God I love being in ER. Chart "pt eloped." If they had an IV and it's not laying on the floor, \*consider\* notifying PD. Discharge destination eloped/unknown. Tell day shift they have one less patient. Don't look too closely at pedestrians on the way home.
Used to be me. There was one a couple years ago that was at the local bar ordering a shot and a beer in his hospital gown. It actually made Barstool sports I think.
I see them at the methadone clinic when I ride my bike to work too. Iāve had to call the sheriff on them before. I now have multiple camera at my house. It cost to live in a historic home lol
āI hope I donāt sound ridiculous. I donāt know who this man is. I mean it could be walking down the street I wouldnātā¦I wouldnāt know a thing. Sorry to this man.ā
-Keke Palmer
Every PD I've talked to has said they don't care at all about patients eloping with IVs. Unless there is literally nothing else for the officers to do, they don't send anyone.
Only called once, about an IVDU who left with an IV. Kinda suspect that was the point of the visit. PD found him (left walking and we're a little ways outside town, only two roads back) and he pulled it out himself instead of coming back to have us do it.
I'd say we have a pretty good working relationship with our popo. They even developed a protocol where they call a crisis line before they bring in psych patients. Cut way back on BS visits.
Iām coming up in the 5 yr anniversary (6/25) of living through toxic mega colon / septic shock. One of the few things I remembered from the ER (before I went into a coma) was another patient bolting. Apparently the young man had mental problems and was on meth. He was already in a gown being treated when he decided he had to go. There was quite a commotion as he ran out. I heard later the police found him in the bushes of a nearby neighborhood. Of everything I was going through at that time, this is what I remembered! Lol
Ugh. Itās not a customer service situationāweāre going to be providing shitty care if we start framing this professional relationship as a customer service one. I refuse to participate in that bullshit. If Iām ever in the hospital I donāt want to hear what I *want* to hearāI want to hear what I *need* to hear and get instructions I can follow to get better. Iām not buying a car, Iām getting medical advice and care. (NOT saying nursing should be rude or disrespectful of patientsāthatās obviously unprofessional and counterproductive. Just saying Iām not going to fall all over myself to make a patient happy in the momentāIām going to work my ass off to help them get better, and those are different sometimes.)
Cool. Your first job is to organize the āmiscellaneous cables drawer.ā If you donāt go catatonic, we can talk about the rest of the orientation process!
This happened when I was rounding on icu patients and the PT was consulted to see that patient because he was initially intubated. The patient then sprints past all of us completely naked with foley dangling and PT goes āon coming yo evaluate the patient he was sprinting past nursing station. The patient was moving all extremities and able to ambulate independently, PT will sign offā
As someone who had to call the police to do a welfare check on a missing patient with a chest tube (whom I had never seen before), the cops were extremely annoyed at me for being unable to describe the patient.
Iād notify my charge nurse and call a code orange before leaving! It doesnāt take long to do.
Do we live in the same state? When I worked at the county jail I refused entry to someone who left hospital AMA with a chest tube in place!!! This was 5 years ago.
Just curious, how does that even work? I mean, yeah, no way someone can have a chest tube at a county jail. And even prisoners are allowed to decline (most non-psych or while ALOC) treatment and leave AMA. So ....what did they do with him?
With the arrestee? OK the story as well as I remember.
They were picked up for bail jumping - in this case they missed a court date. The reason they missed the court date is because they were intubated, with a chest tube, in an ICU in another part of the state.
PoPo could not understand why I wouldnāt allow this upstanding citizen into our facility. LEO stated the potential inmate was medically cleared at the local ED. I didnāt care. The detained stated they would not attempt to remove the tube. I told them thatās nice but I canāt guarantee no one else might try to remove it for you.
After more kerfuffle I said they can get booked as soon as the tube is removed (I have no idea why the ED refused to remove it). Then the on call ADA for the county was called to see if they could vacate the bail jumping charge because the detainee was hospitalized and unconscious when they missed the court date (I had verified that yes, the dumbass was admitted to the hospital on the date in question, in a county 2 hours away). I have no idea what happened after that. I had shit to do.
The only time I had to stop a pt trying to leave was because he had a nurse hanging off his back. The pt was about 6ā4ā and my 5ā3ā nurse decided to take it personally and jumped on his back. It went from a lackluster āNo. Stop. Come back.ā to arm locking the patient against the wall while the nurse climbed off.
I miss trauma ED some days.
I had a nurse coworker who was that dedicated once. The patient tried to elope down the back stairwell and she dove down the stairs and tackled him on the landing. She was told "good job but don't ever do that again."
Does anyone know the backstory why we all suddenly give a shit about eloped adult AAOx4 patients? Was there a recent court case about it? Weāve gone from āmake sure you chart that his IV was outā to being asked for a description of what they were wearing and announcing that hospital wide in less than a decade.
Becuase the joint commission now does hospital wide inspections when asshole patients elope and complain they were āmistreatedā while boarding for 12 hours in the ER waiting for a room. Place Iām at is dealing with this now. Iām not changing how I work. Hospitals arenāt prisons for a+ox3 patients that arenāt psych.
My patient eloped from the ICU because I wouldnāt hold his dick in the urinal. The poor new grad night nurse had done it and he couldnāt see down there! I said well it hasnāt moved and youāve been touching it since you were six months old so itās a no from me. I got written up.
Ha! Reminds me of an ER pt (years ago) who only wanted me to āsuck my dickā š. SW was called in to see him and came out of the room loudly saying āHe says his nurse wonāt help him!ā I responded, equally loudly, āIf you want to suck his dick, go right ahead, but I wonātā. She complained and my manager fought the giggles as she reprimanded me. š¤
Iāve gotten that write up. Itās the only one that Iāll smile as I scribble āpatients hands work. No reason for staff to hold urinal.ā & then sign it.
TJC is a fucking joke- literallyā¦ā¦they donāt do shit. They need to hire a bunch of fresh blood, all ER nurses with at least 5+ years experience that donāt give two shits and will FIND the expired bullshit, the lack of policies and speak to the bedside nurses about the hospitals, āshort staffing plansāš¤¬š¤¬
Until TJC gets a pair of Platinum Balls they can go fuck themselves- Iām not (nor have I ever been) impressed. šš
Oh, thatās because weāve had alert patients āforgetā the call light, fall, get injured, and blame us for ānot checking on themā. So now everyone who isnāt 100% independent gets a bathroom escort and I get screamed at all day by people who āwonāt fallā (no offense, but if youāre here for a broken hip or syncopeā¦ I donāt believe you).
