopter and taken out". Uh-huh.

We were only allowed to use sitters for suicidal or homicidal ideations and nothing else.

I don't know any facilities that provide sitters anymore, order or not.

We were only allowed to use sitters for suicidal or homicidal ideations and nothing else.

We can use sitters for extreme fall risks, non-compliant fluid restriction patients, IV/PICC/Oxygen pullers, etc. However, more often than not, we don't have any sitters available, so we have to pull an aide off the floor to go sit instead.

911 Dispatcher working on prereqs here. We get a ton of calls from patients in hospital/specialty care. The exact wording of 911 abuse can make charges tricky and in my 13 years dispatching, my agency has only filed one case of 911 abuse. Where I live, there has to be an ongoing harassment factor. So calling on 911 (has to be on 911 line not non-emergency) everyday to tell us that we suck and we're horrible people = 911 abuse. Calling 911 for frivolous issues doesn't constitute harassment because they are "real" problems to the person calling. A PSAP also has to deal with individual city/county SOPs on providing service. Where I work, the policy is "if they ask for police/fire/EMS, they get police/fire/EMS." The city doesn't want the liability of denying service even in such circumstances.

Our hospital has a behavior contract for disruptive patients. If they don't abide by our rules for their safe care (including diet and activity restrictions), then they are saying that they are not agreeing to be treated and we can't do anything more for them and we will discharge them.

The other form I'd use is an AMA form and present it to them as an option if they are not happy with their care, diet, or restrictions, reinforcing that they are free to leave anytime they want or are not happy but to not expect to be readmitted for the same condition any time soon. (In particular, for our patients who want to leave to smoke or get high). I find when they realize that I will allow them to leave, patients often become more compliant especially when I explain the if they just leave and go back into the ER, the doctor there will see all their records of this visit and is unlikely to give them any pain meds this time around.

We use sitters all the time. We often don't have enough and an NA is forced to sit. Most of my sitters are for elderly dementia patients...though we have and sitters for suicide watch. Again, this situation would be met with a behavioral contract reinforcing that the patient doesn't have to be there and we don't have to treat them if they are not compliant with our recommendations. They are adults and free to go (assuming no psych diagnoses that remove this right).

I have actually has this happen malp. times in my hospital. Along with 911 calls I had a pt calling dating services and leaving voicemails for people to call her back at her room telephone number...........UM YA... Anyway, if somebody wont stop calling 911 we always take the phone out of their room and security will come up to "make sure they are okay" and get back in contact with police to assure safety... In my area at least, any person using 911 without an EMERGENCY can get in trouble/ even a summons to court.... If a patient was cursing and screaming in the hallway I would definitely be calling for some haldol and a consult to eval her mental state............

Sounds like a BH consult and psychological evaluation would be a good idea to discuss with the admitting provider.

I work for a large primary care organization with clinics scattered all over town, and I've taken calls from patients in SNF's calling to say they had been physically abused because they weren't allowed to go out to smoke, drink cup after cup of coffee as is their usual habit, or that the food was bad. These same patients also had been calling 911 for similar thwarted desires or perceived needs.

One patient at our health care center in particular comes to mind - she routinely calls 911 because she is confused and afraid she will sleep through her alarms alerting her to her Rx med times - one EMS I spoke with said he has been responding to her residence for YEARS. EMS have started the proper documentation, as our facility has too, but my boss has told us all that takes time to get people who are unsafe living alone through the proper channels to an assisted living facility or group home. I filed a APS form 3 weeks ago which took 2 hours of my own time after my shift ended - no one has contacted me, and the patient is still at home in what many of us deem an unsafe situation. And likely still calling 911/EMS several times or more a week.

It can be very frustrating to work with or care for patients who are inappropriate in their actions and reasoning abilities just from the stand point of the large amount of time they require. In light of the things I've seen at this particular employer over the past 3 years, not to mention the things I've seen patients do over the past 2 decades, I very much believe that there are people calling 911 inappropriately from a wide variety of settings.

My mother did this a few months after she moved into a residential care home. Her complaints ranged from straight out abuse, needing to speak to the queen, to being starved to death... Not fun for the home because the police always showed up to check things out. Perhaps this patient has a family member that can make some 'adjustments' to her phone access? I was able to get 999 blocked from my mother's landline in the home. Not sure if that is possible here in the US but worth a try if it is becoming a problem.

I don't know any facilities that provide sitters anymore, order or not.

Very few and far between, and back when I've had them, utterly useless. Either the patient was yanking out the tubes that were a main reason we had the sitter and he/she was obliviously reading a book when I walked in on it or a horrible nuisance pressing the call bell to inform me that they are pulling out (usually already pulled out and now dripping on the floor) their tubes or that the patient is trying to leave the room while they just "sit" there and watch them.

My favorite is the one that stands in the doorway to get my attention. They will not keep the patient in their room, let alone their bed, and if the patient had the sitter or not, I still had to restart their iv 4 times and reinstert their NGT or Foley catheter at least once. I honestly didn't need the extra commentary from the sitter to brighten up my crazy shift.

We still use them for BA 52s. However, the patients have managed to fall or escape from the hospital grounds even when they're in the room "sitting"...I guess this is the gig they got when the last parent fired them for losing their kid while babysitting.