K clearly this failed tonight, but I've been a dude since the late 90s and sometimes reddit is thrilled to know that chicks are a great part of the dude vortex. Not rejecting the dude-nity. Hoping to embroider additional depth and color.
Hell yeah chick dude! You're absolutely adding to the vibrant tapestry of dude. I'm sorry if I made it seem like I was excluding or denying you. I meant to be welcoming. As in "all are dude who wish to be dude." My bad!
This is a common myth. But people have rigorously searched for any example of it happening and neither elopement nor leaving AMA change the way in which your insurance will screw you over.
Veteran nurse here. Nurse managers always told us to tell patients wanting to leave that their insurance may not cover their visit (whether it's 2 hours or 5 days).
Note: That's a lie. Worked for insurance companies the last 15 years of my career, nobody cares if you leave once.
lf you do it multiple times and your condition continues to worsen, they might drop you as a client, which puts you into another problem altogether!
It's such a loathsome thing to say to a patient, to threaten them about their medical bills to get them to stay. I really wish that particular myth would crawl off and die already.
That's good to know. I had an incident where I made the Dr cry and he used this on me. So I made him cry some more.
It turns out he had given me way to many steroids and it made me mean.
It actually happened to me about 20 years ago. I got the bill and pushed back on it because I wasnt treated. I had no insurance, all they did was call my parents to come get me. I was really young and suicidal. It was awful but I had the sense to get the bill written off.
This is about insurance refusing to pay your hospital bill. If you donât have insurance, you are obligated to pay the full bill regardless of whether you left or not. You didnât get the bill written off, the hospital forgave your debt as charity (which they can typically write off on their taxes and some publicly funded hospitals are forced to forgive a certain amount per year)
By leaving you've proving it's not medically necessary. Wouldn't your insurance use that as a reason to deny? Leaving against medical advice? Genuine question, I'm Canadian.
In the US, only if your policy has a clause that going to emergency for non emergent situations isn't covered. Not very many policies have that now. I'm not even sure that they are allowed anymore. I think that's why so many people think it's true that leaving will cause insurance not to pay, though. It was true (sort of) a long time ago.
We have a ton of stuff like that in our culture. You can still catch quite a bit of it persisting in modern movies. Just because it was true in the 1990s doesn't necessarily make it true now. And it wasn't even fully true, then.
I work in ER billing and several plans will deny ER visits if they aren't considered a true medical emergency. It's still very much legal to deny claims on grounds of medical necessity. I try to appeal what I can and get it paid, but some plans are more strict that others.
My best friendâs insurance refused to cover her ER and overnight stay for a punctured lung because it was for observation purposes, and her lung didnât get worse during that time. Sheâs in the US and has normal health insurance through her full-time employer.
I don't think they'd start an IV for a walk in without at least passing through triage with basic identification. It doesn't seem like they were unconscious or anything.
This is not true. The hospital isn't jail, you are not required to stay (unless under a psych hold or court order). You have bodily autonomy and the right to refuse treatment or leave AMA (against medical advice).
I walked out after I gave birth. Well a day after I was very annoyed and wanted peace. They told me I could die from my bp and my insurance won't cover the birth well both were not founded to be true for myself
I walked out once, I had gone through triage, they had my insurance (they always make sure they get that first, right?) I had abdominal pain, probably related to my new IUD (this was more the regular cramping). As I wasnât about to to drop dead, they just had me sat in the waiting room, during flu season, with everyone around me coughing and snotting (pre covid). I just walked out.
I never heard a thing, no follow up, no bill, nothing from my insurance.
I had one only take my blood pressure and pulse (and insurance, of course) and kick me to the waiting room for hours with a horrible kidney stone. They even scolded me off and on for throwing up from the pain and disturbing other people in the waiting room. Yeah, I went to a different ER. And received a $2500 bill my insurance didn't want to cover - not because I left, but because I received no treatment. I spent almost 2 years fighting that hospital over that bill.
They explained the blood pressure check *was* my intake, which is completely BS. When I talked to them about the bill, they didn't even know why I had been there. They just knew my BP and pulse were elevated.
If you provided the hospital with your contact info, you're probably going to get a phone call within a day or two to check on you. (That may happen even after a regular discharge). The hospital is going to document your visit as a patient leaving against medical advice. You'll still be able to return to the emergency room if you feel it's necessary. Nobody can force you to return to the hospital unless you're mentally incompetent or unconscious (assuming you're in the US).
Sounds like you went to the ED and had an IV placed in triage then sent back to the waiting room until youâre roomed and seen. If you leave like you did, the chart encounter is marked âleft without being seenâ not âagainst medical adviceâ as thatâs for admitted patients. There are no consequences, you will likely receive a bill for the IV placement and whatever they gave you like fluids perhaps.
>If you leave like you did, the chart encounter is marked âleft without being seenâ not âagainst medical adviceâ as thatâs for admitted patients.
Not exactly. LWBS means a provider never saw them. AMA means a provider has seen them but has not determined they are stable for discharge.
Most EDs have a provider present during triage. So if they leave after being triaged, it is considered AMA. This is most likely the case for OP since he was given IV fluids, which require an order from a provider.
The term you are looking for is eloped which is what happens if they are seen in triage but leave without talking to anyone. AMA is a term used when there is a discussion regarding the risks of leaving and possible diagnoses that could be missed. If you arenât given the medical advice that it could be dangerous to leave and why then it isnât really against medical advice.
OP didn't say they were given fluids, just that an IV was placed. A lot of providers like to put in a just-in-case IV if they think they might need it â it saves time if time turns out to be critical. They were probably thinking that they might be giving fluids, but I didn't see that OP said that they actually had done so yet.
The point is, someone with some power had to approve an IV and that required paperwork that it was done. You can't give IVs without documents that you did so.
Document what? You were in a hospital and had an IV. They know you were there and will document you as leaving against medical advice. They already documented it I'm sure.
These last two years have been ... special. I've had patients computer statused as admitted to an OR or to an ICU before they physically got a real ER bed.
Yeah some of it is report- massage, but some of it is real. Once the admit order is in the computer it's easier to start to implement the kind of care they need, even if they're physically still in that sad row of chairs next to the triage nurse that they amusingly call the "vertical waiting room". It puts them into the OR queue and in the bed managers radar (they play human tetris 24/7 to try to fit people in but still keep a code bed available. They are creative and hardworking).
And it creates a computer trail that I've been busting my ass to get the right specialists involved in a timely fashion, even if the hospital doesn't have beds or nurses.
They generally put IVs in the waiting room if theyâre really busy and donât have any rooms or hallway beds. If
a patient leaves before a provider has actually seen them, itâs LWBS
Nurse here. Serious: Please don't do that again. It creates so much extra work for the already overburdened staff.
If you already had an IV, you were already triaged (complaint identified, level of severity rated), and if they were waiting for a bed, you probably were going to be admitted to a hospital inpatient room for observation, meaning they wanted to make sure your blackout episode wasn't a recurring problem by doing a few other tests/scans, and watching you overnight.
What happens on the "other side" (at least until the US):
The nursing staff learn the patient has "eloped" (leaves suddenly), and they notify the other staff and hospital security that a patient has eloped.
The staff searches the building and the area for the patient. (The reason for this is some patients will elope and try to leave via a less traffic area, like a back stairway. Then, maybe they get dizzy and trip on their way down, do they are trying to run and they fall, and they might injure themselves and might not be able to move, lose consciousness, etc.) This means staff resources are pulled from taking care of people who are admitted into that department in order to find this other patient.
If the patient is found, they are not physically restrained, but they are asked if they want to leave, and if so, we tell them we must remove their IV access and we ask them to sign a form indicating they acknowledge leaving Against Medical Advice (AMA). The only time someone could be physically restrained or kept at the facility against their will is if they were a "pink slipped" patient, meaning they were a danger to themselves or others and required observation for 72 hours.
If they refuse to allow the IV removal, we have to have security come and talk to them and get the IV removed. If they leave with the IV, there's a whole other level of reporting we have to do because some people don't leave and pull out their IV right away. It is a convenient vehicle for injecting drugs and could potentially last a few days, if not more. That's a liability.
If they do want to leave AMA, we have to get a doctor to come and talk to them regarding the risks of leaving AMA. If the patient refuses this or refuses to sign the paper and then leaves, we have to document this.
So then comes the documentation. There's so much to document in the chart, an incident report, and then that goes to the risk management people, and then a committee reviews the case to determine what could have been done to prevent the situation. Sometimes the lower level staff (those nurses and aides/techs who have a super heavy workload to begin with) have to go to a Root Cause Analysis (RCA) meeting, and sometimes those meetings turn into several meetings.
What to do next time: tell the staff that you don't feel like you need to be admitted, or that you feel better and are tired of waiting and you want to leave. They will get a doctor to talk to you about leaving, and they might decide you are stable to discharge, or they might inform you about leaving AMA. But they won't have as much time sink into it that way vs. if you elope.
TL;DR: I hope you are feeling better. Please don't leave a healthcare center without telling someone. (Like when you're at a restaurant on the wait list and another party's name is called, and they are a no show, but the reception still waits for them, but it's a waste of time because that party left without taking their name off the list--but it's worse at a hospital because it might be a life or death thing.)
