Substance Abuse and Abuse Q 26
A hospitalized client with a history of alcohol abuse tells the nurse, “I am leaving now. I have to go. I don’t want any more treatment. I have things that I have to do right away.” The client has not been discharged. In fact, the client is scheduled for an important diagnostic test to be performed in 1 hour. After the nurse discusses the client’s concerns with the client, the client dresses and begins to walk out of the hospital room. The most important nursing action is to:
A. Restrain the client until the physician can be reached.
B. Call security to block all areas.
C. Tell the client that the client cannot return to this hospital again if the client leaves now.
D. Call the nursing supervisor.
Correct Answer: D. Call the nursing supervisor.
A nurse can be charged with false imprisonment if a client is made to believe wrongfully that the client cannot leave the hospital. Most health care facilities have documents that the client is asked to sign that relate to the client’s responsibilities when the client leaves against medical advice. The client should be asked to sign this document before leaving. A patient must be deemed incompetent and a danger to himself or someone else before his rights may be taken away and the patient placed in restraints and kept in the hospital against his wishes. If a patient does not wish to stay but has not been deemed incapable of making this decision, the hospital and its staff can be held accountable for false imprisonment.
Option A: Use of restraints may precipitate issues of battery and false imprisonment. Before undesired medical care can be undertaken, the EP must first understand the components and requirements of informed consent. Traditionally, patients have the right to determine if and when they want medical care and what care they desire. Patients enter into contractual obligations with physicians by granting permission for medical care and treatment. This is referred to as consent for treatment.
Option B: Calling security to block exits constitutes false imprisonment. Any client has a right to health care and cannot be told otherwise. Individuals are entitled to make decisions about their healthcare if they are deemed competent. Competency is defined as the capacity of a person to act on his/her own behalf; the ability to understand information presented, to appreciate the consequences of acting–or not acting–on that information, and to make a choice.
Option C: The nurse should request that the client wait to speak to the physician before leaving, but if the client refuses to do so, the nurse cannot hold him against his will. Realize, when you deprive someone of his/her freedom, you assume a “fiduciary responsibility.” A fiduciary is similar to a parent, guardian, or prison. It is a relationship of responsibility for the health and welfare of someone else. False imprisonment is the intentional infliction of confinement. It represents confinement and deprivation of personal liberty, for any length of time, without consent.