Another story

First, thanks to BurnPTCruisers for the in-depth comment. I should clarify that I was not in med school at the time of this incident and didn’t have the knowledge I have now (which, granted, is still extremely limited in actual clinical usefulness). But I did what I think any of you would have done in the same situation, which is to say, “If the poor bastard needs oxygen, then let’s give him oxygen!” It is very difficult to hurt somebody with too much oxygen.

I think the bottom line here was that our boss was thinking very short-sightedly, and did not realize that if we had done what he told us to do and the patient was harmed, the company would have been in MUCH bigger trouble. In his defense, he eventually came around to this (but for crying out loud, it shouldn’t even have been an argument!).

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Below is a report that I wrote up after a particularly sticky encounter with a patient at the hospital. The issue here is: the patient snapped her own IV line and walked out of the hospital. This is dangerous, because if the IV is not properly discontinued, she runs the risk of bleeding out. I caught up with her, wrestled with her a little bit, but eventually let her go because I didn't want to get MY ass locked up for assault. In case anything legal ever came of that situation, I wrote up my version of the story...

18 May, 2007

Patient was mid-30 year old female, possibly Native American, brought in by ambulance with a chief complaint of “too drunk for detox.” Patient was admitted to [the hallway where we put the inebriated to sleep it off], remained unarousable for most of her stay. Fluids were administered through an IV to her left hand. After approximately 2 hours, the patient awoke and I witnessed her sitting upright in bed. At approximately 1930 hours, patient was noticed by nurse and myself to be missing. The IV line had been severed and the patient’s belongings (coat and hat) had been left in orange bag beneath bed. Witnesses reported patient to have exited the south end of the ER.

I began searching the hospital for the patient while the nurse contacted security. I found the patient near the main staircase of the lobby, and called her name several times without response. I caught up with the patient and tried to convince her to return to the ED simply so we could pull out her IV and she could get her belongings. The patient refused, asking me on two occasions to pull out her IV there in the lobby. When I asked the patient if she wanted her belongings, she answered “They’re just possessions. Why would I want more possessions?” On two occasions, I took hold of the patient’s arm and attempted to escort her back to the ER, but on both occasions she resisted and said “No touching.” Several people witnessed this exchange. About two minutes after I had initially made contact with the patient, she exited through the lobby doors.

I returned to the ER and reported to the nurse that I had made contact with the patient, but she had refused to return to the ER. The nurse and I reported this to three security officers and the on-duty police officer. Security told us that once the patient was off hospital property, there was nothing they could do. The police officer and myself went outside to the ambulance bay and witnessed the patient walking eastbound on the north side of [omitted] Street. A security officer also witnessed the patient walking away. Security contacted the precint police with a physical description of the patient, who reported they would begin looking for the patient. I returned to the ER and took possession of patient’s belongings, arranging for them to be deposited in the lost and found.