Med/surg nurse needs Help

ChicagolandRN · Dec 11, 2003

(((((kona2)))))

I don't have any specific answers, but I recommend checking out the NIMH (mational institute of mental health) website. If I remember correctly, it has lots of good info. Good luck, sweetie. My thoughts and prayers are with you and your husband. :kiss

Genista, BSN, RN · Dec 11, 2003

Thank you for the reply Chicagoland. It's very frustrating. I have called the unit 5 times (over two separate shifts), but nobody will take my call. I have given my phone # twice. The nurse is always "busy." I'm a nurse, so I know how it goes...but still.

Thanks for the website & support.

ChicagolandRN · Dec 11, 2003

I just had another thought...

Maybe you can schedule a brief meeting with the psychiatrist and/or nurse. This way, the staff will have time to prepare to talk to you. An an onology nurse, my patients' family members always have lots of questions, which I'm always happy to answer...just not while I'm in the middle of passing meds or hanging blood etc!

Will Benson · Dec 11, 2003

kona2

I'm sorry to hear about your family. As a psych nurse, let me lay some ground work for you.

An involuntary admission is a situation in which a patient is admitted to an inpatient facility for evaluation. That 72 hours is the time that doctor has to make an evaluation and disposition of the patient. In Ohio, weekends don't count. Meaning if you are admitted on Fri., the doctor has until Wed., to make a decision. In the meantime, the patient may decide that an admission may help and sign as a voluntary patient. If the patient doesn't sign voluntary, the doctor doesn't HAVE to release the patient. He often can get a court order after a probate hearing (in the hospital) to keep the patient (up to 90 days) until they no longer represent a threat a danger to themselves or others. He can send them to another facility for longer term care. OR discharge them. Many psychiatrists use improvements in insight and judgment as criteria for discharge. I HIGHLY suggest that your family sign voluntary. If the psych unit has a program during the day (ie groups, occupational therapy, etc), this will also help toward discharge.

A psychiatrist is more likely to consider discharge for a patient who is taking medications, participating in milieu and groups and is cooperative, than for a patient who is demanding discharge, is disruptive and shows poor judgmant.

An average length of stay for my hospital is 7-10 days - if the patient shows improvement.

I know all this is frightening to absorb, but that's the way it is in many states. I would imagine it is similar in your situation.

As for the methadone, half life is 15-30 hours. It has a lot of bad withdrawal symptoms if weaned too quickly. Check out your PDR for specifics.

ChicagolandRN had a good suggestion. Set up an appointment with the psychiatrist to have a family meeting. And get the patient's permission for him to talk with you (HIPAA, you know). Only the psychiatrist can tell you how long they'll be there and what he wants to see before sending them home. Good luck and keep us posted!!

Will Benson

Genista, BSN, RN · Dec 11, 2003

Thank you, Will. Those were just the sort of questions I was wondering about. My biggest concern is that if he is released too soon, he will hurt himself more seriously. He is irrational in his thoughts. This has been progressive for him, and the past few days have been particulary scary (which is why we took him in to be evaluated). I still haven't heard from the Psych unit staff, but I am going in tonight with another family member to drop off clothing. My loved one said I am on the "list" of people who can know he's there, but I don't know if he has given permisssion for the Psychiatrist to talk to me. I have a feeling he will say it's okay- he knows I love him & he trusts me. I just wanted the staff to know about the behaviors he was exhibiting, as they are very worrisome. I'm glad he's there, because it's safe for him & I know he is getting some help. Thank you kindly for your reply.I appreciate it.

TitaniaSidhe · Dec 12, 2003

Here is another thought if he was using meth how many days in a row had he gone without sleep? Sleep deprivation can lead to some pretty intese psych symptoms & I second the whole nasty withdrawl symptoms statement. Perhaps another thought would be considering upon stabalization of his behavior an inpatient drug rehabilitation?

BarbPick · Dec 12, 2003

We have the Baker Act. After 72 hours, a Judge decides.