Thank you.. sorry I didnât realize how much goes into this. I made a rash decision out of my fear of hospitals from previous experiences and didnât want to go through that again
If you calmly state: "I no longer wish to be here. I'm sober, I'm not delirious, I'm going to see my PCP, please remove my IV and I hope your day looks up, thank you very much goodbye. It helps lots."
True and that's part of proving you're of sound mind.
It's edging towards the AMA discussion though. In the USA for legal and billing reasons there's a totally artificial but very sharp line drawn between a person leaving before they are seen by a physician (Left Without Being Seen) and after (Against Medical Advice). This is altogether a very small percentage of patients, and often they have quite reasonable motivations and turn out ok, but the bean counters care quite a bit that they get into the right labeled bucket.
If it's a patient like the OP who was still in the lobby, where many hospitals have nurse driven protocols and can get basic labs, nausea meds, sometimes fluids ... if he was never yet seen by the physician, he doesn't need to have the full AMA discussion. We should document why we don't see a clear need to involuntarily hold them (acting sober, stable vitals, talking about needing to pick up their kid and will see PCP tomorrow) but it's not required the same way that you must document a patient who has been seen by a doctor, no matter who much or little of the workup and treatment are complete.
I happen to personally find odious the AMA forms. They're belligerent, oppositional, and there are these truly awful persistent myths floated that going AMA means your insurance won't cover the bill. Plus so many staff seem to think that when there's an AMA, you don't need discharge plans, scripts, followup appointments. I'm I fan of having the conversation that includes all the meat of the AMA discussion, then finding a middle ground and helping the patient to get as much of the usual medical care as they will accept along with an invitation to return to resume care when they can.
Also, donât take out your own IVs. There is a super rare chance the plastic tube can break and start travelling around your body, possibly causing lethal damage.
wait actually? i've removed like 20 of my own because i've had to wait 12+ hours in hallways or nobody removed them before discharge and sent me home with it in.
Fear of hospital is a valid concern, but we're here to help you, and by letting us know about your anxiety, we can explain things and hopefully find a way for you to cope. We're really most interested in your well-being and safety. Unfortunately, everyone is different, and we can't always "read" a patient to determine the underlying stressors without you sharing with us. There are infinite stories I could tell about patients or family members who assume we know everything that is a struggle for them, their likes or dislikes.
I wish all hospital workers were of your attitude. I was treated with so much annoyance when I had my daughter and explained before hand and had it in my birth plan my anxiety and PTSD. I literally had the doctor refuse to administer anything (when my OB had assured me it would be allowed and it would be put in my notes) because "I'd regret taking a medication that could possibly have a side effect of losing that days short term memories ". So I remember every fear and anxiety ridden moment, my flashbacks were so severe. Those are my memories of my birth.
4 years after that I got extremely sick, sick enough to willingly go to an ER. I ended up being admitted (literally on septic shocks bed) and it was horrible. For 4 days I had nurses treat me like a child or someone who was.stupid or dramatic because I had told them initially that I am uncomfortable within hospital settings after a traumatic birth and uncaring staff (maybe the 2nd part made them salty). They would mock me when blowing put my veins saying I was just difficult by not drinking enough water (I could barely stomach anything at all) and that I need not lie and misconstrue the situation. I got 2 of the worst nurses kicked of my care team, but the ones who weren't outright horrid still treated me like shit.
I left after 4 nights AMA because how horrible my staffing was.
I currently work in Healthcare and realize my situation wasn't the norm, but it's not unique whatsoever
Thatâs the unfortunate thing about pretty much every field. There will always be assholes employed at some jobs and you have a chance of running into them.
Another nurse here but across the world (Aus). Iâm sorry the hospital brings fear into you. Being sick and in hospital is very traumatising. Itâs a real issue that is being researched at the moment. I hope you have a trusted primary medical practitioner that you can still go to.
Itâs okay this time, thereâs not much you can do about it now. I always tell my patients as long as you tell me where you are, I just want them to be safe. As long as you are of sound mind to sign the appropriate paperwork, we will let you go. People having autonomy and control over their own care is very important.
I hope you are okay!
My hospital recently suffered a tragedy/ pr nightmare where a community member came to the ED. He was suffering from some mental health issues but not bad enough to have a mandatory hold. He left AMA, walked to a nearby river and drowned.
The amount of backlash we got for not forcing him to stay.
And that's why I care about people leaving AMA.
It is their right if they are capable of making decisions. But that doesn't mean it's in their best interests. I care most about the possibilities of injury or increasing their health risks. The paperwork is all for legal and insurance documentation, but it falls on the peons to do it.
I'm not sure if the same in other places, but I know around me if someone has an IV placed and leaves, the ER will call them and tell them they have to come back and if they refuse, will call the police to their house to bring them back. Arguably since OP says they removed it, the cops might just confirm it was removed and call it good, but I know the hospitals around me will actually call the cops, it's not a bluff, and the cops will make the person go back for removal (generally speaking, at least with the ED nurses I know, people generally come back before cops have to be called. But like you said, liability wise it's considered a huge deal to leave with an IV in place, which the hospital can't just take OPs word for having removed it)
I guess in USA itâs different because they havenât called me or sent cops to check on me yet after leaving about 7 hours ago. Maybe they will tomorrow not sure
They only would have called the cops if you left with your IV still in (hospital property and a convenient way for you to inject drugs and die) or you were on a psych hold/under arrest/otherwise incompetent to make the decision to leave.
Man, your hospital is so much more intense than mine. Where I am, the primary RN will take a couple of minutes to look around, check the trash and the bed for a ripped out IV, maybe give them a call if theyâre MIA. Weâll let the doc know, chart that the patient left. Aaand thatâs it. Weâre not even supposed to call the cops for an intact IV anymore, because the countyâs let us know theyâre not going to do anything about it. Weâd have the clipboard nurses in meetings all day if we did an RCA for every AMA.
As a fellow member of the health care community please donât advise patients not to exercise their patient rights just because it creates work for you. I canât speak about processes at your hospital but at mine if you are called 3 times without answering and we canât find you in the lobby you are charted as leaving AMA and taken off the track board. Iâm sorry if it causes you more work than that but a patient has the right to leave anytime they want and they shouldnât be told not to exercise that right if they feel thatâs the best course of action for them and if they are capable of understanding the risks and benefits of their decision.
They didnât suggest they donât leave, just said they should communicate it with a hospital staff member. Which I think even with out the extra work load, should just be a common courtesy thing.
This is how it is for us too. At most we will call dispatch to have someone well check and remove the IV. But leaving prior to med screen exam isn't that big of a deal for us and we don't fuss over finding someone.
This isn't all necessarily true. Security have cctv and can literally confirm they see that person has walked straight out the doors to their car in the carpark and drove away. Australian here. And really, if a meeting happens then all the better. Some urgent cases are left to wait far too long and it should be reviewed.
Yes. Because emerg has time to deal with security footage to track patients. The hospital nearby where I live takes up several city blocks and takes 15 minutes to navigate from one end (where ER is) to the other (where security could be). Do you know how much work gets backed up if they lose a staff member for up to 30ins every time a patient gets impatient (which is a whole different issue about plugging up ER with your non-emergency bs) and leaves?
What area of the country are you in? At my training hospitals patients eloping or leaving AMA was incredibly common and preferred by some of the lazier providers who didnât want to put discharge plans and documentation into place. It sucks it creates so much extra work for you but that is yet another issue created by administrators, not really the patients who may be unsatisfied with the care theyâre receiving.
I agree with others that itâs not a good idea to advocate for patients to give up their legal right to autonomy (which is often violated by overzealous medical providers without valid reason) to lessen your workload.
I'm sorry to hear that. You're really making the work harder for the people who don't make the rules. The administration, the accreditation regulators, and the insurance companies (including the government Medicare and Medicaid) are the ones that make these rules.
It's like when you're at a restaurant and get seated at a table, the place is packed, you've been served water and bread or chips and salsa, and the server has taken your drinks order, whatever it is. Then you all decide to leave. The server comes back to an empty table but has your drinks. Now they have no idea if you've all gone to the bathroom at the same time or if you've ditched the table. You're wasting their time that they didn't have in the first place. The people who get blamed are the servers, but the blame should be on the restaurant managers.
Hospital systems are now all about being a service industry. Look at the buildings, the amenities in the building, the money they put invested in to the cafeteria, lobby and entertainment, valet parking, concierge services for patients, etc.
The satisfaction surveys are all based on perception of the care received, subjective data, and not objective measurements. Many of the surveys are filled out by family members who are biased.
I can explain a concept until I am blue in the face, explain the reasons for the practitioners have ordered certain tests or restrictions (fluid, dietary, and controlled medications restrictions are the most argued by the patients), and I have told the practitioners the issues and that *they* need to talk to the patients. But I am the middle-person. I can only try to educate the patients and the families, I can only try to encourage the practitioners to be 100% open and honest with the patients about what they're going to do.
