1. Brooke, Penny Simpson RN, MS, JD

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I work at an outpatient clinic. Recently, a patient scheduled for a colonoscopy told us he had no family or friends available that morning who could drive him home, so he'd take a cab home and his daughter would check on him after work. Our policy says no cabs, but the patient raised such a ruckus that we finally said okay. He signed a release.


Well, when the daughter checked on him, she found that he'd left the front door open and forgotten to turn off the stove. Very upset, she called us and said we should have insisted on rescheduling if we knew the anesthesia would have such an effect on him.


Fortunately, he was all right. But if he'd been hurt, wouldn't the release protect us from liability?-P.Y., GA.

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In a word, no. The clinic's policies are self-set standards created to maintain the highest quality of care. If you violate your own standards, you could be found negligent.


The clinic has a no-cab policy for a good reason-patients who've recently undergone anesthesia may not be safe at home alone. If this incident went to court, would you want to tell the judge or jury that you violated a sensible policy because the patient "raised a ruckus"?


To protect patients and maintain the integrity of your policy, make sure all patients know they won't be treated unless they're accompanied by a caregiver who'll take them home. Don't allow a patient to bully you into making an exception-caving in is unsafe for him and legally risky for you and your employer.