Psychiatric Emergency Services (PES) - what do you do?

[New2ER]

I currently work in a PES in Florida. I triage pts that are brought in under BA and sometimes voluntary from the waiting area, draw labs, collect urines, complete EKGs, medicate and evaluate as necessary. I do complete a psychosocial but it's basically asking questions and filling out the questionnaire that I was handed when I got here. I also look up insurance, obtain precerts, and obtain admission orders. On occasion I'll transfer out for insurance of because we're full. Rarely do we discharge. There is no psychiatrist, psychologist, or social worker here. Sometimes pts get admitted but all they really need is a social worker to find them placement.

I'm wondering what PES is like in other states. I want to travel and several agencies have offered me positions in PES in California and PA. Can anyone tell me what happens in PES in other states? Do you have a clinician present to evaluate the pt or is everyone automatically admitted?

[NPAlby]

I'm a travel psych nurse and am a lil confused about what a PES is? WHere I've worked New York state (the city and upstate next to canada) we had CPEP. Comprehensive Psych Eval Program or commonly referred as psych ed. We would get pt's from the main Ed after they were supposedly "medically cleared" and interview the patient for current and past history. On nights with a skeleton crew we would have 2RNs at least 1 tech and 1 psychiatrist. The doc would make the decision to admit after we did the extensive interview (with collateral info from family, friends or providers) and after they did their assessment. Labs and such were done by the tech. That was in upstate NY. In NYC it was a lot smaller with 1 Rn No tech and 1 resident with an attending on call somewhere. There would be SW also up to 7-9pm. A lot smaller and less paperwork but same deal we did the initial assessment and the doc would do their interview with the info we got and then make their decision. Other places I've heard don't have psychiatrist but would have an experienced PAO (psych admission officer) who would evaluate pt for admission/discharge and if needed a psych md would be available during regular day shift hrs. Oh and usually a SW is available during regular hours. They're primary job being what dc planning and providing outpatient services referrals. On nights we took over that part or have patient wait til SW got in.