Here's one question I've been meaning to ask an experienced psych nurse. I work at a Short Term Commitment Facility. We take admissions from our ER as well as from hospitals that can't handle certain patients. My hospital is the last stop before long term care facilities. So, often we're sending patients to a long term facility including the state psychiatric facility.
The philosophy on my unit is not to tell the patient until they're about to go to avoid problems. When I graduated nursing school this past May we were taught never to do anything for the convenience of the nurse. The patient always comes first. I feel like these committed patients have so few rights I try to return as many to them as possible, including telling them when there's plans for them to go to a long term facility instead of leading them to believe they're going home. I'd rather tell the truth and deal with some escalation than take away more rights.
The last patient I sent I told and she was upset and a little agitated, but not dangerous. I gave her PO meds and sent her on her way on a stretcher with restraints. 20 minutes later I get a call from the psych ER that the transport people couldn't deal with her and drove her back to the ER because she was agitated and said she had an upset stomach. She was sent back to the floor and I gave her additional IM meds.
Then we get a call from the facility we sent her to accusing me of practicing poor nursing care sending an agitated patient to them. With the amount of drugs I had to give her I'm surprised she wasn't sleeping. One would expect a psych patient that didn't want to go to be yelling and cursing, right?
I guess if I'm going to tell a patient ahead of time I should medicate them and give enough time for it to kick in before sending them.. Although one would think that ones you don't tell would need more medication.. I can't bring myself to allow patients think they're going home when they're about to be shoved in a long term state hospital. I just don't think its ethical.
What do you think?
Quote from edorn
I would be happy to try to respond to questions you may have. I have worked for some time on acute inpatient settings across the lifespan and also am a psych nursing instructor. I also know how you might feel as I entered psych nursing after over 20 yrs med/surg