[cebugirl]

hello everyone
1. is it possible for suicidal patients to be a DNR/DNI?( IN FOR MAJOR DEPRESSION/ SUICIDAL IDEATION }patient had an attempted suicide in unit by hanging self with sheet but has no DNR/DNI ORDER but only a POWER OF ATTORNEY.
2. can an ICU resident extubate a patient per family member request without any presence of an attending physician? the patient had a attempted hanging incident in unit with sheet but was revived thru the CODE BLUE RAPID RESPONSE TEAM/ fast response by psych staff on duty...
any response greatly appreciated...

[jmgrn65]

Ethically I would have to say no, however does patient have a terminal illness? If not and this is areal situation and ethics committe needs contact ASAP!

[cardiacRN2006]

Originally Posted by cebugirl

2. can an ICU resident extubate a patient per family member request without any presence of an attending physician? the patient had a attempted hanging incident in unit with sheet but was revived thru the CODE BLUE RAPID RESPONSE TEAM/ fast response by psych staff on duty...

Yes. In fact, myself or the RT can extubate a pt without the Attending being there.

But, I'd sure make sure they knew about it beforehand...

[ukstudent]

Originally Posted by cebugirl

hello everyone
1. is it possible for suicidal patients to be a DNR/DNI?( IN FOR MAJOR DEPRESSION/ SUICIDAL IDEATION }patient had an attempted suicide in unit by hanging self with sheet but has no DNR/DNI ORDER but only a POWER OF ATTORNEY.

Depending on the state pt's can have DNR/DNI orders placed on them. The reason for the admission is not what is being considered, it is the current physical state of the pt. Just how much brain damage was done by the hanging!

2. can an ICU resident extubate a patient per family member request without any presence of an attending physician? the patient had a attempted hanging incident in unit with sheet but was revived thru the CODE BLUE RAPID RESPONSE TEAM/ fast response by psych staff on duty...

Once the decision to withdraw has occurred (and yes the attending should be part of that talk), they do not need to be physically in the room during the withdrawal.

any response greatly appreciated...

Was there any talk about organ donation? Hanging leaves the organs in good condition, if the pt had no other medical problems.

[cebugirl]

1. no, patient had no terminal illness..just in for major depression with suicidal ideation and was found hanging self with sheet on closet door , unresponsive and cpr was initiated, CODE BLUE was called and pt had pulse and bp when patient was transferred to icu. he died later in icu.
2. the ff people were on board to investigate the incident
1. medical coroner
2. police
3. detective
4. president of hosp
5. doctors/residents
6. staff working on unit
7. risk manager
8. etc

3. currently, our unit is beefed up on staff bec of investigation but im sure its going to be back again to the same old thing after one week.

4. anybody experienced attempted suicide by hanging and what interventions did they make to protect their license ?

thanks for your input

[elkpark]

Originally Posted by cebugirl

4. anybody experienced attempted suicide by hanging and what interventions did they make to protect their license ?

Of course there is a big investigation any time a client is successful, or nearly successful, in suiciding on a psychiatric unit. In my state, surveyors from the state healthcare licensing agency would also be there, doing their own investigation of whether the hospital staff had failed to follow any of the state or Federal rules they are required to.

As for interventions to "protect" your license, there is nothing that can be done after the fact to protect your license -- I hope that all the staff involved had done everything they were supposed to, and documented that, prior to the event ...

[ukstudent]

Originally Posted by cebugirl

4. anybody experienced attempted suicide by hanging and what interventions did they make to protect their license ?

I hope you had insurance. Either way lawyer up. Do not speak to anyone about it. Do not post anything more about it here. Protect yourself.

[elkpark]

Originally Posted by ukstudent

I hope you had insurance. Either way lawyer up. Do not speak to anyone about it. Do not post anything more about it here. Protect yourself.

Yes, another good point -- I hope you already had your own liability insurance. It may turn out that you don't need it (I hope so! ), but better to have it and not need it, than to need it and not have it ...

[PsychRN03]

Originally Posted by cebugirl

4. anybody experienced attempted suicide by hanging and what interventions did they make to protect their license ?

Unfortunately I have had to intervene on a patient who was hanging themself in their bathroom. Pt's PITA s/o was agitating the pt. with his/her child in the front door of the unit and we made it clear the child was not allowed on the unit (obvious safety concerns). So while we were dealing with the s/o, patient was upset, saw an opportunity to isolate self while staff (3 or 4 of us if I racall) were tied up with s/o, pt. barricaded self in room, put plastic bag over head, tied rope and hung his/herself. Fortunately we broke into room quickly enough to get the pt. before damage was done.

The sight of that patient dangling from the door is something I'll never forget.