Need POLICY on pass privledges for Certified/Committed patients.

[jennascarfe]

I am doing some research for our unit and need policies and guidelines for pass privledges on an Acute Psychiatric Unit. We are a 10 bed unit and have a mix of Certified and Non Certified patients. Currently we don't have a solid policy in place for off unit privledges and we need help developing one.

Thanks for you input!

[elkpark]

I've been in psych nursing for >25 years in five different states, and I've never been anywhere where individuals who were being detained against their will were allowed to have any off-unit privileges. If you were committed, you weren't allowed to leave the unit (except for necessary medical tests/procedures, and then only with staff accompanying you).

[jennascarfe]

That is what the nursing staff on the floor are advocating for. We are a smaller northern hospital so we don't have a long term psychiatrist or physician. We have "locums" come up for a short time and all have different ways of doing things. I am trying to find some concrete evidence to go to my manager with so we can poove that passes for committed patients isn't common (the psychiatrist here now is routinely writing extended passes for committed patients!!). I am not sure if I am allowed to do this, but if anyone has access to their policy and could email it to me ([email protected]) I would greatly appreciate it.

[elkpark]

I have been told, in the hospitals in which I've worked over the years, that this is a legal thing and that we are legally not allowed to let committed clients off the unit. However, laws vary quite a bit among states. I would suggest that your unit involve your hospital's legal department in this discussion to advise on what specific legal restrictions may exist in your state. The hospital is paying a lot of money to have good legal counsel available -- you might as well take advantage of them. :) (Esp. if this is being recommended by a temporary physician who came from somewhere else ...)

[seizetheday]

We do allow certified patients off the floor with a doctor's order. This is usually when people are certified because they are having difficulty caring for themselves but are not a risk to self or others. Mostly psychosis related illnesses. Some of them end up being in hospital for weeks and even months so we let them go out for fresh air, for a walk etc...as long as they are accompanied.

Patients who are not certified and are voluntary patients can leave the floor the same as any other patient in the hospital, basically when they want although we encourage them to not leave during appointments and treatment sessions.

[Whispera, MSN, RN]

If someone is there on court order and it's against his or her will, to let the person have a pass would surely risk that he wouldn't come back. Also if someone is sick enough to require a court order to be hospitalized, he is too sick to go on an outing.