Walk in, walk out

Was on-call with a Medical Officer recently and she updated her facebook with this ;

" will throw her phone if it rings again about some bloody bastard who wants to leave the hospital to sign some stupid document with his *ucking lawyer "

Here's her blog. For those readers with a low tolerance with word that rhymes with LUCK, a word of advice - brace yourselves hahahahaha.

Which brings to mind a rather outdated procedure in the hospital. Any patient who abscond from hospital will be reported to the police (Yeah, and what will the police do about it?). Any patient who wants to leave or be discharged from the hospital will need to sign the "Against Medical Advice" or "At Own Risk" form and countersigned by a doctor of the ward. Perhaps reporting the absconding patient with public health interest (infectious disease, psychiatric patients, medico-legal cases etc) to the police is understandable but for other reasons it's rather pointless. For example those patients with heart failure or poorly controlled diabetes who abscond because they feel they are fine.

Reminds me of ONE tuberculosis patient in the US not too long ago who absconded across the Atlantic and was pursued relentlessly by the police till he was caught. We have a Multi Drug Resistant tuberculosis patient (as far as I personally know) running around the state without any problems, not to mention the NUMEROUS active tuberculosis patients who are assimilated with the public without problems too.

Back to the topic, I truly believe patients are responsible for their own health. Many times, relatives force the patient to be admitted against his will and then not surprisingly the patient will ask for a AOR discharge ASAP which irritates everyone to their limit. I mean if you don't want to be admitted just say so!!! Don't get yourself admitted to avoid argument but the moment your "relatives" leave, you ask for a discharge. Does anybody realize the amount of work that is involved (plus paperwork) if you are admitted and then discharged after an hour ? Not to mention wasting bed space (and preventing other people from being admitted), wasting tons of papers, wasting water and detergents to wash your bedsheet (which was used for an hour) plus lots of other nursing work? This is blatant abuse of a public facility and people like that should be penalized severely.

Another version of the same thing is patients who want to leave the hospital to settle some personal stuffs - seeing his lawyer, going to the bank, visit their "relatives", sign some documents, even to do BUSINESS!!! - some mega businessman he is ! These patients like to walk in and out of the hospital at their whim and fancy.

I say whoever walks out of the hospital consider it an AOR discharge immediately without hesitation. No need signatures or anything. And patients who walk out cannot be readmitted again to the same hospital for say 72 hours. Since they are well enough to walk out they must be fine. Don't bloody waste our time which can be used more productively with patients who actually wants treatment. And whoever who wants to leave, just open the doors to them on the condition they cannot be readmitted to the same hospital again for 72 hours.

Problem solved.