A nurse is caring for a client on a medical-surgical unit who is attempting to leave the facility. Which of the following actions should the nurse take?

Choice A rationale Competent adult clients have the legal right to refuse treatment and leave the hospital at any time. The nurse's responsibility is to ensure the client is fully informed of the potential medical risks associated with leaving prematurely. This process involves the client signing an Against Medical Advice form, which serves as a legal document protecting the facility. The nurse must document the conversation, the client's stated reasons, and that the clinical consequences were explained. Choice B rationale While hospitals often use wheelchairs for standard discharges to ensure safety, the nurse cannot force a client who is leaving against medical advice to use one. Forcing a client into a wheelchair against their will could be legally interpreted as battery or false imprisonment. If the client is steady on their feet and insists on walking, the nurse should allow them to do so while documenting the exit method to ensure a record of the event. Choice C rationale Calling a client's family without the client's explicit permission is a violation of the Health Insurance Portability and Accountability Act. Unless the client is a minor or has been legally declared incompetent, they maintain the right to privacy regarding their healthcare decisions. While involving family can sometimes be helpful for persuasion, the nurse must respect the client's autonomy and confidentiality. The nurse should first ask the client if they wish for family to be notified. Choice D rationale Security should only be notified if the client poses an immediate danger to themselves or others, or if the client is being aggressive. Attempting to leave the facility is not a crime or a security breach for a competent adult. Using security to prevent a client from leaving could lead to charges of false imprisonment. The nurse should focus on the administrative and educational aspects of an AMA discharge rather than using security as a means of detention.