Jump to content

What do you do with psych patients?


medicgirl05

Recommended Posts

In my area we have no inpatient psych facilities. The closest one is about 100 miles away. As a result of this we have repeat patients with underlying problems that aren't being evaluated. I am at a loss for how to help these patients.

One example is one particular patient repeatedly tried to harm himself as a result of a known psych disorder. We would transport this patient sometimes twice a week to an ER and then after being treated for the immediate life threat was sent home to try again.

Law enforcement can get an emergency committal but it usually takes about an hour to get the paper signed by a judge, and the paper must be complete before the patient is under a physician's care otherwise it won't work. The issue with that is that in most of these circumstances sitting on scene with the patient that long is unrealistic. After they get to the ER it doesn't matter what we tell the ER doc, as long as the patient says they don't intend to hurt themselves or others they don't get a psych hold.

I'm curious if other agencies are having this problem, and if so what is being done?

  • Like 1
Link to comment
Share on other sites

Welcome to the mental health system..................Not much you can do on your own its a system thing. I hate having to deal the phyc things in my community as I know that with in a few hrs of being admitted into the hospital they will be on their way,

Link to comment
Share on other sites

Call the attending at the psych clinic yourself for advice. Tell the doc what you're dealing with and if he'd be willing to consult the next time you have this patient. If the psych doc is willing to accept the patient, then transport him to the psych centre next time and bypass the local ER.

  • Like 2
Link to comment
Share on other sites

Sounds like you need to change your protocols, then. Do you at least have sedatives/antipsychotics available to you by standing order to use if you need to?

It sounds like the system isn't working in your area. Protocols, policies and guidelines are meant to make the system work efficiently and effectively; if they're no longer doing that (or haven't ever done that) then it's time to get management involved. How else can you provide the kind of care this patient needs?

Link to comment
Share on other sites

We can't bypass local facilities. The psych places are out of our transport range unfortunately.

Who says you can't? You are supposed to transport the client to the nearest appropriate medical facility, are you not? If this is a psych issue and the doc agrees, then just take him there. Sure, your company might get some heat for it from the local medical staff, but they aren't psychologists now are they? So long as you document, document, and get the psych doc to sign off on the arrangement, you're golden.

  • Like 1
Link to comment
Share on other sites

psych beds are getting hard to find. One of out two regional hospitals actually has a secure ward with a dozen beds, and two secure rooms in ER. Problem is those bed are almost always full and they may have to ship a PT. 7 hours north to find an open bed in an appropriate facility. Juveniles are even harder to find placement for.

edit for spelling

Edited by island emt
Link to comment
Share on other sites

Who says you can't? You are supposed to transport the client to the nearest appropriate medical facility, are you not? If this is a psych issue and the doc agrees, then just take him there. Sure, your company might get some heat for it from the local medical staff, but they aren't psychologists now are they? So long as you document, document, and get the psych doc to sign off on the arrangement, you're golden.

There's no way we can go that far. We don't have the resources to keep a truck out of service that long. I guess it might be a nice thought but it is unrealistic.

I have spoken with our medical director numerous times but the outcome is usually that long term psych care is not my concern. I'm supposed to treat the lifelthreatening emergency but that's the end of my responsibility according to my superiors.

Link to comment
Share on other sites

This thread is quite old. Please consider starting a new thread rather than reviving this one.

Join the conversation

You can post now and register later. If you have an account, sign in now to post with your account.
Note: Your post will require moderator approval before it will be visible.

Guest
Reply to this topic...

×   Pasted as rich text.   Paste as plain text instead

  Only 75 emoji are allowed.

×   Your link has been automatically embedded.   Display as a link instead

×   Your previous content has been restored.   Clear editor

×   You cannot paste images directly. Upload or insert images from URL.

×
×
  • Create New...