Published Oct 6, 2006
annmariern
288 Posts
Hi,
out of my area and much confusion as to the rules. Elective surgical pt, last week an od, 2 in the last 3 weeks. PCP rights "pt at high suicide risk, needs a sitter". Hospital doesn't do sitters without one. MD won't sign. Psych comes in next day, (sitter was supplied), states pt is a risk, but still won't sign one. Later on in the day, UM are insisting. Psych agreed but wouldn't come back to sign the paperwor, faxed back a completed form. Now, is this legal or not? Conflicting info; in the end he got a sitter, was in no way trying to leave etc. But still would like to know the answer. Thanks in advance
traumaRUs, MSN, APRN
88 Articles; 21,268 Posts
Baker Act is the involuntary committment of an individual who is deemed at risk to themselves or others. It is not called a Baker Act in every state - it is a Florida thing:
Here are the criteria:
http://www.psychlaws.org/PressRoom/faqonbakeract.htm
Her is some more general info:
http://www.clerk.co.okeechobee.fl.us/Baker_act.htm
This is not something to be taken lightly but can be used to assist the mentally unstable person to get help.
UM Review RN, ASN, RN
1 Article; 5,163 Posts
Hi,out of my area and much confusion as to the rules. Elective surgical pt, last week an od, 2 in the last 3 weeks. PCP rights "pt at high suicide risk, needs a sitter". Hospital doesn't do sitters without one. MD won't sign. Psych comes in next day, (sitter was supplied), states pt is a risk, but still won't sign one. Later on in the day, UM are insisting. Psych agreed but wouldn't come back to sign the paperwor, faxed back a completed form. Now, is this legal or not? Conflicting info; in the end he got a sitter, was in no way trying to leave etc. But still would like to know the answer. Thanks in advance
In order to Baker Act anyone, it's my understanding that the patient would actively have to say or do something to threaten his own life or others' lives.
So I could see where the act of having surgery (presumably a life-saving measure) without any verbal or behavioral clues to suggest that the patient might hurt himself, negates the possibility of Baker Act-ing the patient.
If you're saying that your hospital policy is no sitter unless Pt is Baker Acted, well, there ought to be room for a nursing judgment call that would allow for it in some cases. And actually, you'd have to look your hospital P&P up for Baker Act patients, regardless. I think I've known patients who needed to be Baker Acted and the order was obtained without the doc being present, but I believe the doc must come in a assess within a certain period of time.
I would think, given post-surgical confusion and Pt hx, a sitter would be the most appropriate thing to do, and usually the safest thing is the best way to go.
If hospital policy is to refuse a sitter for all patients not Baker Acted, this simply does not cover a whole lot of patients and it should not take so much effort to provide one. It's really a safety issue.