Guest guest Posted September 18, 1998 Report Share Posted September 18, 1998 , It appears we all must have missed the boat when it comes to mental health related calls. A few years ago in our area the police could order a emergency commitment and we could transport the patient to the closest facility that handled this type of patient. Of course it didn't take to long before the mental health folks change the rules and we had to transport to our hospital and the physician then had to talk to a mental health worker over the phone and relay the same information that we and the law enforcement folks had observed. After conferring with the physician, if convinced, we could then transport to the mental health office so that they could interview the patient. Far too many times we would arrive at the facility and have to transport the patient back to our county and release them. Nothing really changed in the patients condition from start to finish. So what is my point. It appears to me that wiser folks than myself think it is Ok to allow some of these folks to roam free and mostly endanger themselves. It also seem that the folks that are trained in dealing with these patients have decided to try a new program of if I tell you that you have no problems enough times you will have none. In our area, an emergency commitment isn't worth the paper it is written on. I would be interested in hearing from others around the state about this issue. Henry Barber Willis wrote: > I am curious about a situation I witnessed...An 82 yr. old female is > brought to the ED because she says she needs to go. After seeing two Drs. > she tells both of them she would like to go to a behavioral health place. > Apparently they agreed with her decision. Upon arrival at this particular > place, the admitting attendant will not accept her, because now she says she > does not want to be there! Nurses notes state she was combative (she was > restrained), and delusional. While observing her on the way to the center > she babbled about " off the wall " things (i.e.: she called us because someone > took her records out of her house and put them back in the wrong order) > Should she have been admitted or sent back to the ED??? Please justify > this answer! Maybe I am just not seeing something! > > Oooo > oooO ( ) > ( ) ) / Willis EMT-I > Paramedic student-Tyler Junior College > \ ( (_/ JANDJ.WILLIS@... > \_) > > ______________________________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 18, 1998 Report Share Posted September 18, 1998 Just a question... DO the insurance companies cover mental health admits? I know they don't cover hospital stays for DNR (hospital catageory III/ no code) patients... I work a cardiac floor at a hospital and we see quite a few patients who probally should be mental health admits. :-{)> Jt john emt-p austin ______________________________________________________________________ Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 1998 Report Share Posted September 19, 1998 Henry, It's about Money, and the unwillingness of Texas to deal with the problem. So we at the local level tie up EMS personnel for long periods of time, to put on a good show for by the state for the public to look like Texas is addressing the problem at our expense (in our budgets). If indigent or otherwise we are never reimbursed for these calls, that tie up $100,000 of an emergency vehicle,and equipment. Henry J. Barber wrote: > , > > It appears we all must have missed the boat when it comes to mental health > related calls. A few years ago in our area the police could order a emergency > commitment and we could transport the patient to the closest facility that > handled this type of patient. > > Of course it didn't take to long before the mental health folks change the > rules and we had to transport to our hospital and the physician then had to talk > to a mental health worker over the phone and relay the same information that we > and the law enforcement folks had observed. After conferring with the physician, > if convinced, we could then transport to the mental health office so that they > could interview the patient. Far too many times we would arrive at the facility > and have to transport the patient back to our county and release them. > > Nothing really changed in the patients condition from start to finish. > > So what is my point. It appears to me that wiser folks than myself think it > is Ok to allow some of these folks to roam free and mostly endanger themselves. > It also seem that the folks that are trained in dealing with these patients have > decided to try a new program of if I tell you that you have no problems enough > times you will have none. > > In our area, an emergency commitment isn't worth the paper it is written on. > > I would be interested in hearing from others around the state about this issue. > > Henry Barber > > Willis wrote: > > > I am curious about a situation I witnessed...An 82 yr. old female is > > brought to the ED because she says she needs to go. After seeing two Drs. > > she tells both of them she would like to go to a behavioral health place. > > Apparently they agreed with her decision. Upon arrival at this particular > > place, the admitting attendant will not accept her, because now she says she > > does not want to be there! Nurses notes state she was combative (she was > > restrained), and delusional. While observing her on the way to the center > > she babbled about " off the wall " things (i.e.: she called us because someone > > took her records out of her house and put them back in the wrong order) > > Should she have been