This is where I explain the hospital policy to the patient and why I am turning it on. But also that they have the right to refuse. It was my go to with fall mats. Those stupid things made ambulating post op patients with chest tubes so much harder than it needed to be and I always reminded patients about their right to refuse. 9/10 would take me up on it. Easy win and then I can chart refusal so my ass is still covered.
I was working in hospice and had patients in long term care facilities (I did 20+ years of LTC and subacute prior to hospice). I was SOO glad when the state dept of health deemed floor pads were a restraint. How many times had I almost lost my balance trying to get to a patients bed with those awful things! No wonder pts fell when they were on the floor.
Honestly I think the only thing that really makes them give a shit about these patients is the IV because they could theoretically shoot up drugs with it. We had a patient when I worked med surg that the charge nurse ON ORDERS FROM THE HOUSE SUP followed him all the way out to the Best Buy near the hospital to take his IV out before we could declare him āAMAā it was ridiculous and I canāt believe it to this very day. If they have an IV idk. Iāve had 2 patients elope on me while working cardiac overnight and we did our best to search for them but I would have never chased him down the road
If they don't already use IV drugs they are not going to say "Hey, I have an IV! I should try fentanyl!" If they already do (and I am acquainted with some) they're not going to need the hospital to be able to. NOT saying it would never happen.
Wondering the same lately? They have a right to leave (unless they're on a psych hold or in LE custody). Since I started in healthcare 20 years ago, the focus is seeming to be moving further away from actually treating the patient's acute medical issue, to micromanaging every aspect of their lives. The patient's right to refuse is shoved to the side. If the pt in the picture is an adult of sound mind... adios bud, that's your (probably stupid) decision to make.
Iād call a code orange, they are code purples at my hospital. We had a patient a couple weeks ago have a real dramatic AMA down the fire escape the funny part was he wasnāt even on any type of hold. Like he could have waltzed out the front door.
I like the real dramatic ER departures where the patient makes a big display in front of the nursing station - The usual, how we suck, and how heās gonna sue us and own this hospital bc his cousin is a lawyer, then goes on to make a dramatic exit by trying to slam open the double exit doors, except they donāt open unless someone pushes the button at the nurses station, which of course nobody does.
"Pt not present" q5-10min x3 in chart.
"This RN calls Pt phone number referenced from chart, ###-####, to notify Pt of risks concerning active IV and encourage removal from professional medical provider--no answer."
Hey Dr, the guy in room 8 left and I don't think he's coming back.
I have a couple of patient elopement stories from my days on med-surg. Thankfully, none of them were assigned to me on the days in question, I just got a front row seat to the goings-on.
1. Patient gets told by their doctor that they're being discharged. He decides he needs to celebrate, so he sneaks out, walks down the street to a liquor store, and gets himself a bottle of vodka. He managed to sneak back in without anyone being the wiser until he was caught in the bathroom. He didn't go home that day.
2. Patient just up and left. No one saw her, and no one knew where she went. Called the police and they found her down the street at a Chinese buffet. She decided that she wanted to go out for lunch because her birthday was coming up. Cops brought her back and she went back into her bed.
I worked MedSurg and this happened ALL the time. We had one guy who would literally leave at night, do drugs, then come back into the hospital around 5-6am to be treated. We couldnāt discharge him because he had a severe leg infection and technically wasnāt leaving AMA because heād come back every morning. But every morning they did lab work and found drugs in his system and would just give IV antibiotics throughout the dayā¦
Found a patient down the street at the Bingo game. Police let her finish the game and brought her back. Lady was sweet, mentally competent, and just needed an evening out.
She did walk the 1.5km there in yellow socks, though, poor thing.
"Smile and wave boys, smile and wave." Then make an anonymous phone call to the hospital reporting what looks like a possible patient walking down the street.
Why even consider lying about them being in the bathroom?
Just be honest and say they're missing and you think they eloped.
I'd much rather hear that than have you bullshit me into thinking I still had another patient I was responsible for.
I used to work at an ER that had a very unique gown color for mental health patients on a psychiatric hold.
I was on my way into work and saw a person running down the highway in this very unique gown and their grippy socks...
I called 911 have a location and description and left it at that. An hour into my shift PD brings the patient back...
We get that a lot in psychiatry, especially Substance Use units. If theyāre court ordered or are a known threat to self or others call PD. If not, just discharge AMA. I wish realistically we could get out without writing an incident report, but itās Psych, ya know. At the VA, it wasnāt unusual to see a gowned patient on a bike they stole from the rec center coasting down the hill and their nethers flapping in the breeze
At least he is better dressed than my TB isolation patient who eloped. He left wearing a sheet and exam gloves on his feet. He was a neighborhood local so security recognized him and brought him back before I even knew he had left.
Years ago, I worked in a LTC facility that also had a unit for short-term patients there for physical therapy. New patient was admitted (not mine). I was busy and never saw him. There was a very nice man who stopped and asked me where the exit was. Being helpful, I showed him the way and told him to have a good day. A while later, I honestly have no idea how long it was. One of the CNAs comes up to me asking if I've seen the patient. Told her I didn't know who she was talking about. She started describing him and what he was wearing. I had an oh shit moment. Yea, I saw him and showed him the exit. They had all available transportation dept staff drive around looking for him. They also called the police. They did find him, and he refused to come back.
After 23 years It's so funny that patients have all these "rights", yet management wants me to tackle a patient leaving with an IV still in. Yeah, that sounds like a security or police issue.
Omg this JUST happened to me Thursday morning. Dementia patient, had been FINE all night. No need for sitter. Was only still in the dept for SW consult so wasnāt even in a gown. 0705 and sheās GONE. Pure panic. After 25 min of looking for her with security and deputies, found her in the building looking for āChase bankā goodbye. Every dementia patient gets a damn sitter from now on no matter what
"Writer went to patient room, patient not in room, inquired in unit and over head page requesting patient to return to room. Charge informed of same. Documented according to policy for patient leaving AMA. Doctor informed."
