Open to Interpretation

Specialties Psychiatric

Published

Specializes in Psych (25 years), Medical (15 years).

Poz, a schizophrenic patient on the geriatric psych, was loud, going down to the women's end of the hall, and giving the wonderfully pleasant charge nurse, Rapunzel, a hard time outside of the NS. I was in the NS, heard the commotion and intervened, attempting to quiet Poz down and direct him to his room. Poz said something rather threatening, I repeated his statement, and informed him that making a threat could result in a chemical restraint to assure his, the other patients', and staff's safety.

Rapunzel heard the threat and, unbeknownst to me, went inside the NS to call a code. In the meantime, unbeknownst to Rapunzel, Poz took back the threat and committed to safety.

I was in the process of dealing with Poz when security, the code team, and house sup arrived. I turned around to surprisingly see them, along with LPN Fridgett, armed with a loaded PRN Haldol/Ativan injection. Poz said, "You're all here to kill me!" I reassured Poz that the staff was assuring everybody's safety and the last thing anybody wanted to do was to harm him in any way. Rapunzel requested that the team step back, which they did.

I infomed Poz that all we wanted him to do was to quiet down, follow staff's directions, and go to his room. Poz was delusional, loud, and argumentative, but was not really meeting criteria for a therapeutic hold or chemical restraint. I made known the fact that he didn't meet criteria so that all could hear.

Cruxie, a tech, mentioned that this was Poz's behavior a couple of nights previously and all staff did was to have him go into the Quiet Room where he received the injection willingly.

Poz adamantly stated that he would not go into the Quiet Room, so I requested that he go to his room. With the finesse of herding kittens, I was able to eventually get Poz into his room, where he continued to be loud and delusional, believing we were there to kill him, refusing to take any medication.

At one point during our conversation, Poz was sitting on his bed, had leaned to his left and said,

poz.jpg.eb9e884e0cf9896001d6d62093edebe6.jpg

I publicly openly interpreted Poz's statement, took it as a consent, and Fridgett administered the shot in his RG without incident.

Specializes in Hospice, corrections, psychiatry, rehab, LTC.

Sounds like a consent to me.

Specializes in retired LTC.

I gave a 'thumbs up' to a dentist as he needed to do something extra while I was already under care. He proceeded. ?

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