We actually got a memo that states we cannot hold a patient, whether it be with restraints or not, whether the patient is suicidal, homicidal, drunk or whatever, until a physician (and not a pa) has examined the patient and signed 939 paperwork. If that patient has expresses a wish not to be treated or is refusing treatment that that person's civil rights are being violated if we treat them. My department supervisors state that they do not agree with this DOH requirement. My question is, what do we do in the meantime? Let the patient run (hopefully not injuring anyone along their way), get a pickup order for the pd to execute, bring 'em in, let 'em run, indefinately until the doc is sitting on the doorstep with pen poised above the 939 form? Seems silly to me that the psych on-call staff has not been sent this memo. What about the patient that comes in in PD custody that is actively manic, hallucinating, or otherwise out of control or is even REQUESTING treatment but refusing a shot of good ole vits A+H? Maybe I am overreacting, but seems like a damned if you do, damned if you don't situation for the nurse involved! Any thoughts?