Question

Sundowner or Victim? —Case Mr. Nathan, an elderly male patient hospitalized for prostatic surgery, woke up in the middle of the night, dressed himself, and attempted to leave the nursing unit. An RN approached him to ask him where he was going and tried to detain him. He shoved the woman into a wall and she struck her head, sustaining a concussion. The unit clerk called for help. The patient ran toward the exit and was stopped by two male orderlies and a security guard. As they took him by the arms, he screamed, “I’m being held prisoner! I have the right to leave!” A physician wrote restraining orders to be checked in an hour, and the patient was given an intramuscular sedative. Mr. Nathan sustained some bruises and abrasions in the struggle. The nurse was taken to the ER and was out of work for two weeks. The patient is now suing the hospital for false imprisonment and aggravated assault. 1. What are the known facts in this situation? What else may be going on? 2. What are the responsibilities of the hospital with regard to caring for Mr. Nathan? 3. What should the hospital do about the nurse's injuries? 4. Was the physician justified in giving the patient a sedative and ordering physical restraints? Provide a rationale for your position. 5. Do you think his suit will hold up n court? Why or why not?

Answer 1

1. What are the known facts in this situation? What else may be going on?

Though the patient does have the right to leave against medical advice, the patient must have not harmed the nurse / medical staff. It was wrong on the medical staff’s part to restrain and medicate the patient with IM sedative if the patient wouldn’t have harmed the nurse. If the patient had a history of psychiatric illness, the restraining for this behavior was eligible.

2. What are the responsibilities of the hospital with regard to caring for Mr. Nathan?

The main responsibility for the hospital is patient centered care. But if he was being restrained without his will, that was breach of patient will and security. The intentions of the hospital also should be taken into account.

3. What should the hospital do about the nurse's injuries?

The hospital should provide immediate care for the nurse and admit her. If the hospital staff was doing the right thing, the patient is liable and responsible for his behavior and would be sued / arrested for assault / battery.

4. Was the physician justified in giving the patient a sedative and ordering physical restraints? Provide a rationale for your position.

Keeping in mind that patient was not suffering from any psychiatric illness this seems to be wrong on the medical staff’s part because the patient does have the right to leave as AMA (Against Medical Advice). The case can be justified only if the history or current medical status has any psychiatric illness or similar incidents in history of the patient as the staff does it purely for the safety of the patient and the staff.

5. Do you think his suit will hold up n court? Why or why not?

As discussed above the only turning point is the psychiatric illness. If present the hospital staff would look like doing their job. If not, its violation of patient’s free will or rights.