It is a very busy day at the clinic. A teen approaches the desk and ask to be seen for a headache. It is possible to work him in and you ask him to have a seat in the waiting area until called. The television is on and suddenly others in the waiting areas begin to scream and you and the staff, see this teen now wielding a gun and pointing at the television. He is agitated and shouting at the television "you will not control me", "I will do what you say and then you have to leave me alone". "I will shoot if you try again".
1). What will you do first? 2).What will you say? 3). What safety issues must you consider?
First, is safety for the others in the waiting room and your staff. I will instruct everyone not to move and stay quiet. I will say to the teenager,
"Those voices are bad, try not to listen to them" " They are just trying to control you"."They can not harm you" "I can help you get rid of them".
This is an emergency situation requiring effective milieu management.
I must consider the teenagers safety, the others in the waiting room, and the clinic staff. It is imperative that we do not increase the teenagers
anxiety. We must all remain still and quiet.
Oct 1, '06
How about "person with schizophrenia," if you know their diagnosis, or "extremely agitated person" if you don't?
Otherwise, sounds ok. I'd also call the police/security.
Oct 2, '06
1. Call Security.
2. Probably wouldn't say anything to the teen unless he said something to me (see below).
3. Safety of people in waiting room TOP PRIORITY.
IF the teen were to demand something from me, I would talk in a calm clear voice to him and ask that he please put the gun down on the floor, and then I would do what he asked. All the while standing behind that ER counter BTW, I am NO hero. I would try to get him to calm down though, as best I could.
Oct 2, '06
Yes, call security/code for pt with a weapon and get anyone you can out of sight...pts and staff!
Once security has restrained the threatening pt, then it will be safe to approach, assess, and implement any interventions like sedatives, antipsychotics, etc.
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