Is this out of scope of practice?

Please forgive me, Maddy, but I'm experiencing some difficulty assimilating this situation:

Maddyd said:

Our clinical director feels that clinicians who work in our agency can authorize state beds for clients being admitted to their hospital.

"Authorize state beds"? Specifically, what does that mean?

In a nutshell, in Illinois, a potential psychiatric patient must be assessed and recommended by an treatment team consisting of a psychiatrist, nursing administrator, and therapist. Typically, the patient is recieving treatment in a community hospital and requires long term treatment that a community hospital cannot provide when this assessment and recommendation for admission to a state facility takes place. The state facilty must review the case and accept the patient if criteria is met.

Maddyd said:

I should not be authorizing input beds for ER.

In Illinois, a patient recommended for inpatient treatment must be assessed by an ERP and Therapist. Then, the patient must be accepted by an admitting psychiatrist.

Maddyd said:

IS THIS OUT OF SCOPE OF PRACTICE?

There should be documented process to follow, as in written policy and procedures guidelines. These policies and procedures are reviewed and accepted by surveying and benefitting agencies. These surveying and benefitting agencies have to adhere to state and federal laws. They make sure the agency providing services, such as the one you're referring to, are adhering to those laws.

I hope my post sheds some light on your situation. Good luck to you, Mandy!

Dave

salvadordolly said:

In some states, an RN can start the emergency detention (hold) process. But ultimately to be admitted, a psychiatrist has to agree with your assessment. I've never heard of RN's being able to "direct admit" to a psych hospital or ER.

Agreed. RNs can evaluate patients and make recommendations for admission/transfer to psych or other types of units, but it's the MD/primary care provider who has to order it.