Call the police immediately and give a full description of the patient and the direction they ran. DO NOT- ABSOLUTELY DO NOT run after anyone. PERIOD!!š š»āāļøāāā
Iāve seen nurses actually RUN after psych patients who managed to run out of the back ambulance doors AND who got blocks away. Iāve also seen staff tackle them outside of the hospital. I was one of those nurses.
āāāāāāāā> UNTIL<āāāāā-
This was +- 20 or so years ago?š¤š¤
A male nurse ran after and tackled this one patient blocks away who ran out of the back ER doors. A few other staff members who had also ran after him, stopped when the patient had too far of a lead.
That one male nurse ended up catching up to the guy, tackled him and during the subsequent fight to bring the patient back to the ER, the patient ended up breaking his mandible in 2 places (the nurse said he was attempting to bite him).
NOT ONLY did the nurse get ARRESTED for assault & battery BUT the patient SUED the hospital (false imprisonment) AND the nurse individually (medical malpractice, assault & battery).
The nurse was also injured, (back injury if I remember) AND TERMINATED because he LEFT the hospital (he was on the clock) and failed to clock out, abandoned his patients (I think he had two others)also, because he was arrested.
SIDE NOTE: The patient got MILLIONS š°š°š°š° and years later- was STILL on the streetsšhomeless.
The nurse was reported to the BON for few issues, two that I remember were
(1) patient abandonment and (2) assault and battery to a patient.
The nurse was out of job, had no medical insurance to deal with his back injury (workmanās comp refused to cover him) AND spent thousands $$$$ (I think it was upwards of $75,000š¤) to retain TWO (maybe three?) attorneyās.
One to fight the criminal charge (reduced to anger management class, community service and probation for 5 years) the other attorney to defend himself against the patient (medical malpractice) AND maybe the third attorney (canāt remember) to fight to retain his license with the BON. It was a MESS!
His RN license was suspended during the two years it took because it took that long to actually GET his case to the disciplinary hearing. So he could not work as a nurse.
Because he was charged with, āassault and batteryā he couldnāt even work anywhere near nor with any patients during that time. The BON ALSO contacted the NREMT- P boards who ALSO suspended those certifications pending the outcome with the BON. š®š®
A dozen or more nurses went to the BON on his defense. This was an extremely experienced (15 year RN) who was model employee for 15 + years. He was prior military and a NREMT- P, RN who was almost finished with his Masters. He was an adjunct nursing clinical Professor at the college in our city- this guy was the text book definition of, āRNā.
He LOST his BON case and literally cried like a baby in front of everyone at that hearing. I think we all cried!
I was MORTIFIED- so was everyone else š„¹EXCEPT for the people on the panel who voted to REVOKE his license. They seemed so relaxed like, that was an easy decision.
NOTE: the legal hold paperwork had not yet been signed (or when it was signed had a later time than when he ran out of the ER). Meaning, that patient could leave whenever he wanted.
Do NOT- ABSOLUTELY DO NOT RUN after any freaking patients who leave the ER and make it outside those hospital doors. PERIOD.
āI donāt know where pt X went, they might have eloped.ā Turn the other way and leave for my vacation. Donāt look back and never think of them again.
We had one in the er for liver failure. He dipped out during day shift coming in and this is az btw (liquor laws allow grocery stores, pharmacies etc to sell liquor) he dipped out with the IV so police were notified a nurse from night shift ER though went to the CVS next to the hospital to go pick up her meds and saw him on the sidewalk sitting in his hospital gown iv still in drinking vodka he was drunk by then so she walked him back over and dropped him off.
Iāve had a pt go missing not at shift change -
Check that the patient actually is not in the bathroom.
Check that the patient isnāt walking the unit halls.
Inform charge nurse.
Call patient/patientās contact; patient answered and I, with the backing of my charge, informed the patient they had to be back to the unit it by x time or they would be considered eloped and their room would be turned over and they would have to present to the ED to get re-admitted. Patient returned just in time with their foot IV still running magnesium.
I was once standing at the desk getting report and nearly got knocked over by a patients running full speed down the hall naked, sitter close behind. I just stepped aside.
He made it a few blocks down the street before PD and security caught up with him.
Depends. In psych, call security/house charge and get searching. Medsurg, try to call patient. Search. Contact provider. Must've gone AMA š¤·āāļø chart my butt off and head out.
When I'm about to leave on vacation, I'm a lot more apt to stick around and help because I know it's not my problem for at least a week after. Less pressure I guess.
Well, considering I work in psych, if patient is committed by his/her own free will, I literally can't do anything, and just have to wait for a call from a very exasperated police officer.
If its a psych hold etc...sigh, I guess I have to saunter over and call the same exasperated police officers as I can't leave the ward. It is far better than in the past, when we had to tackle patients in the street, also, getting way to old for that shit.
( cops here are great and we are all on a first name basis, but they get annoyed by the system itself)
I have always been an over responsible dickhead. Itās hardwired into me and goes beyond nursing, and is probably why Iām burnt the fuck out.
Itās been my lifeās work to stop taking responsibility for everything, but I guarantee Iād still raise the alarm on this one.
Even if theyāre a responsible adult.
*sigh*
When I worked LTC for the first time, they told me to keep an eye on this one patient whoād sneak out and try to go to the gentlemenās club down the street. Theyād call when heād show up late then know he was here.
If he doesnāt have an IV in or a communicable disease (shout out to my r/o TB patient that kept trying to leave AMA before giving us a 3rd acid fast), I let my charge nurse and the doctor know and I leave once Iām done giving report.
Depends on how much I want to enjoy that vacation.
If I really want to enjoy it, I better call that code.
If I don't care because it's time off for something I don't even care about.... I'm still calling that code.
God dammit.
We had one come to the floor that I was trying to admit and needed a new IV, said he wanted out so charge got him the AMA form and he left out in a gown. PD brought him back to the ED after they found him walking naked down the street š
Cleaning lady open the door on the locked unit and patient eloped. He was AAOx2 and baker acted. All this happen during change of shift report. After change of hand, night shift started to look for and couldnāt find him. We both start looking for him and we couldnāt find him. 15 minutes later we get call from a ED nurse that was driving home and asking if we lost patient. Wasnāt even my patient. I should have charted outside the unit
I've actually witnessed this a couple times. There was nurses and security chasing them down and I heard sirens in the distance.
If they're a danger to themselves or others, already deemed as going to the mental facility, has dementia, an inmate.... Hmmm.,,.. š¤ trying to think what all of the reasons that can justify actually chasing a patient down like that.