admitted or sent back to the ED??? Please justify > > this answer! Maybe I am just not seeing something! > > > > Oooo > > oooO ( ) > > ( ) ) / Willis EMT-I > > Paramedic student-Tyler Junior College > > \ ( (_/ JANDJ.WILLIS@... > > \_) > > > > ______________________________________________________________________ > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 1998 Report Share Posted September 19, 1998 It becomes very complicated when you have a psych case. The primary concern is whether the patient is a threat to themself or others. Mental health laws are very concerned with the rights of the individual. The particular patient probably needed a mental health evaluation. The " behaviorial center " that did not take her were correct,or they could have been charged with false imprisonment. Whether she should have been taken back to ER with a possibility for a court ordered 72 hr detainment has to be handled on an individual basis. Earnestine Victery RN, CEN Nurse Director ED P.S. Was the patient medically cleared?---checked for electrolyte imbalances or drug interactions? ---------- > > To: egroups > Subject: [] Incompetent or not? > Date: Friday, September 18, 1998 9:01 PM > > I am curious about a situation I witnessed...An 82 yr. old female is > brought to the ED because she says she needs to go. After seeing two Drs. > she tells both of them she would like to go to a behavioral health place. > Apparently they agreed with her decision. Upon arrival at this particular > place, the admitting attendant will not accept her, because now she says she > does not want to be there! Nurses notes state she was combative (she was > restrained), and delusional. While observing her on the way to the center > she babbled about " off the wall " things (i.e.: she called us because someone > took her records out of her house and put them back in the wrong order) > Should she have been admitted or sent back to the ED??? Please justify > this answer! Maybe I am just not seeing something! > > Oooo > oooO ( ) > ( ) ) / Willis EMT-I > Paramedic student-Tyler Junior College > \ ( (_/ JANDJ.WILLIS@... > \_) > > > > > ______________________________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 1998 Report Share Posted September 19, 1998 You can be a DNR and still be hospitalized and be covered by insurance---for instance for pneumonia for IV antibiotics, a myocardial infarction. Just because you are a DNR does not mean that your are ineligble for care. Earnestine Victery ---------- > From: JTyreeLGI@... > To: egroups > Subject: [] Re: Incompetent or not? > Date: Saturday, September 19, 1998 3:47 AM > > Just a question... > > DO the insurance companies cover mental health admits? > > I know they don't cover hospital stays for DNR (hospital catageory III/ no > code) patients... > > I work a cardiac floor at a hospital and we see quite a few patients who > probally should be mental health admits. > > :-{)> > Jt > john emt-p > austin > > ______________________________________________________________________ > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 1998 Report Share Posted September 19, 1998 E. Gandy wrote: > > Willis wrote: > > > > I am curious about a situation I witnessed...An 82 yr. old female is > > brought to the ED because she says she needs to go. After seeing two Drs. > > she tells both of them she would like to go to a behavioral health place. > > Apparently they agreed with her decision. Upon arrival at this particular > > place, the admitting attendant will not accept her, because now she says she > > does not want to be there! Nurses notes state she was combative (she was > > restrained), and delusional. While observing her on the way to the center > > she babbled about " off the wall " things (i.e.: she called us because someone > > took her records out of her house and put them back in the wrong order) > > Should she have been admitted or sent back to the ED??? Please justify > > this answer! Maybe I am just not seeing something! > > > > Oooo > > oooO ( ) > > ( ) ) / Willis EMT-I > > Paramedic student-Tyler Junior College > > \ ( (_/ JANDJ.WILLIS@... > > \_) > > > > ______________________________________________________________________ > > > > Quote Link to comment Share on other sites More sharing options...
Guest guest Posted September 19, 1998 Report Share Posted September 19, 1998 wrote: > > E. Gandy wrote: > > > > Willis wrote: > > > > > > I am curious about a situation I witnessed...An 82 yr. old female is > > > brought to the ED because she says she needs to go. After seeing two Drs. > > > she tells both of them she would like to go to a behavioral health place. > > > Apparently they agreed with her decision. Upon arrival at this particular > > > place, the admitting attendant will not accept her, because now she says she > > > does not want to be there! Nurses notes state she was combative (she was > > > restrained), and delusional. While observing her on the way to the center > > > she babbled about " off the wall " things (i.e.: she called us because someone > > > took her records out of her house and put them back in the wrong order) > > > Should she have been admitted or sent back to the ED??? Please justify > > > this answer! Maybe I am just not seeing something! > > > > > > Oooo > > > oooO ( ) > > > ( ) ) / Willis EMT-I > > > Paramedic student-Tyler Junior College > > > \ ( (_/ JANDJ.WILLIS@... > > > \_) > > > > > > ______________________________________________________________________ > > > > > > Quote Link to comment Share on other sites More sharing options...
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