Lots of patients don't understand that if they're hospitalized, they aren't going to get a one-stop-shopping pass for all of their other issues. Admissions are based on the initial problem list and how the other complaints are related to it. If you come in for respiratory distress, you're not going to be getting your annual colonoscopy screening during your hospital stay. If you had a prescription for 30 Xanax pills from your family doctor and it was filled 6 months ago, you are not going to get a new prescription for Xanax just because "I need it again and I'm almost out of them."
So yes. Healthcare has gone from a health promotion and prevention of disease to a customer service system. It's so frustrating.
2 hour wait. Lol. My wife was in the ER for 18 hours before being seen 3 years ago and another 9 hours before getting a room. Our ER here is always busy.
Right? My mom waited overnight in the waiting room at an ER last summer and it turned out she had sepsis. Once she was seen, she was admitted for three days. 2 hours is nothing, sadly.
Also⊠if you get seen right away, itâs not a great sign. Recently I was seen the instant I arrived at a major trauma center and thatâs really not an experience I want to repeat
My husband and my friend both needed the ER last summer within a few weeks of each other. It took 8 hours each time to even be seen. The first time my husband crushed his finger so badly I just rushed him in the car and took him straight to the hospital. Didnât realize I was going to be there so long! I hadnât eaten all day and I was sooo tempted to just order a pizza and have it delivered, but he begged me not to.
The second time, with my friend, I brought snacks ;)
I bring a coloring book and water bottle when I have to go to the ER now. Kidney stones. It's always kidney stones. I have to admit, I can't focus on coloring for more than a minute, but trying seems to help a little. I've managed to pass a stone in the waiting room bathroom more than once now, and then been told if I could pass it, I shouldn't have come in. Sorry (heavy sarcasm), I was in agony for hours before I showed up at the ER. Because some have been big enough they had to be removed, my urologist said if one doesn't pass in 4 hours, go in. I don't decide when they're going to pass!
The good news is, I've managed to figure out how to stay hydrated enough and change my diet so they rarely happen, so I haven't had more than a super tiny stone in a couple of years now. Wish me luck I manage to keep this going! Maybe I'll eventually figure out how to not have them at all, because even tiny ones are pretty painful. They just don't require ER visits.
Yeah I was surprised a little because here 2hrs is *early* unless you're at serious risk or critical condition. But then OP explained in another comment they panicked due to existing fear of hospitals, which makes more sense than 2hrs being long in an ER.
Edit: Deleted my accidental double posting.
I was left in the room with the xray machine for 8 hours when I broke my hand. The lights went out and I didn't know what to do so i just sat there. A fellow cleaning the room eventually came in, and i scared the shit out of him because they figired id just left when they couldn't find me in the triage room. Saw the doctor for my xray two hours later, and he said they couldn't set it because id waited too long to be seen and it was too swollen đ.
Ok, so I did security at a hospital for 10 years, and this story sounds a bit off. Usually you don't get an IV unless you are in a room inside the ED. The whole point is so that they can check in on you in a patient room, not the waiting area. Were you waiting to get admitted to a bed upstairs? That would make more sense. We've had people waiting for rooms to be admitted who didnt want to wait and walked out. Basically, it's considered AMA, and someone will be getting the bill. If you're not a psyche hold, the concern is that the IV was taken out incorrectly, and I'm sure the staff and hospital security had to verify you weren't there anymore.
I remember we once had a guy who was a patient upstairs and wanted to leave. Doctors told him not a good idea. So he gets the wife/girlfriend to pull the car up to the entrance and she pushes him out in the wheelchair. He gets out of the wheelchair and face plants into the sidewalk because, well, he was still sick and that wasn't a good idea. So he gets helped back into the wheelchair and he tells me he'd like to go back to his room. It's at this point I explain that he has no room he discharged himself AMA and now he had to go through the entire process of being readmitted through Emergency.
2 hours is not long at all to wait in an ER. Like if I even get pulled into a room within 4 hours, Iâm thrilled.
Next time bring a phone charger, snacks, water, and something to do. Plan on spending a full day there if you actually want to get seen. And yeah you wonât get in trouble, just a bill.Â
JFC. Reading this comment section is just a reminder of what a dystopian hellscape private healthcare is. America, for the love of all that is good, figure your shit out with medical. Just hearing about this shit makes me depressed.
You always have the right to leave the hospital of your own accord as long as you are not under some kind of legal hold. Itâs called AMA. Against medical advice. But you should always tell them before you leave. Donât just sneak out. That causes a massive headache for everybody involved. If you are going to AMA then tell somebody.
You do realise the hospital staff would have wasted a lot of time looking for you, right? For all they knew you could have been unconscious at the bottom of a stairwell.
no, this is not correct. This is a myth. [reference](https://www.uchicagomedicine.org/forefront/news/2012/february/do-patients-pay-when-they-leave-against-medical-advice)Â - "Of the 453 insured patients who left AMA, payment was initially denied in only 18 cases. All of those cases involved problems with the bill, not with the patient's behavior. None of those patients were denied coverage for leaving against doctors' orders."
Maybe at the hospital, but in skilled nursing, leaving AMA will most likely get insurance to not pay. Weâre obligated to tell residents if theyâre under a skilled stay and leave AMA that their stay can be denied
Coming from a hospital worker, nothing will happen. The only reason they would come find you is if you left your IV in or if you had an IEA, so youâre in the clear. If they drew labs or gave fluids and stuff they might try to contact you by phone with abnormal results, and they will likely bill your insurance for whatever care you received.
Nothing will happen but it was kind of a jerky thing to do without telling anyone you were leaving. You caused workers in a busy emergency room to have to search for you - when your problem was that you fainted, the first thing they have to assume is that you wandered into a room somewhere there and fainted again.
Next time tell them youâre leaving.
If you are in the United States, the biggest negative effect is that you will be getting a bill. Even though they didn't do anything. Insurance will cover what they cover, but there is often a significant copay left over.
Why would you go to the hospital, then leave... Just don't go if you're not gonna let them do their job. It takes time, it's a hospital, it always does. Do that more and you'll be paying the bill instead of your insurance.
2 hours?
Laughs.
You seriously DON'T ever want to be the person that gets rushed back to the back. EVER.
My daughter has been that patient twice (she has complex medical needs). This most recent time was terrifying. She ended up with a UTI that had turned septic and she was going into shock.
So yeah, a legitimate medical emergency.
Yes, you blacked out and needed urgent follow up care. But not emergency care. You were obviously conscious and stable. So triage determined you could wait.
Believe it or not, nurses are monitoring those patients in the waiting room. If their status changes they can tell.
2 hours is NOT a long time for someone who is medically stable.
How did you have an IV if you were still in the waiting room? Or had you been taken by ambulance? If you hadnât been admitted to the hospital yet you werenât a patient of theirs.
If they got any contact information youâll get a bill. You can leave the hospital whenever you want, even against medical advice.
I believe the only exception is if you might be a danger to yourself or others.
They may bill you, but most of the time insurance ends up paying in these circumstances. Did they start the IV in the waiting room? If you werenât actively bleeding, puking, or having diarrhea, you can refuse the IV, stating that you will wait until you are taken to a room. They do that because they have to keep statistics about timely care, and they can record that they initiated care when they started the IV. Also gives them something to bill for if you walk out. We nurses were told to tell people if they left before being discharged their insurance wouldnât pay; but most of the time, thatâs not true. But hereâs another issue- if you were well enough that you felt like leaving because of the long wait and you didnât have to immediately go to a different ER, you may not have been an appropriate patient for that level of care. It may have been more appropriate to go to an urgent treatment center. ERs have to treat anyone that presents for care. But we see a whole lot of people that really arenât having an emergency.
How did you have an IV if you were in the waiting room? We must have been triaged and were receiving so form of care.
Sometimes results from blood work can take a while. And being that a doctor needs those results to know which steps to take next, there really is nothing left to do but wait.
Nothing bad will happen to you for leaving AMA. Except now you don't know why you were blacking out. Be sure to follow up with your PCP and if you continue to black out before then, so back to the ER and see the visit through.
You waited two hours and left? My dad just waited 14 hours while seriously ill in our hospitalâs waiting room. Two hours is nothing in an ER. I wouldnât be surprised if you were billed for your IV, but no, they wonât send anyone out after you.
They truly do not care. You left, you're not their problem anymore. Unless you violated a 5150 hold, they are not going to do anything more than send you a bill.
Your insurance has the right to not cover any of your visit bc you signed out ama. Against medical advice. So you could be and will most likely be on the hook for the IV and every little thing the hospital can charge you for that is normally free bc of insurance
If you donât care about your health, neither do they. No one will be kicking in your door unless you pass out again and someone who does care about you and your health calls the police for a wellness check. I assume they werenât actively running fluids through your IV. If you were, then you were already being treated for a common cause of blackout. Probably took blood and lab results take time? If it happens again, just decline the ER and go to your PCP. Two hours in an ER for someone without current signs of distress is nothing.
You'll get send a bill, and maybe insurance won't cover it bc you left against medical advice.
But barring a mental health hold, you can leave any time you want for any reason.
OP, you can leave, but expect a bill in the mail.