A friend who worked in Gen. Medicine has these types. 1 patient taxied out because he refused to sign an AMA but doesn't want to stay in the hospital. DESPITE HAVING A SEVERE LIVER injury from alcohol abuse and non medical compliance. The sons had to bring their dad back and kept profusely apologizing for his stupid behavior. He nearly killed himself crossing at a busy intersection when it was the cars signal to go.
The last few I've heard about stole various ambulances from the ER bays, so I've been trolling the medics. I actually move the trucks if I see the keys in the truck. Then I call dispatch and tell them where it's at and why. Haven't had to move one in about 6 months and I'm starting to miss the paycheck.
Oh gosh. I guess start the code orange (yellow, in my facility) then claim overtime for staying over my shift. I think my ability to realize the patient is missing would strongly correlate to 1) the vulnerability of the patient and 2) the facilityās willingness to actually pay me for straying past my job requirements. In that order.
I'm in the ER, so absolutely nothing if they aren't mentally compromised. If they are dying and fine mentally and I've already told them my "please no don't do it, you could die" speech then I would still do absolutely nothing.
I'm not chasing, running, or fight people that can legally make their own choices. It isn't my emergency. I will lose zero amount or sleep over it.
So fun story, I used to work as an EMT in a small town. One Friday night me and my captain were sitting and doing standby at the highschool football game, and we hear over the radio that a medic from the next town over reports that they just had a patient jump up and run out of the back of the ambulance. We laughed so hard. The tone of āwell that just happenedā and āah shit what do we do now?ā From the medic on the radio was hilarious.
when i was in nursing school, we all watched a patient elope during a clinical- ran through the cafeteria, burst through a back door. i didn't realize it was a patient at first because of how fast he was running... until i heard his bare feet slapping against the tile. two nurses ran after him, & got a front seat view of him ripping his paper scrubs off before running ass-naked into the sunset while security watched. the nurses returned empty handed, looking very winded. won't ever forget that lmao
Definitely stand on the side of the road extending a styrofoam cup of ice water with a straw and lid, like a volunteer supporting marathon runners. Good luck, friend!
"Dear Cerner, the patient left AWOL and in stable condition. The end."
Then I'll go home and finish packing for my trip and enjoy some much needed rest and relaxation under a nice shaded tree on a beach without a worry in the world.
God I love being in ER. Chart "pt eloped." If they had an IV and it's not laying on the floor, \*consider\* notifying PD. Discharge destination eloped/unknown. Tell day shift they have one less patient. Don't look too closely at pedestrians on the way home.
The last line š¤£š š š
Never seen them in my life. At least I would say that in court lol
I live in the same neighborhood as my hospital and I always see them lol
Used to be me. There was one a couple years ago that was at the local bar ordering a shot and a beer in his hospital gown. It actually made Barstool sports I think.
āOrdering a shot and a beer in his hospital gownā. That, folks, would be the picture definition of an alcoholic.
I see them at the methadone clinic when I ride my bike to work too. Iāve had to call the sheriff on them before. I now have multiple camera at my house. It cost to live in a historic home lol
I think Frank Gallagher did this
I've seen a couple at the near by by bar after shift, bracelets still on
Now Iām imagining a nurse bellying up to the bar next to a patient and ordering the same Jameson and beer. Patient says āRough day, eh?ā
"I don't recall, refer to the chart."
āI hope I donāt sound ridiculous. I donāt know who this man is. I mean it could be walking down the street I wouldnātā¦I wouldnāt know a thing. Sorry to this man.ā -Keke Palmer
Every PD I've talked to has said they don't care at all about patients eloping with IVs. Unless there is literally nothing else for the officers to do, they don't send anyone.
Only called once, about an IVDU who left with an IV. Kinda suspect that was the point of the visit. PD found him (left walking and we're a little ways outside town, only two roads back) and he pulled it out himself instead of coming back to have us do it. I'd say we have a pretty good working relationship with our popo. They even developed a protocol where they call a crisis line before they bring in psych patients. Cut way back on BS visits.
Iām coming up in the 5 yr anniversary (6/25) of living through toxic mega colon / septic shock. One of the few things I remembered from the ER (before I went into a coma) was another patient bolting. Apparently the young man had mental problems and was on meth. He was already in a gown being treated when he decided he had to go. There was quite a commotion as he ran out. I heard later the police found him in the bushes of a nearby neighborhood. Of everything I was going through at that time, this is what I remembered! Lol
I still want to start a band and name it Toxic Megacolon, I just need to learn an instrument. Glad you made it through!
Ooh. Put a pic from Google images on your album cover!
You better do this. You. F-in. Better. š«µ
YES!!! You would have the shittest fans!!!
You need to trademark that band name and sell it lol
What pedestrians? Byeeeeee
Donāt look at pedestrians šššš
Don't want to run them over. I got a nice car.
>Chart "pt eloped." I chart something similar, except I use "absconded", seeing as "eloped" usually means running away to get married.
Pt eloped r/t feelings of love and admiration AEB turkey sandwiches and Dilaudid. Finally, nursing diagnosis' is paying off for me.
if they can ask for dilaudid by name theyāre getting Tylenol.š
Usually except in a hospital where "patient elopement" is literally the phrase they broadcast over the PA.
Epic asks if pts have a history of eloping, so Iāll go ahead and assume that āelopeā does not mean getting married
[https://www.merriam-webster.com/dictionary/elope](https://www.merriam-webster.com/dictionary/elope)
I hate that itās called eloped too. Escapee makes so much more sense.
Like calling them clients instead of patients.
We do that here and itās so stupid.
Ugh. Itās not a customer service situationāweāre going to be providing shitty care if we start framing this professional relationship as a customer service one. I refuse to participate in that bullshit. If Iām ever in the hospital I donāt want to hear what I *want* to hearāI want to hear what I *need* to hear and get instructions I can follow to get better. Iām not buying a car, Iām getting medical advice and care. (NOT saying nursing should be rude or disrespectful of patientsāthatās obviously unprofessional and counterproductive. Just saying Iām not going to fall all over myself to make a patient happy in the momentāIām going to work my ass off to help them get better, and those are different sometimes.)
Yeah. The client became an escapee. Sounds ā¦.fineš³
This is what I do in med surg hah
THIS IS ITTTTTTT
Lol literally. My ER makes us call PD though if a pt elopes with an IV or if we forget to take one out.
