If a patient or relatives decide to leave the hospital against the advice of the doctor, he/she has to sign ______ form before discharge.

Appeared in: RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

Explanation

LAMA is the acronym for 'Leave Against Medical Advice'.
This is a legal form signed by a patient who decides to be discharged before their physician recommends it.
The purpose of the form is to document that the patient has been informed of the risks of leaving and to release the healthcare facility and its staff from liability for any negative health outcomes.
The patient's signature must be witnessed, and the form becomes a permanent part of their medical record.

Option A: Absconding refers to a patient leaving the hospital without informing staff. No form is signed by the patient in this situation; rather, the staff documents the event.
Option B: MLC stands for Medico-Legal Case. This is a classification for cases involving legal authorities (e.g., accidents, assaults, poisoning), not a discharge form.
Option C: NMLC stands for Non-Medico-Legal Case. This is simply a classification for a routine hospital admission with no legal implications.

Visual 1: Sample LAMA Form - To show the typical sections of the form, including patient details, acknowledgment of risks, and signature lines for the patient and witness.

Clinical Relevance

Nursing practice connection: Safe nursing care depends on performing Hospital discharge procedures and medico-legal documentation in the correct sequence, documenting the action clearly, and monitoring for the expected response.
Properly handling a LAMA situation is a critical nursing responsibility that protects the patient, the nurse, and the hospital. It ensures the patient's autonomy is respected while mitigating legal risks.
Nurses must act as patient advocates by ensuring the patient truly understands the risks they are accepting. This includes using simple language and confirming comprehension.
What if? If a patient refuses to sign the LAMA form but insists on leaving, the nurse should not physically restrain them. Instead, the nurse should thoroughly document the refusal to sign, the education provided, and the patient's departure, with a witness if possible. This documentation is crucial for legal protection.

How to Approach the Question

First, identify the core of the question: what is the formal process for a patient leaving against a doctor's orders?
Analyze the keywords: 'leave hospital', 'against advice', and 'sign form'. This points to a specific administrative and legal procedure.
Evaluate the options based on your knowledge of hospital terminology. 'Abscond' means to run away, so a form is illogical. 'MLC' and 'NMLC' are case classifications, not actions or forms for discharge.
Recall the acronym LAMA (Leave Against Medical Advice). This term directly matches the scenario described in the question.
Confirm that LAMA involves signing a form to formalize the patient's decision and protect the hospital from liability.

Concept Tested & Keywords

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Practise the full RRB Nsg. Superintendent - 29 April 2025 (Shift-3rd)

Attempt every question from this paper in a timed mock, then review the full solution for each one.