Who is at fault for elopement?

LlamaLlamaMamaJamaac · May 16, 2024

I would need to know more information to say. My grandmother eloped in upper Midwest Winter (sadly died of hypothermia) — she had dementia. She got out sometime between the 20:00 and 22:00 CNA rounds, which from my experience I know each round can take the better part of 2 hours, so nobody sitting around eating bonbons

The door alarm had malfunctioned. So in her case it was clearly not the fault of the staff... The building had not been adequately maintained

That could be the case here but I can't say. I also can't tell if the RN or CNAs were working in a negligent manner—or if they were doing the best they could.

muggs · May 17, 2024

I am very sorry to hear that about your grandmother, that's terrible.

Form my understanding of it the nurse walks around the building every hour, not into residents rooms like the aides are supposed to but still looking and listening for anything out of the ordinary, and on the security footage the nurse was seen walking through the main lobby 10-15 minutes before the resident went out the main doors. The aides may or may not have been sleeping, From what I've gathered they told the directors that the nurse lets them sleep in various spots which I find highly unlikely and most likely just trying to cover their own butts. I've worked with this nurse for a while and can't see that being the case.. The aides must not have been doing rounds as they should though because the resident was oof until the morning when the manager of the store right down the road called and told the day nurse he was there.

JKL33 · May 18, 2024

If the resident is considered "eloped" as opposed to a resident who has the faculties to come and go as they please, then it stands to reason (or there is a very good chance) that the resident was an elopement risk before this incident. Routine rounds does not sound like a reasonable level of care to keep tabs on someone who is an elopement risk. It sounds like a situation where the resident's level of care was not appropriate for the resident's needs.

I suspect that is the basic problem; the rest is just pointing fingers after something has gone wrong.

RACHAEL BOUGHTON · Mar 14

Hi everyone,

I am a new grad nurse in Los Angeles, California. I work in a private low income hospital, with scarce resources. Recently, while I was still in training, a patient escaped down the staircase who was conserved and had high chance of elopement. Then, literally eight nurses chased her. She almost got on the bus, several nurses almost got hit by cars, and I was told that if the patient elopes and actually escapes, the nurse can lose their license. I'm having a really hard time believing this, as there are not enough people to be sitters, we can't have them in restraints, obviously, and they could run out at any time. This is not a lockdown facility. I work in MedSurg and we have tons of psych patients that we have this issue with that are conserved. I'm considering quitting before my first day on my own because I am frightened of losing the license that I worked so hard for. I know that I can document at beginning of shift, my concerns, etc., but is that enough? Many thanks for any insight on this.

JKL33 · Mar 15

RACHAEL BOUGHTON said:

and I was told that if the patient elopes and actually escapes, the nurse can lose their license. I'm having a really hard time believing this, as there are not enough people to be sitters, we can't have them in restraints, obviously, and they could run out at any time. This is not a lockdown facility. I work in MedSurg and we have tons of psych patients that we have this issue with that are conserved

I don't know about losing one's license. But other kinds of negative repercussions, sure.

If there is no plan or resources to appropriately care for these patients and no concern from administration other than “*You* better make sure no one gets out, good luck with that”—that's a hard no from me. I do not acquiesce to being expected to accept sole responsibility for situations that call for other people to also participate, when they are refusing to participate/accept their portion of responsibility. That would be your administration in your case. It is not your job to staff the place appropriately; reasons for their refusal to do so are irrelevant. They have accepted these patients and thus are responsible for enabling their appropriate care.

AutumnApple · Mar 17

That's a loaded question. Whose fault is it is only a concern for the facility after the fact. An elopement is a sentinel event so, yes, the powers that be will be in administrations office. And no, "It was the CNA's fault" will not be enough for them to exit said office.

There should be "layers" to the daily operating procedures that make multiple people responsible for avoiding such events. The CNA's doing four hour rounds is one layer. Making sure doors that should be locked and indeed locked, usually is the nurse's duty. Having alarms and such installed where they should be, the facility's responsibility. If she's a known flight risk, are there protocol in place for dealing with it? If a person continues to "escape" whatever precautions are in place, was it addressed by direct caregivers and the facility?

Point is, those who decide what is going to be done about it (and that'd be the people in your administrator's offices, not the people working for the facility) don't care much if it's the nurse's or CNA's fault. Even if it's known who or what caused the problem, they'll levy their "penalties" in such a way that everyone feels the pain, even those less involved.

Now, after, much finger pointing and attempts at throwing one specific person under the bus will take place. But that's all just a product of your facility.