5150 patient absconded from the ER........

[TazziRN]

CHP initiated a 5150 on a psych pt and called the ambulance for transport. Medic says pt needs medical clearance and brings him to us instead of taking him to a psych facility. We are a 6-bed ER, with two RNs and a tech on at a time. My coworker and the tech were behind a door taking care of a sick baby, so I had the rest of the ER. CHP decided that he didn't need to stay to babysit the pt so he said "Call me if you need me." Like a fool I let him go. I checked on the pt frequently, even got him a dinner tray. Fifteen minutes later his bed was empty and he was gone, along with the knife from the tray. I started storming about how I shouldn't have let the cop leave, and the doc tried to pin it on me! Yes, I bear some of the responsibility, but how was I supposed to babysit him and take care of the other 4 pts???

Yes, I called dispatch, and I also called my manager. She is supporting me but I have been kicking myself with "I should have's" and "What if's?"

ARRGHHH! :banghead:

[NurseCherlove]

5150 is the CA state code for someone who is a danger to himself or others and needs to be commited involuntarily. No, he was not free to go. I say it was CHP's responsibility since they were the one who initiated the hold. Doc says CHP didn't need to stay because he wasn't under arrest. No, we do not have a written policy. Manager is going to a seminar next month about 5150s and is going to bring up this situation and ask what our liability.

I have never heard of a 5150 before (of course why would I, I live in GA) and I had always heard of those type cases referred to as a 1013. I guess I learned something new today....I thought 1013 was some official code that everyone everywhere used (in the US) - I did not realize it was a state code.

[TazziRN, RN]

I have never heard of a 5150 before (of course why would I, I live in GA) and I had always heard of those type cases referred to as a 1013. I guess I learned something new today....I thought 1013 was some official code that everyone everywhere used (in the US) - I did not realize it was a state code.

Same with me! When I first started nursing I thought 5150 was used everywhere, until I found out it was the code in California!!

[TazziRN, RN]

Unless someone has developed cellulitis from a cat bite, it really isnt an emergency. A routine medical evaluation for a psych pt isnt an emergency.

The cat bite is an urgency, which qualifies for an ER visit. She needed IV abx as well as a HyperTet, neither of which the PMD's office would carry/do. Cat bite cellulitis, as I'm sure you are aware, can result from a bite within hours, so quick treatment is essential.

Psych pts on a hold are considered an emergency also. They have a medical problem that, if left unattended, can escalate (or decomp, depending on how you look at it) to a life-threatening problem if not dealt with.

I am not trying to argue with you, but you and I just see things differently. I understand your point of view, I just don't agree with it.

As for feeding pts, it's not something we do routinely, believe me!