Damn it, Jim. I'm a nurse, not a lawyer!
ER: "I'm calling to give you report on Mr. x."
Ok, one moment, let me get the intake form....
How old is the patient? (used to verify the correct unit he will be admitted to)
Ok, and who was the psychiatrist who cleared him? Has he been cleared medically?
Did they sign the voluntary? Who has power of attorney? Well, was crisis involved? I think you'll need to get a 302. No, I CAN'T just take them based on a psych history. Please check with your nurse supervisor, she should have the protocol. That's what I'm trying to tell you. Because it is illegal. No, we have to have a copy ON.OUR.CHART. We can accept a fax until they bring in the original. Yes, we have a bed, please call back when you get in touch with the son.
Four-point leather restraints, IM Haldol/Cogentin/Ativan.
DEM attending calls to inform me that the son is "legal guardian", and he is signing the 201.
Does he have durable power of attorney?
He is the legal guardian.
But there is no DPOA?
A judge signed him as his guardian, that is acceptable.
Do we have proof of this claim?
He said he'll bring it in this weekend.
We can't hold someone here on a statement that someone is allegedly responsible. He will need to be 302'd.
The family is refusing involuntary commitment.
...what the f...?
Well, I'll look into this further, I do know we were expecting him today, but our rules work just a leeeeetle bit differently than do yours.
(For instance, restraints - either mechanical or chemical - are NOT as easy to just slap on to any old body we feel is a wee bit testy.)
[In addition, the ER has a tendency to get voluntary signatures in a not-quite-full-disclosure manner. "Here, you need to sign this paper so we can admit you". Or, "This will allow us to treat you for three days, then you can decide if want to go". Don't even get me started.]
Call placed to the director of our program, my nurse manager, and the social worker. Messages left.
Five minutes later, but what to my wondering eyes should appear...
Yup. Accompanied by three security guards, the daughter who is NOT to have any information shared, and a handful of ER staff to assist this unruly gentleman into his new digs.
Where is the son? The guardian? The man you are accepting direction from?
Argh! This sucks on so many levels. I have a foley that should have been placed an hour ago, a dressing to change, readminister medications that Miss P. had cheeked earlier, and 15 or so notes to chart.
In the interest of patient safety, we do place him into a room, assign a 1:1, place a call to the on-call shrink just in case we need PRNs, and goddamnitineedaciggerettenow.
Two calls returned, both with an emphatic NO to the legality of 'guardianship' for this whole shabang. Well, guess what, they sent him on over anyway, so now what? ::gritting my teeth::
You need to obtain the documents.
well.duh. um... how? (and just when did this become my job anyway??) ???
As luck would have it the social worker is familiar with the family, esp. the son with the super powers that transcend state law, and Mr. x is spending the night tucked away in a nice cozy bed down the hall.
Why can't this ever be easy?
Ok, one moment, let me get the intake form....
How old is the patient? (used to verify the correct unit he will be admitted to)
Ok, and who was the psychiatrist who cleared him? Has he been cleared medically?
Did they sign the voluntary? Who has power of attorney? Well, was crisis involved? I think you'll need to get a 302. No, I CAN'T just take them based on a psych history. Please check with your nurse supervisor, she should have the protocol. That's what I'm trying to tell you. Because it is illegal. No, we have to have a copy ON.OUR.CHART. We can accept a fax until they bring in the original. Yes, we have a bed, please call back when you get in touch with the son.
Four-point leather restraints, IM Haldol/Cogentin/Ativan.
DEM attending calls to inform me that the son is "legal guardian", and he is signing the 201.
Does he have durable power of attorney?
He is the legal guardian.
But there is no DPOA?
A judge signed him as his guardian, that is acceptable.
Do we have proof of this claim?
He said he'll bring it in this weekend.
We can't hold someone here on a statement that someone is allegedly responsible. He will need to be 302'd.
The family is refusing involuntary commitment.
...what the f...?
Well, I'll look into this further, I do know we were expecting him today, but our rules work just a leeeeetle bit differently than do yours.
(For instance, restraints - either mechanical or chemical - are NOT as easy to just slap on to any old body we feel is a wee bit testy.)
[In addition, the ER has a tendency to get voluntary signatures in a not-quite-full-disclosure manner. "Here, you need to sign this paper so we can admit you". Or, "This will allow us to treat you for three days, then you can decide if want to go". Don't even get me started.]
Call placed to the director of our program, my nurse manager, and the social worker. Messages left.
Five minutes later, but what to my wondering eyes should appear...
Yup. Accompanied by three security guards, the daughter who is NOT to have any information shared, and a handful of ER staff to assist this unruly gentleman into his new digs.
Where is the son? The guardian? The man you are accepting direction from?
Argh! This sucks on so many levels. I have a foley that should have been placed an hour ago, a dressing to change, readminister medications that Miss P. had cheeked earlier, and 15 or so notes to chart.
In the interest of patient safety, we do place him into a room, assign a 1:1, place a call to the on-call shrink just in case we need PRNs, and goddamnitineedaciggerettenow.
Two calls returned, both with an emphatic NO to the legality of 'guardianship' for this whole shabang. Well, guess what, they sent him on over anyway, so now what? ::gritting my teeth::
You need to obtain the documents.
well.duh. um... how? (and just when did this become my job anyway??) ???
As luck would have it the social worker is familiar with the family, esp. the son with the super powers that transcend state law, and Mr. x is spending the night tucked away in a nice cozy bed down the hall.
Why can't this ever be easy?
posted by Julie, RN at 9/30/2006 12:18:00 AM
6 Comments:
I love your blog, and I've put you on my blogroll. Great post!
oh no - is the ED in your facility also? I wouldn't have let him in the door! Ack ! What a nightmare! I have that same experience with people sending folks to me who I'm not expecting. I've even had them bring the belongings and put them away, show the person to an avail bed, then notify me they were on the floor!
Almost more trouble dealing with the personality issues BEHIND the counters! Grrr. :(
When I was admitted to the psych unit, I had two choices, 201 admission(voluntary) or 302 admission(involuntary). My mother and grandmother called crisis intervention on me and had me admitted.
I hear you there. Why can't this be easy?
Thanks for visiting my blog. Thought I would do the same. You've got a great start here. I'm going to add you to my link list, if that's ok.
I wish I had super powers that transcend state law. There are some people that annoy me and I think I'd like to have them committed. ;)
Great post. And I love the blog name.
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