State Mental Hospitals

msrn · Jun 23, 2004

I work in a state hospital for adults with acute MI; I love it and can't imagine doing anything else. We have a men's unit and a women's unit with 25 beds on each. There are 1 to 3 RNs and 3 to 5 MHTs to each unit during a shift which lasts 8 1/2 hours. As far as a pt refusing meds, the doctor can give a 'may not refuse order' (if it is determined that the patient may be a danger to self or others) which means staff can use a 'show of force' to give an IM injection. 'Show of force' means that MHTs and security are called to a private area such as the patient's room where the RN gives the IM. If the patient becomes violent or threatens staff, the RN may have the MHTs and security take the pt to the seclusion or restraint room; then, the RN must contact the physician and nurse practitioner to get an order. The LIP comes to the hospital to assess the pt and write further orders. I hope this is clear; it's been a long day :) .

elkpark · Jun 25, 2004

As other posters have noted, the laws on forcing meds vary from state to state. It's important to be aware of the law in the state you are practicing in, and be sure that you follow it. In general, psych patients have the same right to refuse treatment (including meds) that any other patient does, and there are some legal restrictions put on that right to refuse.

In the case of a person who has been adjudicated incompetent and has a legal guardian, it is the guardian who gives or withholds consent.

There are good and bad and mediocre state hospitals (as places to work), just like anyplace else, and there are some advantages and some disadvantages to working at a state hospital as compared to a community hospital. IMO, the important thing is to find out as much as you can in order to make a good decision, the same as you would with any other hospital or potential employer.