If a patient want DAMA what is nursing responsibility & x20; - NORCET 2 -2021 (Shift-2)

NORCET 2 -2021 (Shift-2)

Nursing Foundation

Medium

Appeared in: NORCET 2 -2021 (Shift-2)

Explanation

The primary nursing responsibility when a patient wishes to leave against medical advice (DAMA) is to ensure patient safety and facilitate an informed decision.
Notifying the physician is the correct first action. This allows the physician, who is legally responsible for the patient's medical care, to discuss the risks, benefits, and alternatives with the patient.
This step is crucial for the process of 'informed refusal,' where the patient makes a decision after understanding all potential consequences.
It also fulfills the nurse's duty to act as a patient advocate and protects the nurse and the institution from legal liability.

Option B: A competent adult patient has the legal right to refuse medical treatment and leave a facility. Forbidding them to leave can be considered false imprisonment, which is a chargeable offense.
Option C: Simply allowing the patient to leave without following the proper procedure is considered negligence. The nurse has a duty of care to ensure the patient is aware of the risks before they depart.
Option D: This option is incorrect because 'Don't give permission' and 'Allow to leave' (without following procedure) are both incorrect nursing actions.

Visual 1: Flowchart: DAMA/AMA Process for Nurses. This visual would outline the steps: 1. Patient states intent to leave -> 2. Nurse assesses reason and patient's capacity -> 3. Nurse notifies physician immediately -> 4. Physician speaks with patient about risks -> 5. Patient signs AMA form -> 6. Nurse documents everything -> 7. Patient is discharged.

Clinical Relevance

Nursing practice connection: Use the key finding related to Nursing responsibility in cases of Discharge Against Medical Advice (DAMA/AMA) to guide bedside assessment, documentation, and the next nursing action.
Handling a DAMA request involves a critical balance between respecting patient autonomy (the right to self-determination) and the ethical principle of beneficence (the duty to act in the patient's best interest).
Thorough and accurate documentation is the nurse's best legal protection in a DAMA situation. It serves as proof that the duty of care and the duty to warn were fulfilled.
What if? If the physician is unavailable and the patient insists on leaving immediately, the nurse should notify the nursing supervisor or charge nurse, explain the risks to the patient to the best of their ability, document these conversations, and have the patient sign the AMA form.

How to Approach the Question

First, identify the core of the question: it's about the correct procedure and legal/ethical responsibilities in a specific nursing scenario (DAMA).
Recall the legal principle of patient autonomy, which grants competent adults the right to refuse treatment.
Consider the nurse's duty of care, which includes ensuring patient safety and advocating for informed decision-making.
Evaluate each option against the standard DAMA protocol. The nurse's role is not to grant or deny permission, but to facilitate a safe and informed process.
The first step in this process is always to escalate to the physician, who holds the ultimate responsibility for discussing medical risks. Therefore, notifying the physician is the most appropriate initial action.

Concept Tested & Keywords

Concept Tested: Nursing responsibility in cases of Discharge Against Medical Advice (DAMA/AMA)
Stem keywords: DAMA, patient want, nursing responsibility
Lead-in keywords: what is
Negative lead-in flag: false

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