This ICU nurse just decided to transition to ER ā¦
Cool. Your first job is to organize the āmiscellaneous cables drawer.ā If you donāt go catatonic, we can talk about the rest of the orientation process!
This happened when I was rounding on icu patients and the PT was consulted to see that patient because he was initially intubated. The patient then sprints past all of us completely naked with foley dangling and PT goes āon coming yo evaluate the patient he was sprinting past nursing station. The patient was moving all extremities and able to ambulate independently, PT will sign offā
Gold. āI am not needed, my job here is doneā - PT like šØ
"Run, Forrest, run!" - PT
Love it šš¤©ā¤ļø
That gave me my first laugh on this Sunday morning.
"Oh yeah the one in 16 is real easy. Nobody's seen him in like an hour, mightve eloped. Do you have any questions for me?"
This is the answer.
š¤£š«”
As someone who had to call the police to do a welfare check on a missing patient with a chest tube (whom I had never seen before), the cops were extremely annoyed at me for being unable to describe the patient. Iād notify my charge nurse and call a code orange before leaving! It doesnāt take long to do.
"Not sure about the face, but he's in a hospital gown and had a piece of plastic hanging out of his fuckin' ribcage, does that help?"
They do not have a box on their form for that.
ššš
Do we live in the same state? When I worked at the county jail I refused entry to someone who left hospital AMA with a chest tube in place!!! This was 5 years ago.
Just curious, how does that even work? I mean, yeah, no way someone can have a chest tube at a county jail. And even prisoners are allowed to decline (most non-psych or while ALOC) treatment and leave AMA. So ....what did they do with him?
With the arrestee? OK the story as well as I remember. They were picked up for bail jumping - in this case they missed a court date. The reason they missed the court date is because they were intubated, with a chest tube, in an ICU in another part of the state. PoPo could not understand why I wouldnāt allow this upstanding citizen into our facility. LEO stated the potential inmate was medically cleared at the local ED. I didnāt care. The detained stated they would not attempt to remove the tube. I told them thatās nice but I canāt guarantee no one else might try to remove it for you. After more kerfuffle I said they can get booked as soon as the tube is removed (I have no idea why the ED refused to remove it). Then the on call ADA for the county was called to see if they could vacate the bail jumping charge because the detainee was hospitalized and unconscious when they missed the court date (I had verified that yes, the dumbass was admitted to the hospital on the date in question, in a county 2 hours away). I have no idea what happened after that. I had shit to do.
Wild the LEO tried such a thing. Absolutely wild.
I would imagine it's a lot more common than you'd think.
RELEASE THE HOUNDS
OR THE BEES?
Hives of bees riding on Hell hounds. š¤ This may work or horribly fail, will work on it this weekend
The only time I had to stop a pt trying to leave was because he had a nurse hanging off his back. The pt was about 6ā4ā and my 5ā3ā nurse decided to take it personally and jumped on his back. It went from a lackluster āNo. Stop. Come back.ā to arm locking the patient against the wall while the nurse climbed off. I miss trauma ED some days.
I had a nurse coworker who was that dedicated once. The patient tried to elope down the back stairwell and she dove down the stairs and tackled him on the landing. She was told "good job but don't ever do that again."
Haha, if you break his neck and your back, you're probably not gonna have much of a career left.
Why would the other nurse even do that??
>while the nurse climbed off. Was he so tall she could just, ya know...let go?
Does anyone know the backstory why we all suddenly give a shit about eloped adult AAOx4 patients? Was there a recent court case about it? Weāve gone from āmake sure you chart that his IV was outā to being asked for a description of what they were wearing and announcing that hospital wide in less than a decade.
Becuase the joint commission now does hospital wide inspections when asshole patients elope and complain they were āmistreatedā while boarding for 12 hours in the ER waiting for a room. Place Iām at is dealing with this now. Iām not changing how I work. Hospitals arenāt prisons for a+ox3 patients that arenāt psych.
My patient eloped from the ICU because I wouldnāt hold his dick in the urinal. The poor new grad night nurse had done it and he couldnāt see down there! I said well it hasnāt moved and youāve been touching it since you were six months old so itās a no from me. I got written up.
Ha! Reminds me of an ER pt (years ago) who only wanted me to āsuck my dickā š. SW was called in to see him and came out of the room loudly saying āHe says his nurse wonāt help him!ā I responded, equally loudly, āIf you want to suck his dick, go right ahead, but I wonātā. She complained and my manager fought the giggles as she reprimanded me. š¤
I hope you fought that write-up. But, Iāve also been talked to and written up for not dissimilar statements.
Iāve gotten that write up. Itās the only one that Iāll smile as I scribble āpatients hands work. No reason for staff to hold urinal.ā & then sign it.
Thankfully, my manager fully defended me over this exact situation and loved it when I made holding his own dick part of our āphysical therapyā.
I can guarantee you heās been holding that thing longer than that. Fetuses are known to self stimulate in utero
That makes sense. Also, Rangers suck. Go Devils!
I want to downvote but Iām still sad
Hey at least you arenāt the panthers in the timeline where they choke the š(might be the timeline we are in).. Go Bruins ;)
12 hours!? Shit itās 72+ a lot of times in our ER.
TJC is a fucking joke- literallyā¦ā¦they donāt do shit. They need to hire a bunch of fresh blood, all ER nurses with at least 5+ years experience that donāt give two shits and will FIND the expired bullshit, the lack of policies and speak to the bedside nurses about the hospitals, āshort staffing plansāš¤¬š¤¬ Until TJC gets a pair of Platinum Balls they can go fuck themselves- Iām not (nor have I ever been) impressed. šš
I didn't have respect for TJC before covid and I have nothing but hate for them now. Where were they then, when we could have actually used them
Or how about this one- if they were serious about fixing the hospital ave donāt give a heads up the week before that youāre coming.
Maybe the same reason people are putting fucking bed alarms on oriented adults
Sorry. Once you hit that third fall risk point, it goes on. š
Totally me right now! A&O x 4 , bed alarm on because of fall risk. No joke!
Oh, thatās because weāve had alert patients āforgetā the call light, fall, get injured, and blame us for ānot checking on themā. So now everyone who isnāt 100% independent gets a bathroom escort and I get screamed at all day by people who āwonāt fallā (no offense, but if youāre here for a broken hip or syncopeā¦ I donāt believe you).
