Leaving the Hospital Against Medical Advice, GCSE Coursework Example

Introduction

Patients who are discharged and receive plans that include pharmacology and wellness objectives must be able to meet the required objectives of the comprehensive plan in accordance with nurse and physician recommendations. However, this process is not simple to accomplish when there is no continuous monitoring of patients in the home environment. Therefore, there must be a strategy in place that aims to support patients and their needs effectively and that support and engage patients in the plan as part of a long-term approach to recovery. In some cases, such as the example case, there is a resistance to any type of wellness and pharmacology plan after discharge and even in the hospital setting. This poses a challenge for nurses working with this type of patient in the context of his lack of compliance with the proposed treatment and wellness plan. This is not an uncommon circumstance and poses a serious risk to patients who elect this option.

Analysis

A patient who makes the decision to discharge against medical advice poses a risk to himself in that he is unwilling to comply with the requirements of the treatment protocol (Alfandre and Henning, 2013). In this context, the patient faces a considerable risk that could have a lasting impact on his overall health over the long term (Alfandre and Henning, 2013). Unfortunately, these circumstances occur and pose a risk to patients with a variety of health concerns, creating a climate in which trust is lacking and physician-patient collaboration does not effectively exist (Alfandre and Henning 2013). In this context, it is important to identify the reasons why a patient might not be willing to comply with doctor’s orders and discuss the potential that exists to overcome these obstacles and to send the proper message to patients and to the medical community (Alfandre and Henning, 2013).

A study by Onukwugha et.al (2012) addresses the significance of patients with cardiovascular disease who go against medical advice (AMA) and the possible reasons why this decision is made. The study determined that some patients do not have faith or trust in the doctor with whom they are working, while others do not want to wait to receive the required services (Onukwugha et.al, 2012). In this capacity, patients must be able to overcome some of these obstacles in order to develop greater faith and trust in their physicians so that they do not pose a threat to their long-term health and wellbeing (Onukwugha et.al, 2012). Patients must be able to develop a relationship with their patients that will have a positive and lasting impact on their health (Onukwugha et.al, 2012). In addition, they must be able to accept advice from physicians, as they are experts in the field and understand the potential risks that are involved in this type of decision (Onukwugha et.al, 2012).

Patients who are discharged against medical advice may also face a higher risk of mortality as a result of this practice, along with higher readmission rates (Southern, Nahvi, & Arnsten, 2012). In this context, patients who leave the hospital in this manner pose a serious threat to themselves, particularly if they are deemed high risk and are unable to effectively overcome their condition (Southern et.al, 2012). Compliance with the recommended treatment regimen is a serious problem that has a significant impact on the work of healthcare organizations, particularly when their patients go against their advice and the realities of their situation (Southern et.al, 2012). Although patients may be uncomfortable with the idea of remaining in the hospital for a lengthier period of time, it is in their best interest to listen to their physician rather than to make this decision on their own and placing themselves in potentially grave danger as a result (Southern et.al, 2012).

A study by Kraut et.al (2013) addresses the significance of patients leaving against medical advice, using a population-based approach. It is believed that some patients have a greater tendency to leave the hospital than others, and that this is largely based upon their condition and current health status in many cases (Kraut et.al, 2013). As a result, it is necessary to further expand studies regarding the types of patients who are most likely to leave against medical advice and to develop strategies that may minimize this type of decision for some patients (Kraut et.al, 2013). It is believed that patients who require surgery may not be as likely to leave against medical advice because they want to heal and recover as quickly as possible, and this is only achieved by remaining in the hospital and under a doctor’s care for the desired period of time (Kraut et.al, 2013). It is believed that by evaluating specific population-based characteristics, patients are likely to be identified who are likely to be discharged against medical advice so that their needs are met more closely and greater attention is paid to their health status (Kraut et.al, 2013).

Conclusion

Patients who go against doctor’s orders and are discharged against medical advice face serious risks in many cases that are difficult to overcome. Therefore, these conditions must be evaluated more closely in future research studies in order to determine the reasons behind this choice and a method that will be feasible to reduce the likelihood that patients will elect to make this decision. It is possible that if they recognize their own risks, they may be willing to remain hospitalized until the physician believes that the time is appropriate to discharge the patient when a greater chance of recovery is possible. This will encourage the use of different tools and resources to examine the tendency of patients to make this decision in order to reduce its overall likelihood.

References

Alfandre, D., & Schumann, J.H. (2013). What is wrong with discharges against medical advice (and how to fix them). Journal of the American Medical Association, E1-E2.

Kraut, A., Fransoo, R., Olafson, K., Ramsey, C.D., Yogendran, M., & Garland, A. (2013). A population-based analysis of leaving the hospital against medical advice: incidence and associated variables. BMC Health Services Research, 13, 1-9.

Onukwugha, E., Saunders, E., Mullins, C.D., Pradel, F.G., Zuckerman, M., Loh, F.E., & Weir, M.R. (2012). A qualitative study to identify reasons for discharges against medical advice in the cardiovascular setting. BMJ Open, 2, 1-8.

Southern, W.N., Navhi, S., & Arnsten, J.H. (2012). Increased risk of mortality and readmission among patients discharged against medical advice. American Journal of Medicine, 125(6), 594-602.