When a patient goes missing, no matter how innocently

This happens.

A patient decides not to go through the entire rigamarole of leaving AMA.

Sometimes it is a confused patient who slips away unnoticed.

Sometimes they are just in another department, getting a test, or an X-Ray, or a treatment. The Epic EHR that the hospital I work for uses has a system in place that shows where the patient is in real-time. But sometimes this is buggy and places can’t show where the patient is. But they try.

And sometimes there is an alert that goes over on the PA, explaining what the patient looks like, and what they were wearing at last sight.

Sometimes it is a room-by-room search. Because you know that the computer system just may not be capturing their location.

Depending on the patient’s needs and condition this can escalate to a full-blown, all-hands-on-deck search. Maybe they are late for a test, or maybe they need their meds.

Sometimes a patient who has been weeks in the hospital and is finally feeling better just wants to stretch their legs. Maybe see the hospital a little. Maybe they want a snack from the cafeteria that is different than that on offer for their lunch. Maybe they have a hankering for Frito chips and they know that the vending machine in the basement has it.

It is best for the patient to explain that they are going for a walk. Of course, depending on who they tell, the message is not passed on.

I happened upon such a patient. They had done everything right, informed someone of their destination, not gotten something they shouldn’t have on their diet, stayed plugged into their IV, took the IV pump with them. They did it all.

And were still scolded like a child who was late for dinner.

This was not the best reaction from the nurse. The patient is an adult, and had informed someone where they were going, and was only gone a half an hour.

It turns out they were only looking for a phone charger as the one they had with them broke. And the promised replacement never appeared and the phone was nearly dead.

And the nurse reacted in exasperation.


Think about what is going on from the patient’s point of view.

And stop scolding an adult like a child, threatening to withhold a treat after dinner.

And maybe follow up when there is a problem and a promised solution.

The confused patient who slipped away unnoticed? That was more problematic than an adult looking to solve a very real problem.

Thankfully the confused adult happens very rarely.

But don’t get mad at someone who was seeking an answer to their problem. And maybe tell them about the charging stations in every waiting room.

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