Is this a malpractice or ..?

[itblowsmymind]

I went to ER for a condition I have, there are clear standing orders for my condition. The nurse proceded to call a doctor who ordered something, not my standard treatment. The nurse gave me one shot and told me to drive home. I told her that isn't what I get, nor do I drive home after one shot. She argued with me, telling me she was not going to sit there until things were under control, just for me to drive myself home (it was 3:00 a.m.), and sleep it off after the meds kicked in at home. I got up and left, with almost no vision or barely conscious. What would you do, or what do you think is right? Input appreciated. Thanks.

[ecmst12]

Impossible to even guess without more specific information. What is your condition? What is your usual medication? What medication were you given in the ER?

[itblowsmymind]

I have daily, excruciating migraines which seem to come on during the night. I take Maxalt daily, which is not cheap and my doctor had to appeal to my insurance several times to get on a regular basis. When I go to ER, it is because I have not been able to keep them under control at home and I cannot self medicate after a certain point because I have heart condition. When I go to ER, I usually get shots of demoral and morphine at intervals until the migraines subside. I told the nurse of two previous ER visits where something new had been tried and I had adverse reactions to that particular approach so I could NOT have those meds. My respirations went way low and they could not keep me breathing. The shot she gave me the other night was demoral, and in my near unconscious state I understood her to say it was demoral so I was ok with that. But as soon as she told me to drive home as soon as she gave me the shot, I contested the treatment plan. On top of all of this, she did not have me sign anything... nor did she give me any discharge papers with signatures. I just got up and.... drove myself home through the city! The standing orders were never read or followed.

[Proserpina]

Originally Posted by itblowsmymind

I have daily, excruciating migraines which seem to come on during the night. I take Maxalt daily, which is not cheap and my doctor had to appeal to my insurance several times to get on a regular basis. When I go to ER, it is because I have not been able to keep them under control at home and I cannot self medicate after a certain point because I have heart condition. When I go to ER, I usually get shots of demoral and morphine at intervals until the migraines subside. I told the nurse of two previous ER visits where something new had been tried and I had adverse reactions to that particular approach so I could NOT have those meds. My respirations went way low and they could not keep me breathing. The shot she gave me the other night was demoral, and in my near unconscious state I understood her to say it was demoral so I was ok with that. But as soon as she told me to drive home as soon as she gave me the shot, I contested the treatment plan. On top of all of this, she did not have me sign anything... nor did she give me any discharge papers with signatures. I just got up and.... drove myself home through the city! The standing orders were never read or followed.

What's the nature of your heart condition?

Are you going to the ER for ongoing migraine therapy?

[itblowsmymind]

I have aortic insufficiency. I am scheduled to see a cardiologist again soon. Yes, I have to go to ER several times a month, sometimes a few times a week. There are times that I have maintained at home for weeks, but then there are times it is impossible to avoid an ER visit. I have three small tots at home and cannot take care of them after my husband leaves for the day if the migraines are out of control. I have had multiple tests to hopefully find the reason for the migraines with no luck as of yet. This has been ongoing for many years, my case is well-known at our clinic and hospital. I don't know when this nurse started working there or how often she works, but she definitely did not refer to the doctor's orders or use any sense in sending me out to drive under medication and in such horrific pain.

[Hot Topic]

It's unlikely that you could have driven yourself home "through the city" in the condition you describe.

[itblowsmymind]

Hot topic, you have no idea... I did exactly that! I will wait for worthwhile advice or remarks, thank you.

[lealea1005]

How were you able to drive to the ER with severe migraine symptoms (severe pain, blurred vision, etc.)?

Morphine would have depressed your respirations. Since you have previous respiratory distress after being given Morphine, I can understand the hesitation in administering the med.

Then, there is always the possibility that the standing order had expired...OR...they attempted to call your regular Physician for verification, he wasn't available, and they got the Doc on call.

[itblowsmymind]

I know when I need to get to ER, before it is unsafe to drive. It was not morphine which depressed my respirations, it was other drugs. I told the nurse exactly what I could NOT have, she did not even look for the standing orders which are written all over my charts in RED and are current. She took it upon herself to call the doctor on call that night and did not consider the standing orders.
I have since talked to my doctor and he is livid! I can see that this forum is just going in circles, so I will leave this to the professionals.