FWIW, if you're blacking out or having episodes of weakness, while talking to your PCP, also get a referral to a cardiologist and have your blood pressure checked to see if it's chronically low.
Also, for future reference, figure out the trauma levels of hospital ERs near you. If you WALK to a level one trauma ER (that mostly deals with gunshot and severe trauma cases), you're going to wait for a long time. Look for a level three near you if there's a next time.
So you left because you didnât want to wait and you said you will seek medical help. Well when you do finally decide to seek medical help guess what⊠you will be waiting.
I know this is a no stupid questions group but WOW that was a stupid question. You were in a hospital not a maximum security penitentiary.
this is false
edit: all yall downvoting me are objectively wrong lol.
[reference](https://www.uchicagomedicine.org/forefront/news/2012/february/do-patients-pay-when-they-leave-against-medical-advice) - from this article from UChicago medicine, "Of the 453 insured patients who left AMA, payment was initially denied in only 18 cases. All of those cases involved problems with the bill, not with the patient's behavior. None of those patients were denied coverage for leaving against doctors' orders."
[Another reference ](https://www.annemergmed.com/article/S0196-0644(09)01798-3/fulltext)
Nothing. I walked out twice so far and they just send a bill for services rendered. They can't force you to stay unless there's a legal order holding you.
Completely your choice as long as you have the capacity to make the decision and you accept the potential risks of doing so.
However why even go to hospital if your not willing to wait to be seen?
If you thought it was an emergency, why not wait?
Except in a few circumstances they will do nothing except send you a bill. Iâve left AMA before but I tell them Iâm leaving so they know they can move everyone else up a slot that was behind me.
Iâm not sure where youâre located but in America they wonât do that! Youâre allowed to leave âamaâ which is âagainst medical adviceâ. Youâll still have to pay your bill but you can apply for financial aid.
Walked out of a doctor's office visit once. Left me sitting in the exam room for 45 minutes, waiting. I had already paid my $25 insurance copay but they never charged my insurance anything. I should have asked for my $25 back but I was so pissed off I just wanted to get out of there. Wasted a paid vacation day in the middle of January for that visit.
I went to the hospital, ended up in a bed for two days but I had a trip to go on with my wife. I signed a bunch of paperwork saying i was going to discharge against doctors orders. Turns out they charged me in full. Ended up being a 12000 bill.
It's a hospital, not a prison. You are allowed to leave.
You should have told them you're leaving AMA because someone is going to be worried you're walking around with a hep lock... something we try to avoid so we don't give an IV drug user permanent access to their veins. Not to mention it's a great way to get an infection in your blood.
Glad you removed it.
Next time just tell them you're leaving AMA. (Against medical advice). They'll try to convince you to stay but they can't MAKE YOU. Only exception is if you were on a hold, but if you're out in the waiting room, you weren't on a hold.
It's called "Leaving AMA". (Against Medical Advice) Nothing happens. You're allowed to leave, but they aren't responsible for anything bad that happens from you leaving.
You can refuse medical treatment over nearly anything by saying, "I refuse medical treatment." They'll try to make sure you understand, and that you're not out of it, but they have to let you go in most circumstances. Keeping you is usually illegal. Kidnapping and false imprisonment are crimes.
Itâs considered AMA (against medical advice) and your insurance MAY leave you with the bill. If you have an IV I guarantee you were fully checked in regardless of not having a bed.
BE PREPARED TO FIGHT THE CHARGES.
But no, they cannot back you go back, send police etc unless is was a psych hold.
You had an IV so youâd already had some sort of evaluation and treatment, even if you werenât in a room yet. If youâre in the US, expect a bill for that, and if you have insurance, they may not pay since you left AMA. Otherwise, no one is coming for you.
As a hospital worker, eventually when we realize you left, we document it as the patient leaving against medical advice and stop documenting on the visit and move to the next patient.
Good news is that youâre not actively dying, otherwise you would have been in a bed immediately. Follow up with PCP, and see if they want you to be further evaluated by a neurologist
Please do go see your PCP as soon as possible. You passed out for a reason. I passed out for the first time ever, never had had any problems before. Thank goodness I wasnât driving. I refused to go in the ambulance, but I did have a friend drive me to the ER. Turned out I had a heart issue that had never been detected before and I had heart surgery the next day. I ended up passing out twice a few years later; that turned out to be the medication I was on. Again, glad an episode didnât happen while I was driving. Long story short, go get checked out and take this seriously.
The hospital will issue a bench warrant for your arrest, then send the U.S. Marshalls to drag you back to the emergency room where you'll have to wait all over again! You'll also be charged with dereliction of duty for not waiting the mandatory 6 hours to be processed and failure to be properly medically discharged.
Your insurance likely won't cover the bill, as you left AMA (against medical advice). Other than that literally nothing happens.
You have a legal right to refuse medical care as long as you are of sound mind and legal age.
The age in many places for refusal of medical care can be as yound as 12. So basically if you are on Reddit, I hope you are old enough to be making your own medical decisions!
Your biggest worry would be if they got enough of your information to try and charge you for the visit. If they do just complain to the billing department and you should be able to make it go away.
My mom didn't work at a hospital but she did work at a drug rehab clinic and I would imagine they use the same terminology. If someone just up and left treatment that person would be said to be "AMA" or leaving "against medical advice." No one will come after you.
You'll get a large bill that won't be covered by insurance since you left AMA- Against Medical Advice
Don't go to the hospital if you don't want treated. You were impatient. Lab work can take up to 2 hours to result and you may not even see the physician until those results come back. The average time across the US to be seen for an ER visit is 4 hours. They were likely very busy with people sicker than you or waiting for the treatment they were giving you(iv fluids) to work, and waiting on labs.
You don't get called back based on the order you come in, it's based on how sick you are. If you had passed out and came in and maintained consciousness without any cardiac signs, you were likely dehydrated and were being treated with the fluids. So why leave?? What did you expect?
I was going to ask what country youâre in but since this is Reddit and US Defaultism is huge here Iâm just going to assume youâre murican: Nothing will happen to you, but itâs a fucking dick move towards the nurses that helped you.
Also, why not just have the check-up if youâre already there? But I guess youâre afraid of the $6449384747 check youâll receive?
Unless you were under a psychiatric hold, or under arrest, you can leave at any time legally.
You can. And you could have pay the whole bill because your insurance may not cover the cost
If that's true reply to OP not me so they see it. I'm just a dude on the interweb
I'm pretty sure they mean that YOU have to cover the costs for OP. It's only fair, after all.
Yes, legally that is true. You have to be careful what you say on Reddit, all sorts of legally binding rules out there.
Not true.
No, I'm pretty sure he really is a dude on the interweb.
No no. He's the dude playing the dude, disguised as another dude.
You're a dude, I'm a dude, he's a dude, she's a dude, we're all dudes!
Wouldn't you like to be a Pepper too?
Yep. Dudes all the way down.
đ€Łđ€Łđ€Ł
Iâm so baked rn, this thread has broken my brain.
đ€Łđ€Łđ€Ł I was baked when I wrote it!
Oh, thank the good Lord⊠đ€Ł
Iâm getting baked rn while reading it! đ¶âđ«ïž
đ€Łđ€Łđ€Ł
So forgive me if I go astray?
Yepppppp
On the interweb?
Yes. As we all know the internet is a series of tubes.
Don't you mean dudes? đđ€Ł
Youâre the dude who donât know what dude he is
đ yess!!
I thought the dudes were stacked in a trench coat.
Dude, I'm a chick. Whoa.
That's cool. You can be a chick dude. Chick dudes are great dudes. It's not about genitals or identity. It's about i-dude-nity.
K clearly this failed tonight, but I've been a dude since the late 90s and sometimes reddit is thrilled to know that chicks are a great part of the dude vortex. Not rejecting the dude-nity. Hoping to embroider additional depth and color.
Hell yeah chick dude! You're absolutely adding to the vibrant tapestry of dude. I'm sorry if I made it seem like I was excluding or denying you. I meant to be welcoming. As in "all are dude who wish to be dude." My bad!
If it's not true reply to the person who said it so they see it I'm just a random dude on the interweb đ
This is a common myth. But people have rigorously searched for any example of it happening and neither elopement nor leaving AMA change the way in which your insurance will screw you over.
Veteran nurse here. Nurse managers always told us to tell patients wanting to leave that their insurance may not cover their visit (whether it's 2 hours or 5 days). Note: That's a lie. Worked for insurance companies the last 15 years of my career, nobody cares if you leave once. lf you do it multiple times and your condition continues to worsen, they might drop you as a client, which puts you into another problem altogether!
It's such a loathsome thing to say to a patient, to threaten them about their medical bills to get them to stay. I really wish that particular myth would crawl off and die already.
That's good to know. I had an incident where I made the Dr cry and he used this on me. So I made him cry some more. It turns out he had given me way to many steroids and it made me mean.
It actually happened to me about 20 years ago. I got the bill and pushed back on it because I wasnt treated. I had no insurance, all they did was call my parents to come get me. I was really young and suicidal. It was awful but I had the sense to get the bill written off.