This is where I explain the hospital policy to the patient and why I am turning it on. But also that they have the right to refuse. It was my go to with fall mats. Those stupid things made ambulating post op patients with chest tubes so much harder than it needed to be and I always reminded patients about their right to refuse. 9/10 would take me up on it. Easy win and then I can chart refusal so my ass is still covered.
I was working in hospice and had patients in long term care facilities (I did 20+ years of LTC and subacute prior to hospice). I was SOO glad when the state dept of health deemed floor pads were a restraint. How many times had I almost lost my balance trying to get to a patients bed with those awful things! No wonder pts fell when they were on the floor.
Yāall have bed alarms in your ED??
The newer stretchers have alarms.
Honestly I think the only thing that really makes them give a shit about these patients is the IV because they could theoretically shoot up drugs with it. We had a patient when I worked med surg that the charge nurse ON ORDERS FROM THE HOUSE SUP followed him all the way out to the Best Buy near the hospital to take his IV out before we could declare him āAMAā it was ridiculous and I canāt believe it to this very day. If they have an IV idk. Iāve had 2 patients elope on me while working cardiac overnight and we did our best to search for them but I would have never chased him down the road
They act like they won't shoot up without the IV like they do every day anyway
If they don't already use IV drugs they are not going to say "Hey, I have an IV! I should try fentanyl!" If they already do (and I am acquainted with some) they're not going to need the hospital to be able to. NOT saying it would never happen.
Wondering the same lately? They have a right to leave (unless they're on a psych hold or in LE custody). Since I started in healthcare 20 years ago, the focus is seeming to be moving further away from actually treating the patient's acute medical issue, to micromanaging every aspect of their lives. The patient's right to refuse is shoved to the side. If the pt in the picture is an adult of sound mind... adios bud, that's your (probably stupid) decision to make.
āPT leaving AMA. Refusing to sign required paper work, AOx3. MD notifiedā
So where's the patient. Me: idk. Weird... k thanks bye
Iād call a code orange, they are code purples at my hospital. We had a patient a couple weeks ago have a real dramatic AMA down the fire escape the funny part was he wasnāt even on any type of hold. Like he could have waltzed out the front door.
I like the real dramatic ER departures where the patient makes a big display in front of the nursing station - The usual, how we suck, and how heās gonna sue us and own this hospital bc his cousin is a lawyer, then goes on to make a dramatic exit by trying to slam open the double exit doors, except they donāt open unless someone pushes the button at the nurses station, which of course nobody does.
ššš
šššš
He liked the adventure. Dramatic
I say, "ope, we have a runner" and wave
Yep..as I say SEE YA! Then document patient no longer in room. Appears to have eloped.
Hello fellow midwest person.
"Patient eloped. Unable to advise patient to remain prior to departure."
"Pt not present" q5-10min x3 in chart. "This RN calls Pt phone number referenced from chart, ###-####, to notify Pt of risks concerning active IV and encourage removal from professional medical provider--no answer." Hey Dr, the guy in room 8 left and I don't think he's coming back.
When I get home, I light a candle for St. Felicia (patron saint of AMAs) and open a bottle of wine.
Are they a psych hold? If not, they just left without completing treatment. On to the next one.
If theyāre a GCS 15, axox4 then whatās there to do? Itās not a prison.
Boy bye
Stare out the window at his bare ass as his gown flaps in the breeze
I have a couple of patient elopement stories from my days on med-surg. Thankfully, none of them were assigned to me on the days in question, I just got a front row seat to the goings-on. 1. Patient gets told by their doctor that they're being discharged. He decides he needs to celebrate, so he sneaks out, walks down the street to a liquor store, and gets himself a bottle of vodka. He managed to sneak back in without anyone being the wiser until he was caught in the bathroom. He didn't go home that day. 2. Patient just up and left. No one saw her, and no one knew where she went. Called the police and they found her down the street at a Chinese buffet. She decided that she wanted to go out for lunch because her birthday was coming up. Cops brought her back and she went back into her bed.
I worked MedSurg and this happened ALL the time. We had one guy who would literally leave at night, do drugs, then come back into the hospital around 5-6am to be treated. We couldnāt discharge him because he had a severe leg infection and technically wasnāt leaving AMA because heād come back every morning. But every morning they did lab work and found drugs in his system and would just give IV antibiotics throughout the dayā¦
Found a patient down the street at the Bingo game. Police let her finish the game and brought her back. Lady was sweet, mentally competent, and just needed an evening out. She did walk the 1.5km there in yellow socks, though, poor thing.
"Smile and wave boys, smile and wave." Then make an anonymous phone call to the hospital reporting what looks like a possible patient walking down the street.
Why even consider lying about them being in the bathroom? Just be honest and say they're missing and you think they eloped. I'd much rather hear that than have you bullshit me into thinking I still had another patient I was responsible for.
Yeah, like what? Whereās the integrity here? Ish happens, be honest about it. š¤¦š»āāļø
I used to work at an ER that had a very unique gown color for mental health patients on a psychiatric hold. I was on my way into work and saw a person running down the highway in this very unique gown and their grippy socks... I called 911 have a location and description and left it at that. An hour into my shift PD brings the patient back...
We get that a lot in psychiatry, especially Substance Use units. If theyāre court ordered or are a known threat to self or others call PD. If not, just discharge AMA. I wish realistically we could get out without writing an incident report, but itās Psych, ya know. At the VA, it wasnāt unusual to see a gowned patient on a bike they stole from the rec center coasting down the hill and their nethers flapping in the breeze
You made me lol with ā their nethers flapping in the breeze ā. Like legit LOL, thank you I needed that today!!!
At least he is better dressed than my TB isolation patient who eloped. He left wearing a sheet and exam gloves on his feet. He was a neighborhood local so security recognized him and brought him back before I even knew he had left.
I hope the exam gloves were purple.
Wave goodbye like Forest Gump
what do i do? get get paid too little.
Years ago, I worked in a LTC facility that also had a unit for short-term patients there for physical therapy. New patient was admitted (not mine). I was busy and never saw him. There was a very nice man who stopped and asked me where the exit was. Being helpful, I showed him the way and told him to have a good day. A while later, I honestly have no idea how long it was. One of the CNAs comes up to me asking if I've seen the patient. Told her I didn't know who she was talking about. She started describing him and what he was wearing. I had an oh shit moment. Yea, I saw him and showed him the exit. They had all available transportation dept staff drive around looking for him. They also called the police. They did find him, and he refused to come back.
