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24 Cards in this Set
- Front
- Back
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Psychiatrist has 72 hours to assess whether pt is treat to self or others
It LIP feel pt should stay, must go to court and have judge concur
protects pt form being held indefinitely wtihout due cause or TX |
Involuntary Emergency commitment |
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Pt admitted involuntarily by 2 MDs bc pt felt to be a threat to self or others or gravely ill All other civil rights remain Can be kept up to 60 days After 60 days hospital must reapply to judge Client can request lawyer and court date |
Involuntary civil commitment |
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Pt voluntarily admits self, needs assessment by MD to verify need for admission Can request to leave any time but must be assessed by MD (72 hr letter) If MD concurs-pt d/c AMA If MD feels pt threat to self or others-MD will make pt involuntary Pt will be appointed lawyer and court date to contest MD decision |
Voluntary Admission |
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Use before restraints Always have sufficient staff (4 min) Always 1:1 Initiated by RN, PO follow RN instructions Can be done without LIP order, LIP must see pt within 1/2-1 hr Explain pt how to behave to be released |
Seculsion |
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Pt tied to bed by each limb and stomach Can be initiated by RN LIP order must be written with 1/2-1 hr, good for 2 hrs Be prepared for physical struggle Will need much man power Pt must be 1:1 Last resort |
Restraints |
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Communication protected by law, does not have to be released in a court hearing Pt can waive by signed release/consent
excludes: child abuse (elder, MR), domestic violence, STD's, prevention of serious crime |
Privileged communication |
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Mental health professional has legal obligation to warn any person of a credible threat against them Tarasoff Case (1976)-therapist using priviledged comm. did not/could not warn gf of credible threat made by bf |
Duty to Warn |
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Does person understand charges against them? Can they work with lawyer to defend themself If there is doubt, judge will order psych eval |
Competency to stand trial |
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state of mind at time of crime did pt know he was committing a crime did pt know right from wrong unable to control self was pt psychotic at time |
Insanity defense/M'Naghten Rule |
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Responsible for providing safe, competent, and ethical care Standards of Care-set of expectations of what a similarly trained RN would do in similar situation Negligence-SoC is not met and pt was measurably harmed |
Nursing Liability |
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Wrongful act that results in injury, loss, or damage
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Tort |
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Specific type of negligence Specific to RN, MD, DO, DMD, etc |
Malpractice |
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Most severe form of negligence RN willfully neglects duties and pt harmed
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Gross negligence |
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Most cases of negligence or malpractice are handled in civil court not criminal court
Unless RN intentionally tried to harm pt ie: Richard Angelo, Charles Cullen |
General info card |
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Medication administration-wrong med, time, refuse to give PRN when indicated Seclusion & Restraint-improper use, poor documentation Assault-threats for PRN/restraint for lack of cooperation |
Areas of liability for psych RNs |
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know state laws concerning profession & area of practice know hospital policy & protocol do not make unilateral decisions document accurately but not excessively pt welfare comes first establish therapeutic alliance never put self in position where sexual misconduct could be misconstrued by pt |
Ways to avoid liability |
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theory that bases decisions on "the greatest good for the greatest number" |
Utilitarianism |
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Theory that says decisions should be based on whether or not an action is morally right with no regard for the result or consequences |
Deontology |
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Person's right to self-determination and indepence |
Autonomy |
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one's duty to benefit or promote good for others |
Beneficence |
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Requirement to do no harm intentionally or unintentionally |
Nonmaleficence |
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Fairness |
Justice |
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Duty to be honest and truthful |
Veracity |
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Obligation to honor commitments and contracts |
Fidelity |