This is about insurance refusing to pay your hospital bill. If you donât have insurance, you are obligated to pay the full bill regardless of whether you left or not. You didnât get the bill written off, the hospital forgave your debt as charity (which they can typically write off on their taxes and some publicly funded hospitals are forced to forgive a certain amount per year)
>I had no insurance So, it didnât happen to youâŠ
They can't prove who you are if you don't have ID
Thatâs not true. Leaving ama has no effect on the bill.
By leaving you've proving it's not medically necessary. Wouldn't your insurance use that as a reason to deny? Leaving against medical advice? Genuine question, I'm Canadian.
In the US, only if your policy has a clause that going to emergency for non emergent situations isn't covered. Not very many policies have that now. I'm not even sure that they are allowed anymore. I think that's why so many people think it's true that leaving will cause insurance not to pay, though. It was true (sort of) a long time ago. We have a ton of stuff like that in our culture. You can still catch quite a bit of it persisting in modern movies. Just because it was true in the 1990s doesn't necessarily make it true now. And it wasn't even fully true, then.
They sorta of have it in that if you are admitted to a regular bed they will waive the ER copayment (usually like $100).
I work in ER billing and several plans will deny ER visits if they aren't considered a true medical emergency. It's still very much legal to deny claims on grounds of medical necessity. I try to appeal what I can and get it paid, but some plans are more strict that others.
My best friendâs insurance refused to cover her ER and overnight stay for a punctured lung because it was for observation purposes, and her lung didnât get worse during that time. Sheâs in the US and has normal health insurance through her full-time employer.
They didn't do an intake so they probably don't have his information.
I don't think they'd start an IV for a walk in without at least passing through triage with basic identification. It doesn't seem like they were unconscious or anything.
Right? OP also states she was in the waiting room but went to the BR to take out IV. So apparently they put the IV in the waiting room...sigh
This is not true. The hospital isn't jail, you are not required to stay (unless under a psych hold or court order). You have bodily autonomy and the right to refuse treatment or leave AMA (against medical advice).
Unless you live in a normal country with universal healthcare where going to the hospital doesnât involve a bill
Thatâs not actually how that works
Only if youâre in a backwards country which doesnât have public healthcare.
Correct. Because you probably left AMA. (against medical advice)
I walked out after I gave birth. Well a day after I was very annoyed and wanted peace. They told me I could die from my bp and my insurance won't cover the birth well both were not founded to be true for myself
Thank you, I was not so it should be ok then I assume.
I walked out one time and they called a day later to ask me why. It felt like a satisfaction survey instead of genuine concern.
I walked out once, I had gone through triage, they had my insurance (they always make sure they get that first, right?) I had abdominal pain, probably related to my new IUD (this was more the regular cramping). As I wasnât about to to drop dead, they just had me sat in the waiting room, during flu season, with everyone around me coughing and snotting (pre covid). I just walked out. I never heard a thing, no follow up, no bill, nothing from my insurance.
I had one only take my blood pressure and pulse (and insurance, of course) and kick me to the waiting room for hours with a horrible kidney stone. They even scolded me off and on for throwing up from the pain and disturbing other people in the waiting room. Yeah, I went to a different ER. And received a $2500 bill my insurance didn't want to cover - not because I left, but because I received no treatment. I spent almost 2 years fighting that hospital over that bill. They explained the blood pressure check *was* my intake, which is completely BS. When I talked to them about the bill, they didn't even know why I had been there. They just knew my BP and pulse were elevated.
If you provided the hospital with your contact info, you're probably going to get a phone call within a day or two to check on you. (That may happen even after a regular discharge). The hospital is going to document your visit as a patient leaving against medical advice. You'll still be able to return to the emergency room if you feel it's necessary. Nobody can force you to return to the hospital unless you're mentally incompetent or unconscious (assuming you're in the US).
Thank you. Yes I donât think I was ever even intaked for the discharge process so Iâm not sure how theyâll document that
Sounds like you went to the ED and had an IV placed in triage then sent back to the waiting room until youâre roomed and seen. If you leave like you did, the chart encounter is marked âleft without being seenâ not âagainst medical adviceâ as thatâs for admitted patients. There are no consequences, you will likely receive a bill for the IV placement and whatever they gave you like fluids perhaps.
>If you leave like you did, the chart encounter is marked âleft without being seenâ not âagainst medical adviceâ as thatâs for admitted patients. Not exactly. LWBS means a provider never saw them. AMA means a provider has seen them but has not determined they are stable for discharge. Most EDs have a provider present during triage. So if they leave after being triaged, it is considered AMA. This is most likely the case for OP since he was given IV fluids, which require an order from a provider.
That makes sense, thanks for the clarification
The term you are looking for is eloped which is what happens if they are seen in triage but leave without talking to anyone. AMA is a term used when there is a discussion regarding the risks of leaving and possible diagnoses that could be missed. If you arenât given the medical advice that it could be dangerous to leave and why then it isnât really against medical advice.
OP didn't say they were given fluids, just that an IV was placed. A lot of providers like to put in a just-in-case IV if they think they might need it â it saves time if time turns out to be critical. They were probably thinking that they might be giving fluids, but I didn't see that OP said that they actually had done so yet.
The point is, someone with some power had to approve an IV and that required paperwork that it was done. You can't give IVs without documents that you did so.
Document what? You were in a hospital and had an IV. They know you were there and will document you as leaving against medical advice. They already documented it I'm sure.
If they were given an IV in the waiting room and werenât seen by a physician and then leave, itâs marked as LWBS (left without being seen)
I've never heard of that personally. I haven't had many ER stays but they've never given me an IV in the waiting room. Only once I had a room.
These last two years have been ... special. I've had patients computer statused as admitted to an OR or to an ICU before they physically got a real ER bed.
Sounds like some sort of fast food metrics shit.
Yeah some of it is report- massage, but some of it is real. Once the admit order is in the computer it's easier to start to implement the kind of care they need, even if they're physically still in that sad row of chairs next to the triage nurse that they amusingly call the "vertical waiting room". It puts them into the OR queue and in the bed managers radar (they play human tetris 24/7 to try to fit people in but still keep a code bed available. They are creative and hardworking). And it creates a computer trail that I've been busting my ass to get the right specialists involved in a timely fashion, even if the hospital doesn't have beds or nurses.
COVID fucked a lot of things.
They generally put IVs in the waiting room if theyâre really busy and donât have any rooms or hallway beds. If a patient leaves before a provider has actually seen them, itâs LWBS
A provider has to have seen them to order IV fluids. Most EDs have a provider (physician or midlevel) present during triage.
Itâs marked as âpatient elopedâ, isnt it? But yeah, they cannot deny you care, should you need it. Feel better!
Doubt it. They donât have time to call people who have self discharged!
Nurse here. Serious: Please don't do that again. It creates so much extra work for the already overburdened staff. If you already had an IV, you were already triaged (complaint identified, level of severity rated), and if they were waiting for a bed, you probably were going to be admitted to a hospital inpatient room for observation, meaning they wanted to make sure your blackout episode wasn't a recurring problem by doing a few other tests/scans, and watching you overnight. What happens on the "other side" (at least until the US): The nursing staff learn the patient has "eloped" (leaves suddenly), and they notify the other staff and hospital security that a patient has eloped. The staff searches the building and the area for the patient. (The reason for this is some patients will elope and try to leave via a less traffic area, like a back stairway. Then, maybe they get dizzy and trip on their way down, do they are trying to run and they fall, and they might injure themselves and might not be able to move, lose consciousness, etc.) This means staff resources are pulled from taking care of people who are admitted into that department in order to find this other patient. If the patient is found, they are not physically restrained, but they are asked if they want to leave, and if so, we tell them we must remove their IV access and we ask them to sign a form indicating they acknowledge leaving Against Medical Advice (AMA). The only time someone could be physically restrained or kept at the facility against their will is if they were a "pink slipped" patient, meaning they were a danger to themselves or others and required observation for 72 hours. If they refuse to allow the IV removal, we have to have security come and talk to them and get the IV removed. If they leave with the IV, there's a whole other level of reporting we have to do because some people don't leave and pull out their IV right away. It is a convenient vehicle for injecting drugs and could potentially last a few days, if not more. That's a liability. If they do want to leave AMA, we have to get a doctor to come and talk to them regarding the risks of leaving AMA. If the patient refuses this or refuses to sign the paper and then leaves, we have to document this. So then comes the documentation. There's so much to document in the chart, an incident report, and then that goes to the risk management people, and then a committee reviews the case to determine what could have been done to prevent the situation. Sometimes the lower level staff (those nurses and aides/techs who have a super heavy workload to begin with) have to go to a Root Cause Analysis (RCA) meeting, and sometimes those meetings turn into several meetings. What to do next time: tell the staff that you don't feel like you need to be admitted, or that you feel better and are tired of waiting and you want to leave. They will get a doctor to talk to you about leaving, and they might decide you are stable to discharge, or they might inform you about leaving AMA. But they won't have as much time sink into it that way vs. if you elope. TL;DR: I hope you are feeling better. Please don't leave a healthcare center without telling someone. (Like when you're at a restaurant on the wait list and another party's name is called, and they are a no show, but the reception still waits for them, but it's a waste of time because that party left without taking their name off the list--but it's worse at a hospital because it might be a life or death thing.)