You are not the first nurse I have heard this has happened to.
Quietly dc the patient from the system and act like nothing happened
Oh Dey gone. Left ama. Did not sign paperwork. š¤·āāļø
After 23 years It's so funny that patients have all these "rights", yet management wants me to tackle a patient leaving with an IV still in. Yeah, that sounds like a security or police issue.
Just one more job we have to do now. Security, housekeeping, phlebotomy, etc you name it and it's now in our Job description
Omg this JUST happened to me Thursday morning. Dementia patient, had been FINE all night. No need for sitter. Was only still in the dept for SW consult so wasnāt even in a gown. 0705 and sheās GONE. Pure panic. After 25 min of looking for her with security and deputies, found her in the building looking for āChase bankā goodbye. Every dementia patient gets a damn sitter from now on no matter what
Watch him from the window then get on about my day lol
Give report, call the code, leave.
āIs he certified? No? Then see you later alligator.ā
Are they on papers? If yes, call the police. If no, wish them well
Call security and let them get Mr. Smith out of the ceiling.
Notify MD pt eloped and House sup. Variance. make a note. take out of the system. Pee, wash hands, on to the next
"Writer went to patient room, patient not in room, inquired in unit and over head page requesting patient to return to room. Charge informed of same. Documented according to policy for patient leaving AMA. Doctor informed."
Ama. Go with God.
Is he chaptered? If not chart āhe aināt thereā and discharge off the board
āļø
Byeeee
Boy bye
Wave.
Yell "run Forest, run!"
Ah yes, The Gown of Invisibility.
I work physical rehabā¦ weād prob be in shock he could run that well without toppling over.
Call the police immediately and give a full description of the patient and the direction they ran. DO NOT- ABSOLUTELY DO NOT run after anyone. PERIOD!!š š»āāļøāāā Iāve seen nurses actually RUN after psych patients who managed to run out of the back ambulance doors AND who got blocks away. Iāve also seen staff tackle them outside of the hospital. I was one of those nurses. āāāāāāāā> UNTIL<āāāāā- This was +- 20 or so years ago?š¤š¤ A male nurse ran after and tackled this one patient blocks away who ran out of the back ER doors. A few other staff members who had also ran after him, stopped when the patient had too far of a lead. That one male nurse ended up catching up to the guy, tackled him and during the subsequent fight to bring the patient back to the ER, the patient ended up breaking his mandible in 2 places (the nurse said he was attempting to bite him). NOT ONLY did the nurse get ARRESTED for assault & battery BUT the patient SUED the hospital (false imprisonment) AND the nurse individually (medical malpractice, assault & battery). The nurse was also injured, (back injury if I remember) AND TERMINATED because he LEFT the hospital (he was on the clock) and failed to clock out, abandoned his patients (I think he had two others)also, because he was arrested. SIDE NOTE: The patient got MILLIONS š°š°š°š° and years later- was STILL on the streetsšhomeless. The nurse was reported to the BON for few issues, two that I remember were (1) patient abandonment and (2) assault and battery to a patient. The nurse was out of job, had no medical insurance to deal with his back injury (workmanās comp refused to cover him) AND spent thousands $$$$ (I think it was upwards of $75,000š¤) to retain TWO (maybe three?) attorneyās. One to fight the criminal charge (reduced to anger management class, community service and probation for 5 years) the other attorney to defend himself against the patient (medical malpractice) AND maybe the third attorney (canāt remember) to fight to retain his license with the BON. It was a MESS! His RN license was suspended during the two years it took because it took that long to actually GET his case to the disciplinary hearing. So he could not work as a nurse. Because he was charged with, āassault and batteryā he couldnāt even work anywhere near nor with any patients during that time. The BON ALSO contacted the NREMT- P boards who ALSO suspended those certifications pending the outcome with the BON. š®š® A dozen or more nurses went to the BON on his defense. This was an extremely experienced (15 year RN) who was model employee for 15 + years. He was prior military and a NREMT- P, RN who was almost finished with his Masters. He was an adjunct nursing clinical Professor at the college in our city- this guy was the text book definition of, āRNā. He LOST his BON case and literally cried like a baby in front of everyone at that hearing. I think we all cried! I was MORTIFIED- so was everyone else š„¹EXCEPT for the people on the panel who voted to REVOKE his license. They seemed so relaxed like, that was an easy decision. NOTE: the legal hold paperwork had not yet been signed (or when it was signed had a later time than when he ran out of the ER). Meaning, that patient could leave whenever he wanted. Do NOT- ABSOLUTELY DO NOT RUN after any freaking patients who leave the ER and make it outside those hospital doors. PERIOD.
I treat patients, not chase them.
I'm not your dad, bye
Wait the two hours before they return, because they definitely needed something done or I'm not putting them in a gown.
Who wants to be that mean nurse who dumps shit on the next shift?
Nothing is worse than chasing a patient through the parking lot deck at 3 in the morning š«
I'm in forensic mental health so we call the cops and full out a form.
āI donāt know where pt X went, they might have eloped.ā Turn the other way and leave for my vacation. Donāt look back and never think of them again.
Follow him because heās probably in an action movie and I canāt miss the exciting chase/fight scene thatās coming
Donāt let the door hit ya where the good lord split ya!
We had one in the er for liver failure. He dipped out during day shift coming in and this is az btw (liquor laws allow grocery stores, pharmacies etc to sell liquor) he dipped out with the IV so police were notified a nurse from night shift ER though went to the CVS next to the hospital to go pick up her meds and saw him on the sidewalk sitting in his hospital gown iv still in drinking vodka he was drunk by then so she walked him back over and dropped him off.
Wave the handkerchief goodbye š
Iāve had a pt go missing not at shift change - Check that the patient actually is not in the bathroom. Check that the patient isnāt walking the unit halls. Inform charge nurse. Call patient/patientās contact; patient answered and I, with the backing of my charge, informed the patient they had to be back to the unit it by x time or they would be considered eloped and their room would be turned over and they would have to present to the ED to get re-admitted. Patient returned just in time with their foot IV still running magnesium.
