DAMA/HAMA_

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It is really disheartening to learn of some of the patients we take care of at Intermediate Medical Care Unit or IMCU, are brought home by their significant others because of the not-improving conditions despite the management of the doctors, nurses, and the other medical health care providers. A waiver is signed by the immediate member of the patient’s family which should be signed by the attending doctor and witnessed by a nurse-on-duty and other family member. DAMA is Discharged against Medical Advice, and HAMA is Home Against Medical Advice. Last Thursday, a male patient whom we handled since January was DAMA. He was on mechanical ventilator, endotracheal tube, nasogastric tube for feeding, indwelling foley catheter, and on intravenous fluids. His wife and children did not agree on tracheostomy tube insertion. The doctors said tracheostomy can be done so he will no longer use the mech.vent. (mechanical ventilator) and he can be discharged after. His wife thought having the trach (tracheostomy) tube will worsen his condition but the doctors said otherwise. A person can live with tracheostomy tube in place, either temporary or permanent. My student accompanied the patient until at the lobby of the hospital. There, the significant other pulled out the endotracheal tube and nasogastric tube, while the nurse-on-duty pulled out the indwelling foley catheter. The intravenous fluids were removed while the patient was still in his bed. The mech.vent. was also switched off in the ward. I hope our one patient yesterday won’t be DAMA/HAMA today.