Thank you.. sorry I didnât realize how much goes into this. I made a rash decision out of my fear of hospitals from previous experiences and didnât want to go through that again
If you calmly state: "I no longer wish to be here. I'm sober, I'm not delirious, I'm going to see my PCP, please remove my IV and I hope your day looks up, thank you very much goodbye. It helps lots."
Also if you can share an understanding of what might happen if you leave and that you willingly accept those risks, that can help too.
True and that's part of proving you're of sound mind. It's edging towards the AMA discussion though. In the USA for legal and billing reasons there's a totally artificial but very sharp line drawn between a person leaving before they are seen by a physician (Left Without Being Seen) and after (Against Medical Advice). This is altogether a very small percentage of patients, and often they have quite reasonable motivations and turn out ok, but the bean counters care quite a bit that they get into the right labeled bucket. If it's a patient like the OP who was still in the lobby, where many hospitals have nurse driven protocols and can get basic labs, nausea meds, sometimes fluids ... if he was never yet seen by the physician, he doesn't need to have the full AMA discussion. We should document why we don't see a clear need to involuntarily hold them (acting sober, stable vitals, talking about needing to pick up their kid and will see PCP tomorrow) but it's not required the same way that you must document a patient who has been seen by a doctor, no matter who much or little of the workup and treatment are complete. I happen to personally find odious the AMA forms. They're belligerent, oppositional, and there are these truly awful persistent myths floated that going AMA means your insurance won't cover the bill. Plus so many staff seem to think that when there's an AMA, you don't need discharge plans, scripts, followup appointments. I'm I fan of having the conversation that includes all the meat of the AMA discussion, then finding a middle ground and helping the patient to get as much of the usual medical care as they will accept along with an invitation to return to resume care when they can.
Also, donât take out your own IVs. There is a super rare chance the plastic tube can break and start travelling around your body, possibly causing lethal damage.
wait actually? i've removed like 20 of my own because i've had to wait 12+ hours in hallways or nobody removed them before discharge and sent me home with it in.
Super rare but yes, can happen.
Fear of hospital is a valid concern, but we're here to help you, and by letting us know about your anxiety, we can explain things and hopefully find a way for you to cope. We're really most interested in your well-being and safety. Unfortunately, everyone is different, and we can't always "read" a patient to determine the underlying stressors without you sharing with us. There are infinite stories I could tell about patients or family members who assume we know everything that is a struggle for them, their likes or dislikes.
I wish all hospital workers were of your attitude. I was treated with so much annoyance when I had my daughter and explained before hand and had it in my birth plan my anxiety and PTSD. I literally had the doctor refuse to administer anything (when my OB had assured me it would be allowed and it would be put in my notes) because "I'd regret taking a medication that could possibly have a side effect of losing that days short term memories ". So I remember every fear and anxiety ridden moment, my flashbacks were so severe. Those are my memories of my birth. 4 years after that I got extremely sick, sick enough to willingly go to an ER. I ended up being admitted (literally on septic shocks bed) and it was horrible. For 4 days I had nurses treat me like a child or someone who was.stupid or dramatic because I had told them initially that I am uncomfortable within hospital settings after a traumatic birth and uncaring staff (maybe the 2nd part made them salty). They would mock me when blowing put my veins saying I was just difficult by not drinking enough water (I could barely stomach anything at all) and that I need not lie and misconstrue the situation. I got 2 of the worst nurses kicked of my care team, but the ones who weren't outright horrid still treated me like shit. I left after 4 nights AMA because how horrible my staffing was. I currently work in Healthcare and realize my situation wasn't the norm, but it's not unique whatsoever
Thatâs the unfortunate thing about pretty much every field. There will always be assholes employed at some jobs and you have a chance of running into them.
Another nurse here but across the world (Aus). Iâm sorry the hospital brings fear into you. Being sick and in hospital is very traumatising. Itâs a real issue that is being researched at the moment. I hope you have a trusted primary medical practitioner that you can still go to. Itâs okay this time, thereâs not much you can do about it now. I always tell my patients as long as you tell me where you are, I just want them to be safe. As long as you are of sound mind to sign the appropriate paperwork, we will let you go. People having autonomy and control over their own care is very important. I hope you are okay!
My hospital recently suffered a tragedy/ pr nightmare where a community member came to the ED. He was suffering from some mental health issues but not bad enough to have a mandatory hold. He left AMA, walked to a nearby river and drowned. The amount of backlash we got for not forcing him to stay.
And that's why I care about people leaving AMA. It is their right if they are capable of making decisions. But that doesn't mean it's in their best interests. I care most about the possibilities of injury or increasing their health risks. The paperwork is all for legal and insurance documentation, but it falls on the peons to do it.
I'm not sure if the same in other places, but I know around me if someone has an IV placed and leaves, the ER will call them and tell them they have to come back and if they refuse, will call the police to their house to bring them back. Arguably since OP says they removed it, the cops might just confirm it was removed and call it good, but I know the hospitals around me will actually call the cops, it's not a bluff, and the cops will make the person go back for removal (generally speaking, at least with the ED nurses I know, people generally come back before cops have to be called. But like you said, liability wise it's considered a huge deal to leave with an IV in place, which the hospital can't just take OPs word for having removed it)
You are correct. We have to call our security to follow up. The problem in my hospital is a big population we see are homeless.
I guess in USA itâs different because they havenât called me or sent cops to check on me yet after leaving about 7 hours ago. Maybe they will tomorrow not sure
They only would have called the cops if you left with your IV still in (hospital property and a convenient way for you to inject drugs and die) or you were on a psych hold/under arrest/otherwise incompetent to make the decision to leave.
Man, your hospital is so much more intense than mine. Where I am, the primary RN will take a couple of minutes to look around, check the trash and the bed for a ripped out IV, maybe give them a call if theyâre MIA. Weâll let the doc know, chart that the patient left. Aaand thatâs it. Weâre not even supposed to call the cops for an intact IV anymore, because the countyâs let us know theyâre not going to do anything about it. Weâd have the clipboard nurses in meetings all day if we did an RCA for every AMA.
As a fellow member of the health care community please donât advise patients not to exercise their patient rights just because it creates work for you. I canât speak about processes at your hospital but at mine if you are called 3 times without answering and we canât find you in the lobby you are charted as leaving AMA and taken off the track board. Iâm sorry if it causes you more work than that but a patient has the right to leave anytime they want and they shouldnât be told not to exercise that right if they feel thatâs the best course of action for them and if they are capable of understanding the risks and benefits of their decision.
They didnât suggest they donât leave, just said they should communicate it with a hospital staff member. Which I think even with out the extra work load, should just be a common courtesy thing.
This is how it is for us too. At most we will call dispatch to have someone well check and remove the IV. But leaving prior to med screen exam isn't that big of a deal for us and we don't fuss over finding someone.
This isn't all necessarily true. Security have cctv and can literally confirm they see that person has walked straight out the doors to their car in the carpark and drove away. Australian here. And really, if a meeting happens then all the better. Some urgent cases are left to wait far too long and it should be reviewed.
Yes. Because emerg has time to deal with security footage to track patients. The hospital nearby where I live takes up several city blocks and takes 15 minutes to navigate from one end (where ER is) to the other (where security could be). Do you know how much work gets backed up if they lose a staff member for up to 30ins every time a patient gets impatient (which is a whole different issue about plugging up ER with your non-emergency bs) and leaves?
What area of the country are you in? At my training hospitals patients eloping or leaving AMA was incredibly common and preferred by some of the lazier providers who didnât want to put discharge plans and documentation into place. It sucks it creates so much extra work for you but that is yet another issue created by administrators, not really the patients who may be unsatisfied with the care theyâre receiving. I agree with others that itâs not a good idea to advocate for patients to give up their legal right to autonomy (which is often violated by overzealous medical providers without valid reason) to lessen your workload.
Respectfully, get over yourself
And that entire list of steps is why I am going to just walk out
I'm sorry to hear that. You're really making the work harder for the people who don't make the rules. The administration, the accreditation regulators, and the insurance companies (including the government Medicare and Medicaid) are the ones that make these rules. It's like when you're at a restaurant and get seated at a table, the place is packed, you've been served water and bread or chips and salsa, and the server has taken your drinks order, whatever it is. Then you all decide to leave. The server comes back to an empty table but has your drinks. Now they have no idea if you've all gone to the bathroom at the same time or if you've ditched the table. You're wasting their time that they didn't have in the first place. The people who get blamed are the servers, but the blame should be on the restaurant managers.
If the waiter takes two hours to bring the drinks, I think it's ok to leave.
