What should the nurse do if a client leaves the facility against medical advice?

What should the nurse do if a client leaves the facility against medical advice?

• A. Notify provider and discuss risks with client; document
• B. Try to physically prevent leaving
• C. Ignore the situation
• D. Call the police

Answer: (A)

When a client leaves against medical advice, the nurse’s immediate priority is to support informed self-determination while addressing safety. The right action is to involve the provider and have a clear, respectful discussion with the client about why staying in care is important and what risks could arise from leaving early. This includes explaining the diagnosis, recommended treatment, potential complications, and warning signs that would require the client to return for care. Assessing decision-making capacity is essential: if the client demonstrates understanding and voluntariness, document the conversation and the decision in detail, including the information shared, the client’s questions, and the reasons given for leaving. If possible, obtain an AMA acknowledgment or form and provide written discharge instructions and a plan for follow-up care. Ensure the client knows how to seek care if symptoms worsen and arrange appropriate next steps. Physically detaining a patient is not appropriate unless there is clear incapacity or imminent danger to self or others, and police involvement is not a standard response for an AMA departure. The focus should remain on informed discussion, thorough documentation, and safe transition of care.

When a client leaves against medical advice, the nurse’s immediate priority is to support informed self-determination while addressing safety. The right action is to involve the provider and have a clear, respectful discussion with the client about why staying in care is important and what risks could arise from leaving early. This includes explaining the diagnosis, recommended treatment, potential complications, and warning signs that would require the client to return for care.

Assessing decision-making capacity is essential: if the client demonstrates understanding and voluntariness, document the conversation and the decision in detail, including the information shared, the client’s questions, and the reasons given for leaving. If possible, obtain an AMA acknowledgment or form and provide written discharge instructions and a plan for follow-up care. Ensure the client knows how to seek care if symptoms worsen and arrange appropriate next steps.

Physically detaining a patient is not appropriate unless there is clear incapacity or imminent danger to self or others, and police involvement is not a standard response for an AMA departure. The focus should remain on informed discussion, thorough documentation, and safe transition of care.