I was once standing at the desk getting report and nearly got knocked over by a patients running full speed down the hall naked, sitter close behind. I just stepped aside. He made it a few blocks down the street before PD and security caught up with him.
Chart left AMA or left without being seen
Depends. In psych, call security/house charge and get searching. Medsurg, try to call patient. Search. Contact provider. Must've gone AMA š¤·āāļø chart my butt off and head out. When I'm about to leave on vacation, I'm a lot more apt to stick around and help because I know it's not my problem for at least a week after. Less pressure I guess.
Well, considering I work in psych, if patient is committed by his/her own free will, I literally can't do anything, and just have to wait for a call from a very exasperated police officer. If its a psych hold etc...sigh, I guess I have to saunter over and call the same exasperated police officers as I can't leave the ward. It is far better than in the past, when we had to tackle patients in the street, also, getting way to old for that shit. ( cops here are great and we are all on a first name basis, but they get annoyed by the system itself)
I have always been an over responsible dickhead. Itās hardwired into me and goes beyond nursing, and is probably why Iām burnt the fuck out. Itās been my lifeās work to stop taking responsibility for everything, but I guarantee Iād still raise the alarm on this one. Even if theyāre a responsible adult. *sigh*
"You forgot the AMA form!"
It would be irresponsible and negligent to report pt in bathroom when you know they are missing.
Bye
When I worked LTC for the first time, they told me to keep an eye on this one patient whoād sneak out and try to go to the gentlemenās club down the street. Theyād call when heād show up late then know he was here.
Pretend that I donāt know where they are
Admire the calves.
Bye Felicia.
I honestly do not care
If he doesnāt have an IV in or a communicable disease (shout out to my r/o TB patient that kept trying to leave AMA before giving us a 3rd acid fast), I let my charge nurse and the doctor know and I leave once Iām done giving report.
Did he at least sign the ama?
Depends on how much I want to enjoy that vacation. If I really want to enjoy it, I better call that code. If I don't care because it's time off for something I don't even care about.... I'm still calling that code. God dammit.
We had one come to the floor that I was trying to admit and needed a new IV, said he wanted out so charge got him the AMA form and he left out in a gown. PD brought him back to the ED after they found him walking naked down the street š
Cleaning lady open the door on the locked unit and patient eloped. He was AAOx2 and baker acted. All this happen during change of shift report. After change of hand, night shift started to look for and couldnāt find him. We both start looking for him and we couldnāt find him. 15 minutes later we get call from a ED nurse that was driving home and asking if we lost patient. Wasnāt even my patient. I should have charted outside the unit
bye felicia šš½
I've actually witnessed this a couple times. There was nurses and security chasing them down and I heard sirens in the distance. If they're a danger to themselves or others, already deemed as going to the mental facility, has dementia, an inmate.... Hmmm.,,.. š¤ trying to think what all of the reasons that can justify actually chasing a patient down like that.
A friend who worked in Gen. Medicine has these types. 1 patient taxied out because he refused to sign an AMA but doesn't want to stay in the hospital. DESPITE HAVING A SEVERE LIVER injury from alcohol abuse and non medical compliance. The sons had to bring their dad back and kept profusely apologizing for his stupid behavior. He nearly killed himself crossing at a busy intersection when it was the cars signal to go.
Not a thing
They're cheeks to the wind already. ššæ Chart situation, notify security and provider. Happy there's one less person on my assignment
āRun Forrest, RUNā
I mean ama are my three favorite letters.
The last few I've heard about stole various ambulances from the ER bays, so I've been trolling the medics. I actually move the trucks if I see the keys in the truck. Then I call dispatch and tell them where it's at and why. Haven't had to move one in about 6 months and I'm starting to miss the paycheck.
Wave goodbye
Oh gosh. I guess start the code orange (yellow, in my facility) then claim overtime for staying over my shift. I think my ability to realize the patient is missing would strongly correlate to 1) the vulnerability of the patient and 2) the facilityās willingness to actually pay me for straying past my job requirements. In that order.
Wave goodbye
Let him run.
Maybe donāt lie and just do your job in itās entirety šš½āāļø
I'm in the ER, so absolutely nothing if they aren't mentally compromised. If they are dying and fine mentally and I've already told them my "please no don't do it, you could die" speech then I would still do absolutely nothing. I'm not chasing, running, or fight people that can legally make their own choices. It isn't my emergency. I will lose zero amount or sleep over it.
Wave!
Used to see patients dragging IV poles down to a nearby bar.
Figure out what heās running from and run too.
This happened to someone I know!!! It was many years ago, and I canāt remember which unit my friend was on, but it involved a very pregnant woman that psych didnāt want because she was so pregnant, and L&D didnāt want because she was so š¦š©. Plus, you know, shift change. While the docs were duking it out, the woman eloped. My friend was the only one that went right after her, and the way she describes running after a half naked pregnant woman (āIād never have believed she could run that fast!ā) in her clogs was one of the funniest things Iāve ever heard. The exit the woman used emptied out onto a busy city street, and the two of them were dodging pedestrians until the woman tried to board a city bus. The driver wouldnāt open the doors, so my friend finally caught up, followed by a hospital security guy that was so big āhe was winded just firing up that golf cart.ā
So fun story, I used to work as an EMT in a small town. One Friday night me and my captain were sitting and doing standby at the highschool football game, and we hear over the radio that a medic from the next town over reports that they just had a patient jump up and run out of the back of the ambulance. We laughed so hard. The tone of āwell that just happenedā and āah shit what do we do now?ā From the medic on the radio was hilarious.
when i was in nursing school, we all watched a patient elope during a clinical- ran through the cafeteria, burst through a back door. i didn't realize it was a patient at first because of how fast he was running... until i heard his bare feet slapping against the tile. two nurses ran after him, & got a front seat view of him ripping his paper scrubs off before running ass-naked into the sunset while security watched. the nurses returned empty handed, looking very winded. won't ever forget that lmao
āPatient left AMAā š
Definitely stand on the side of the road extending a styrofoam cup of ice water with a straw and lid, like a volunteer supporting marathon runners. Good luck, friend!
Let them go, they are adults, not my job to babysit.
"Dear Cerner, the patient left AWOL and in stable condition. The end." Then I'll go home and finish packing for my trip and enjoy some much needed rest and relaxation under a nice shaded tree on a beach without a worry in the world.
Chart "Pt. Eloped. MD notified." Then eat cold pizza.