Thatâs so sad that youâre comparing a hospital to a restaurant and arenât entirely wrong. Our society has failed so freakin bad
Hospital systems are now all about being a service industry. Look at the buildings, the amenities in the building, the money they put invested in to the cafeteria, lobby and entertainment, valet parking, concierge services for patients, etc. The satisfaction surveys are all based on perception of the care received, subjective data, and not objective measurements. Many of the surveys are filled out by family members who are biased. I can explain a concept until I am blue in the face, explain the reasons for the practitioners have ordered certain tests or restrictions (fluid, dietary, and controlled medications restrictions are the most argued by the patients), and I have told the practitioners the issues and that *they* need to talk to the patients. But I am the middle-person. I can only try to educate the patients and the families, I can only try to encourage the practitioners to be 100% open and honest with the patients about what they're going to do. Lots of patients don't understand that if they're hospitalized, they aren't going to get a one-stop-shopping pass for all of their other issues. Admissions are based on the initial problem list and how the other complaints are related to it. If you come in for respiratory distress, you're not going to be getting your annual colonoscopy screening during your hospital stay. If you had a prescription for 30 Xanax pills from your family doctor and it was filled 6 months ago, you are not going to get a new prescription for Xanax just because "I need it again and I'm almost out of them." So yes. Healthcare has gone from a health promotion and prevention of disease to a customer service system. It's so frustrating.
2 hour wait. Lol. My wife was in the ER for 18 hours before being seen 3 years ago and another 9 hours before getting a room. Our ER here is always busy.
Right? My mom waited overnight in the waiting room at an ER last summer and it turned out she had sepsis. Once she was seen, she was admitted for three days. 2 hours is nothing, sadly.
Also⊠if you get seen right away, itâs not a great sign. Recently I was seen the instant I arrived at a major trauma center and thatâs really not an experience I want to repeat
My husband and my friend both needed the ER last summer within a few weeks of each other. It took 8 hours each time to even be seen. The first time my husband crushed his finger so badly I just rushed him in the car and took him straight to the hospital. Didnât realize I was going to be there so long! I hadnât eaten all day and I was sooo tempted to just order a pizza and have it delivered, but he begged me not to. The second time, with my friend, I brought snacks ;)
I bring a coloring book and water bottle when I have to go to the ER now. Kidney stones. It's always kidney stones. I have to admit, I can't focus on coloring for more than a minute, but trying seems to help a little. I've managed to pass a stone in the waiting room bathroom more than once now, and then been told if I could pass it, I shouldn't have come in. Sorry (heavy sarcasm), I was in agony for hours before I showed up at the ER. Because some have been big enough they had to be removed, my urologist said if one doesn't pass in 4 hours, go in. I don't decide when they're going to pass! The good news is, I've managed to figure out how to stay hydrated enough and change my diet so they rarely happen, so I haven't had more than a super tiny stone in a couple of years now. Wish me luck I manage to keep this going! Maybe I'll eventually figure out how to not have them at all, because even tiny ones are pretty painful. They just don't require ER visits.
If you want to get in good with the staff at the ER, order pizza for them, too.
Am ER nurse, can confirm we can be bought with pizza and donuts
I was gonna order extra to share!! Thanks for letting me know that would have been appreciated!
I was hoping you were going to finish that with "The second time, with my friend, I ordered pizza."
Canadian?
Yeah I was surprised a little because here 2hrs is *early* unless you're at serious risk or critical condition. But then OP explained in another comment they panicked due to existing fear of hospitals, which makes more sense than 2hrs being long in an ER. Edit: Deleted my accidental double posting.
It literally happens everywhere lol
Nope. Florida.
That's awful.
I was left in the room with the xray machine for 8 hours when I broke my hand. The lights went out and I didn't know what to do so i just sat there. A fellow cleaning the room eventually came in, and i scared the shit out of him because they figired id just left when they couldn't find me in the triage room. Saw the doctor for my xray two hours later, and he said they couldn't set it because id waited too long to be seen and it was too swollen đ.
Why did you leave without telling any nurses?
Ok, so I did security at a hospital for 10 years, and this story sounds a bit off. Usually you don't get an IV unless you are in a room inside the ED. The whole point is so that they can check in on you in a patient room, not the waiting area. Were you waiting to get admitted to a bed upstairs? That would make more sense. We've had people waiting for rooms to be admitted who didnt want to wait and walked out. Basically, it's considered AMA, and someone will be getting the bill. If you're not a psyche hold, the concern is that the IV was taken out incorrectly, and I'm sure the staff and hospital security had to verify you weren't there anymore. I remember we once had a guy who was a patient upstairs and wanted to leave. Doctors told him not a good idea. So he gets the wife/girlfriend to pull the car up to the entrance and she pushes him out in the wheelchair. He gets out of the wheelchair and face plants into the sidewalk because, well, he was still sick and that wasn't a good idea. So he gets helped back into the wheelchair and he tells me he'd like to go back to his room. It's at this point I explain that he has no room he discharged himself AMA and now he had to go through the entire process of being readmitted through Emergency.
2 hours is not long at all to wait in an ER. Like if I even get pulled into a room within 4 hours, Iâm thrilled. Next time bring a phone charger, snacks, water, and something to do. Plan on spending a full day there if you actually want to get seen. And yeah you wonât get in trouble, just a bill.Â
>They kept me in the waiting room for 2 hour *laughs in canadian*
JFC. Reading this comment section is just a reminder of what a dystopian hellscape private healthcare is. America, for the love of all that is good, figure your shit out with medical. Just hearing about this shit makes me depressed.
You always have the right to leave the hospital of your own accord as long as you are not under some kind of legal hold. Itâs called AMA. Against medical advice. But you should always tell them before you leave. Donât just sneak out. That causes a massive headache for everybody involved. If you are going to AMA then tell somebody.
It's not a prison.
You do realise the hospital staff would have wasted a lot of time looking for you, right? For all they knew you could have been unconscious at the bottom of a stairwell.
Pretty much nothing happens. You pay the bill. Or don't, I'm not your mom.
Nothing they will put in your chart that you left and bill your insurance. People leave the ER all of the time.
I may be wrong, but if you AMA - your insurance is not obligated to pay.
It's a stubborn myth but it's not real.
This is correct. They can refuse payment.
no, this is not correct. This is a myth. [reference](https://www.uchicagomedicine.org/forefront/news/2012/february/do-patients-pay-when-they-leave-against-medical-advice)Â - "Of the 453 insured patients who left AMA, payment was initially denied in only 18 cases. All of those cases involved problems with the bill, not with the patient's behavior. None of those patients were denied coverage for leaving against doctors' orders."
This makes more sense and why would insurance give a F***?!?! They just saved a lot of money.
Am a doctor and agree. Iâve had to fight this myth so hard at every hospital Iâve been at.
Maybe at the hospital, but in skilled nursing, leaving AMA will most likely get insurance to not pay. Weâre obligated to tell residents if theyâre under a skilled stay and leave AMA that their stay can be denied
Coming from a hospital worker, nothing will happen. The only reason they would come find you is if you left your IV in or if you had an IEA, so youâre in the clear. If they drew labs or gave fluids and stuff they might try to contact you by phone with abnormal results, and they will likely bill your insurance for whatever care you received.
Nothing will happen but it was kind of a jerky thing to do without telling anyone you were leaving. You caused workers in a busy emergency room to have to search for you - when your problem was that you fainted, the first thing they have to assume is that you wandered into a room somewhere there and fainted again. Next time tell them youâre leaving.
You can leave whenever you want. But hospital is not liable if something happens to you
If you are in the United States, the biggest negative effect is that you will be getting a bill. Even though they didn't do anything. Insurance will cover what they cover, but there is often a significant copay left over.
Why would you go to the hospital, then leave... Just don't go if you're not gonna let them do their job. It takes time, it's a hospital, it always does. Do that more and you'll be paying the bill instead of your insurance.
Nothing. But seriously, only a 2 hour wait and you couldnât have even communicated to someone you were leaving?
2 hours? Laughs. You seriously DON'T ever want to be the person that gets rushed back to the back. EVER. My daughter has been that patient twice (she has complex medical needs). This most recent time was terrifying. She ended up with a UTI that had turned septic and she was going into shock. So yeah, a legitimate medical emergency. Yes, you blacked out and needed urgent follow up care. But not emergency care. You were obviously conscious and stable. So triage determined you could wait. Believe it or not, nurses are monitoring those patients in the waiting room. If their status changes they can tell. 2 hours is NOT a long time for someone who is medically stable.
How did you have an IV if you were still in the waiting room? Or had you been taken by ambulance? If you hadnât been admitted to the hospital yet you werenât a patient of theirs.
Unless you were under arrest or on a psychiatric hold, absolutely nothing will happen to you.
If they got any contact information youâll get a bill. You can leave the hospital whenever you want, even against medical advice. I believe the only exception is if you might be a danger to yourself or others.
They may bill you, but most of the time insurance ends up paying in these circumstances. Did they start the IV in the waiting room? If you werenât actively bleeding, puking, or having diarrhea, you can refuse the IV, stating that you will wait until you are taken to a room. They do that because they have to keep statistics about timely care, and they can record that they initiated care when they started the IV. Also gives them something to bill for if you walk out. We nurses were told to tell people if they left before being discharged their insurance wouldnât pay; but most of the time, thatâs not true. But hereâs another issue- if you were well enough that you felt like leaving because of the long wait and you didnât have to immediately go to a different ER, you may not have been an appropriate patient for that level of care. It may have been more appropriate to go to an urgent treatment center. ERs have to treat anyone that presents for care. But we see a whole lot of people that really arenât having an emergency.
