I have posted this also on another forum....Just looking for advice
I am a working new nurse since May 2011. I did my 3 month orientation on med/surg and now I am on my own!! I am so excited until last night. My patient fired me Ok from the beginning to catch you up to speed....I was doing my initial assessment (i.e. history, allergies, contact information, etc...) As I came to the question about previous suicide attempts the patient stated no. Next question, do you have any suicidal thoughts patient answered yes due to loss of job, living pay check to pay check, no health insurance, multiple hospital bills, etc... I stated due to acknowledgement of suicidal thoughts suicidal precautions would have to be implemented and a sitter would have to sit with them until the physican can come in the morning hours for further evaluation. Patient became irrate stated they wanted to retract their statement, they need their privacy, and refused sitter. Charge nurse, house supervisor, and hospitalist informed. Hospitalist reienforced suicidal precaution implementation. Security was called to control patient ourburst. Patient stated he had no plan of harming themself and it was my word against theirs, we were violating their patient rights, and they wanted to leave. Patient could not leave due to protocol, so patient had to be upgraded to invol. committed until a psych doc could come evaluate. Well, his surgeon came in the early AM and dc'd the sitter and stated the patient was not suicidal and we blew everything out of portion and the patient is very unhappy. I tried to explain that it was protocol, but fell on the drs deaf ears.
Question: 1) Protocol is protocol, right?
2) If patient has no plan should I have implemented suicide precautions?
3) What could I have done differently?
4) Why do I feel so guilty of the whole thing spiraling out of control?
! I am so excited until last night. My patient fired me 
Ok from the beginning to catch you up to speed....I was doing my initial assessment (i.e. history, allergies, contact information, etc...) As I came to the question about previous suicide attempts the patient stated no. Next question, do you have any suicidal thoughts patient answered yes due to loss of job, living pay check to pay check, no health insurance, multiple hospital bills, etc... I stated due to acknowledgement of suicidal thoughts suicidal precautions would have to be implemented and a sitter would have to sit with them until the physican can come in the morning hours for further evaluation. Patient became irrate stated they wanted to retract their statement, they need their privacy, and refused sitter. Charge nurse, house supervisor, and hospitalist informed. Hospitalist reienforced suicidal precaution implementation. Security was called to control patient ourburst. Patient stated he had no plan of harming themself and it was my word against theirs, we were violating their patient rights, and they wanted to leave. Patient could not leave due to protocol, so patient had to be upgraded to invol. committed until a psych doc could come evaluate. Well, his surgeon came in the early AM and dc'd the sitter and stated the patient was not suicidal and we blew everything out of portion and the patient is very unhappy. I tried to explain that it was protocol, but fell on the drs deaf ears.