[Proserpina]

Originally Posted by itblowsmymind

I know when I need to get to ER, before it is unsafe to drive. It was not morphine which depressed my respirations, it was other drugs. I told the nurse exactly what I could NOT have, she did not even look for the standing orders which are written all over my charts in RED and are current. She took it upon herself to call the doctor on call that night and did not consider the standing orders.
I have since talked to my doctor and he is livid! I can see that this forum is just going in circles, so I will leave this to the professionals.

You can't say with certainty that morphine didn't depress your respiration.

So, what are your damages?

[JessiesGirl]

Ok, what state are you in? I read thru your posts and didn't see it mentioned, only that you "drove thru the city" to get home.

I don't see damages, thankfully, and your post indicates to me that you are upset that you didn't get the drugs that you believe work for you when your migraines become monsters.

I get monster migraines constantly, and have had them for almost 13 years (I can pinpoint them to pregnancy, unfortunately ). I used to take Maxalt but it stopped working for me, and have tried many other things to make these headaches go away. I've even been to 2 of the top 3 neurologists in my state, with no success, and I've had everything done, from allergy testing to chiropractic/massage, acupuncture, prayer, many, many types of drugs (prescription), and am currently working with reflexology. I've not given up hope, because if the reflexology doesn't work, I'm going to try hypnosis (which my hubby doesn't approve of -yet- says it's devil worship - go figger, eh?).

Back to the legal aspects. No case because no damages. You should NOT have driven home after a shot of Demerol, but any sensible person would know that. Even IF the nurse said go home, and you are not in condition to drive, it falls on YOU to not drive. Wait until you feel safe. Otherwise, you could (should) be responsible for an accident caused on your way home. So you apparently weren't given release papers. I think that's irrelevant. You drove yourself to the hospital and they gave you a powerful narcotic. In your condition, per your words, you were practically incoherent, so what really happened?

I hope you find the cause of your migraine pain, and are able to get them under control. I really do. I'm still waiting to find my triggers as well. I understand that it's frustrating as all get out but because a nurse didn't follow your orders/demands doesn't mean it's malpractice.

P.S. Demerol and Morphine additiction is a B**ch to get out from under. You may be suffering from rebound headaches to boot if you are visiting an ER as often as you stated.

Good luck,

K

[lya]

It's gonna take all the self control I have to not venture into aortic insufficiency, migraine headaches, narcotics intake, primary caregiver for three young children**************...but**************as for the topic of the posters unstated legal question:


It was an unsafe discharge and apparently an improper discharge. Each is against standards of care.

Treatment seems OK; the RN is under no obligation to follow standing orders from a physician who is not currently involved, either by phone or in person. The physician on-call or in the ER is the appropriate treating physician.

[itblowsmymind]

I think I will just leave this be. This must be the wrong forum to even discuss my concern. No, there was no physical damage. My question was.... IS this malpractice or ? meaning is there a case at all. First, I will say I am not addicted to anything, who would 'in their right mind' want to be? I would like to give my migraines to whoever wants them or thinks they can handle them any differently. My complaint was that the nurse did not follow the standard orders on file, she used her own judgement instead of the doctor who treats me. The professional with a presumably clear head should never have told me to drive home, I obviously did not have a clear head! I don't have the resources to monitor my respirations at home, and with my heart condition it was her responsibility to pay attention to the doctor's orders for that reason.

I will leave it at that, this is going nowhere. Free advice is just that, Free and in this instance not helpful.

[JessiesGirl]

Hi Lya,

I'm sorry if I upset you. I don't know what I said that made you mad. I suffer mightily from migraines like this OP does and I understand what she's going thru but aside from that, did I respond poorly on the legal issue (that I believe I now know I didn't know what her legal question was, and sorry)?

You can PM or reply on this thread.

Sorry to the OP for hijacking the thread. I only want to help but if I'm not, I want to know how so I don't waste anyone's time.

Thank you,
Kathy

[ecmst12]

The RN didn't use HER judgement, she did what the doctor told her to do. Which is what she should have done. However, the discharge (according to Lya) was still improper.