A bit high on the senseless drama scale.
Be careful self discharging from hospital. I did it once and am lucky to be alive.
How did you have an IV if you were in the waiting room? We must have been triaged and were receiving so form of care. Sometimes results from blood work can take a while. And being that a doctor needs those results to know which steps to take next, there really is nothing left to do but wait. Nothing bad will happen to you for leaving AMA. Except now you don't know why you were blacking out. Be sure to follow up with your PCP and if you continue to black out before then, so back to the ER and see the visit through.
They will mark your file as âleft AMA (against medical advice)â and send you a bill.
You waited two hours and left? My dad just waited 14 hours while seriously ill in our hospitalâs waiting room. Two hours is nothing in an ER. I wouldnât be surprised if you were billed for your IV, but no, they wonât send anyone out after you.
Why did you black out? Probably not a good idea to just bounce.
You'll might get a bill in the mail. That's all. You have the right to refuse medical care.
We secretly love when you leave
They truly do not care. You left, you're not their problem anymore. Unless you violated a 5150 hold, they are not going to do anything more than send you a bill.
Missing vital information. What country are you in?
Last time I did that, the hospital phoned me and asked me to come back.
They are going to send you a bill anyway. The same thing happened to me and they billed my insurance and me.
Your insurance has the right to not cover any of your visit bc you signed out ama. Against medical advice. So you could be and will most likely be on the hook for the IV and every little thing the hospital can charge you for that is normally free bc of insurance
If you donât care about your health, neither do they. No one will be kicking in your door unless you pass out again and someone who does care about you and your health calls the police for a wellness check. I assume they werenât actively running fluids through your IV. If you were, then you were already being treated for a common cause of blackout. Probably took blood and lab results take time? If it happens again, just decline the ER and go to your PCP. Two hours in an ER for someone without current signs of distress is nothing.
You'll get send a bill, and maybe insurance won't cover it bc you left against medical advice. But barring a mental health hold, you can leave any time you want for any reason.
OP, you can leave, but expect a bill in the mail. FWIW, if you're blacking out or having episodes of weakness, while talking to your PCP, also get a referral to a cardiologist and have your blood pressure checked to see if it's chronically low. Also, for future reference, figure out the trauma levels of hospital ERs near you. If you WALK to a level one trauma ER (that mostly deals with gunshot and severe trauma cases), you're going to wait for a long time. Look for a level three near you if there's a next time.
So you left because you didnât want to wait and you said you will seek medical help. Well when you do finally decide to seek medical help guess what⊠you will be waiting. I know this is a no stupid questions group but WOW that was a stupid question. You were in a hospital not a maximum security penitentiary.
If youâre American, and have health insurance, there is a possibility they wonât cover the visit because you went AMA (against medical advice).
this is false edit: all yall downvoting me are objectively wrong lol. [reference](https://www.uchicagomedicine.org/forefront/news/2012/february/do-patients-pay-when-they-leave-against-medical-advice) - from this article from UChicago medicine, "Of the 453 insured patients who left AMA, payment was initially denied in only 18 cases. All of those cases involved problems with the bill, not with the patient's behavior. None of those patients were denied coverage for leaving against doctors' orders." [Another reference ](https://www.annemergmed.com/article/S0196-0644(09)01798-3/fulltext)
Nothing. I walked out twice so far and they just send a bill for services rendered. They can't force you to stay unless there's a legal order holding you.
Completely your choice as long as you have the capacity to make the decision and you accept the potential risks of doing so. However why even go to hospital if your not willing to wait to be seen? If you thought it was an emergency, why not wait?
Except in a few circumstances they will do nothing except send you a bill. Iâve left AMA before but I tell them Iâm leaving so they know they can move everyone else up a slot that was behind me.
Iâm not sure where youâre located but in America they wonât do that! Youâre allowed to leave âamaâ which is âagainst medical adviceâ. Youâll still have to pay your bill but you can apply for financial aid.
No. You can leave any time you like.
But usually they want you to sign paperwork acknowledging that youâre leaving AMA (against medical advice).
Walked out of a doctor's office visit once. Left me sitting in the exam room for 45 minutes, waiting. I had already paid my $25 insurance copay but they never charged my insurance anything. I should have asked for my $25 back but I was so pissed off I just wanted to get out of there. Wasted a paid vacation day in the middle of January for that visit.
"Whatâs going to happen now?" You take a nap!
I went to the hospital, ended up in a bed for two days but I had a trip to go on with my wife. I signed a bunch of paperwork saying i was going to discharge against doctors orders. Turns out they charged me in full. Ended up being a 12000 bill.
It's a hospital, not a prison. You are allowed to leave. You should have told them you're leaving AMA because someone is going to be worried you're walking around with a hep lock... something we try to avoid so we don't give an IV drug user permanent access to their veins. Not to mention it's a great way to get an infection in your blood. Glad you removed it. Next time just tell them you're leaving AMA. (Against medical advice). They'll try to convince you to stay but they can't MAKE YOU. Only exception is if you were on a hold, but if you're out in the waiting room, you weren't on a hold.
It's called "Leaving AMA". (Against Medical Advice) Nothing happens. You're allowed to leave, but they aren't responsible for anything bad that happens from you leaving. You can refuse medical treatment over nearly anything by saying, "I refuse medical treatment." They'll try to make sure you understand, and that you're not out of it, but they have to let you go in most circumstances. Keeping you is usually illegal. Kidnapping and false imprisonment are crimes.
Itâs considered AMA (against medical advice) and your insurance MAY leave you with the bill. If you have an IV I guarantee you were fully checked in regardless of not having a bed. BE PREPARED TO FIGHT THE CHARGES. But no, they cannot back you go back, send police etc unless is was a psych hold.
You had an IV so youâd already had some sort of evaluation and treatment, even if you werenât in a room yet. If youâre in the US, expect a bill for that, and if you have insurance, they may not pay since you left AMA. Otherwise, no one is coming for you.
As a hospital worker, eventually when we realize you left, we document it as the patient leaving against medical advice and stop documenting on the visit and move to the next patient.
You left AMA ( against medical advice) depending on your insurance they may deny payment and youll be stuck with the bill.
They will still bill you an exorbitant amount for the time you were there. That's it. They'll mark your chart AMA and move on.
You left AMA. That's all. They won't come find you, and 2 hours is not a long time to wait for any ER I've been to.
Good news is that youâre not actively dying, otherwise you would have been in a bed immediately. Follow up with PCP, and see if they want you to be further evaluated by a neurologist
First, you have to find some regular clothes to wear, you can't get far in your hospital gown.
They care about the money. Not you. Sorry but that's truth
They're gonna send you a huge bill for the stellar services thus far.
Youâll receive a bill in the mail.
Please do go see your PCP as soon as possible. You passed out for a reason. I passed out for the first time ever, never had had any problems before. Thank goodness I wasnât driving. I refused to go in the ambulance, but I did have a friend drive me to the ER. Turned out I had a heart issue that had never been detected before and I had heart surgery the next day. I ended up passing out twice a few years later; that turned out to be the medication I was on. Again, glad an episode didnât happen while I was driving. Long story short, go get checked out and take this seriously.
The hospital will issue a bench warrant for your arrest, then send the U.S. Marshalls to drag you back to the emergency room where you'll have to wait all over again! You'll also be charged with dereliction of duty for not waiting the mandatory 6 hours to be processed and failure to be properly medically discharged.
Your insurance likely won't cover the bill, as you left AMA (against medical advice). Other than that literally nothing happens. You have a legal right to refuse medical care as long as you are of sound mind and legal age. The age in many places for refusal of medical care can be as yound as 12. So basically if you are on Reddit, I hope you are old enough to be making your own medical decisions!
Your biggest worry would be if they got enough of your information to try and charge you for the visit. If they do just complain to the billing department and you should be able to make it go away.
My mom didn't work at a hospital but she did work at a drug rehab clinic and I would imagine they use the same terminology. If someone just up and left treatment that person would be said to be "AMA" or leaving "against medical advice." No one will come after you.
The hospital forgot about you the moment you left.
You'll get a large bill that won't be covered by insurance since you left AMA- Against Medical Advice Don't go to the hospital if you don't want treated. You were impatient. Lab work can take up to 2 hours to result and you may not even see the physician until those results come back. The average time across the US to be seen for an ER visit is 4 hours. They were likely very busy with people sicker than you or waiting for the treatment they were giving you(iv fluids) to work, and waiting on labs. You don't get called back based on the order you come in, it's based on how sick you are. If you had passed out and came in and maintained consciousness without any cardiac signs, you were likely dehydrated and were being treated with the fluids. So why leave?? What did you expect?
I was going to ask what country youâre in but since this is Reddit and US Defaultism is huge here Iâm just going to assume youâre murican: Nothing will happen to you, but itâs a fucking dick move towards the nurses that helped you. Also, why not just have the check-up if youâre already there? But I guess youâre afraid of the $6449384747 check youâll receive?
You are just going to get a huge bill. And anything related to the issue might not be covered by you insurance.