We're having issues with psych pts who are being held at our facility (acute care hospital without psych unit) while waiting for mental health assessment/transfer to mental health facility. Most of the time, there will be as much as week wait for bed opening at the other facility....
as we're not set up as psych...we're trying to develop policies and procedures....and how to protect pt while at our facility
..any input/advice/direction from anyone with similiar problems would be MUCH appreciated.
Specializes in Interventional Pain Mgmt NP; Prior ICU and L/D RN.
We do get psych patients at times....mainly attempted suicides..
I work on a medical intermediate unit and none of the staff like it.
Policy says that if suicide precautions are ordered they require a 1:1 sitter...q15min checks.....YEA RIGHT!!! We do not have the staff and honestly the patience for this. I am not a psych nurse!
We have both a psych unit (adult, geriatric, and child units) and med-psych unit.
The doctors won't send them to psych b/c they "aren't medically stable" Mostly tylenol overdoses....send them to med-psych, do the labs, give them the mucomyst, etc.....
It is not fun for us to have the psych pt....
The other type of psych pt's do have "medical diagnosis" so we don't have much choice but to take the paranoid schizo, bipolar, etc.....(who don't usually take their meds!!!)
I'm wondering why a "sitter" outside the door is not considered a restraint but one inside the room is. Interesting .... maybe I'll suggest it to my manager and see what she says. If they have no restraint for 24 hours, we can get them placed somewhere else.
psych pt's sit in the er. folks like us (maternity) staff are pulled to be makeshift sitters. that's because the nursing supv's. think we are never busy! god help those psych pt. w/o insurance or ma they often sit in the "observation" room for days. those w/ insurance can go to a hospital w/ a psych unit about 20 miles away IF there's a bed. we recently had a pp depression mom transferred approx. 120 miles away to a facility in north central pa. there are so many psych pt's out there, we are really selling them short w/ our current system.
I'm wondering why a "sitter" outside the door is not considered a restraint but one inside the room is. Interesting .... maybe I'll suggest it to my manager and see what she says. If they have no restraint for 24 hours, we can get them placed somewhere else.
I was curious and i asked this.
If i'm sitting OUTSIDE of the door, it is not ACTUALLY blocking this person from leaving, therefore not restraining. Sitting beside of his bed is because i am stopping him from even getting up.
believe it or not but when we got those suicides they were evaluated by a psych md and released home. we never held psych pts. they always found a way to send them home.
Our suicide pt's get an ICU bed so they can be monitored 1:1 until stablized enough to transfer to a psyche facility.
I do find that we get a lot of medical pt's whose basic problem is psyche but that doesn't get addressed by the doc's. Psyche consults are few and far between.
and i asked this.
Marie_LPN, RN, LPN, RN
12,126 Posts
Psych-surg, sounds like our floor