My practicum experience is at a not for profit, sliding scale organization. We get referrals from area crisis organization as well as primary care physicians. Senior staff carefully screens all of our clients. Novice practitioners are not assigned to individuals who may have suicidal ideation or complex conditions. However, these conditions are not always easily assessed during the phone screenings. If during an assessment or session if the client exhibits an emergency such as described by our text as suicide, threatening violence or other issue which is concerning to the student, we are to call our supervisor on the phone, we are not to leave the client alone (Russell-Chapin, 2016). We have an older phone system with an intercom system
Thathamkulam led the initiative to revise and wrote Telecare’s Computer Downtime Policy (Memorandum 118-Tele-015). He has further contributed to minimizing costs to the Houston MEDVAMC, as he has developed documentation protocols to ensure quality documentation for SI/HI callers who called from the After Hour off Site Call Centers. He served as a preceptor to new RN staff, he emphasized the importance of RNs including the Financial Disclaimer in all symptom calls received to help control cost due to negligence by failure to inform Veterans in regards to the disclaimer and failure to address the disclaimer in documentation. As a chair person in one of the Performance Improvement projects for Abandonment Rate Committee, he identified that the Telecare unit was experiencing a high rate (36.7%) of caller abandonment according to 2014 abandonment rate data. This was a problem that had been occurring for the last few years. In collaboration with Pharmacy team, IT team and mental health team, he decided to cut short the documentation policy for Telecare nurses, who are receiving symptom calls including suicidal calls. One suicidal call usually takes approximately 30 minutes to one hour, that back up other patients’ calls in the queue. It automatically resulted in increasing the abandonment rate for the incoming calls. He initiated and created a committee to resolve this issue. The committee meets on a monthly basis to evaluate the situation, and he initiated a plan of action that recommended management to hire additional staff and alert to revisit the documentation policy in order to reduce the current abandonment rates. Mr. Thathamkulams’ vast experiences in Mental Health, he was managed to convinced the Telecare management team and suicidal prevention team by eliminating some of the unnecessary suicidal protocol, which helped to reduced the call handling time to 25minitus per each suicidal call. He also monitored about calling procedures of staff to make sure that
I found your post interesting, having worked in an emergency department during my paramedic years. In my career as a nurse working in a clinic on occasion we must send a patient to the emergency department. I always call to speak with the charge nurse to provide report prior to just sending the patient, often I am on hold for greater than 15 minutes. This often results in the patient arriving at the ER before I can give report. Adding to this the charge nurse on more than one occasion is calling me on another line to ask why the patient it there! However, from past experience I do know how busy the ER can be at any given time.
Sophia Rizera is a 19 year old female who self referred herself to Mobile Crisis Management (MCM) at 8:37pm. Dispatcher reported to Qualified Professional (QP), Ms. Rizera expressed suicidal ideation without a plan, feeling overwhelmed, and a history of PTSD. Before arrival to Ms. Rizera residence QP contacted Sandhills Center (SHC) at 8:57pm. QP spoke with licensed professional Margret who informed QP, Ms. Rizera was not currently in SHC system. QP contacted Ms .Rizera at 9:01 pm and left a voicemail in regards to estimated time of arrival (ETA) time to her residence at 600 Eagle Rd. Greensboro, NC 27410. QP was able to get into contact with Ms. Rizera before arrival to communicate with her of ETA.
All trained professionals associating with possible suicidal veterans need additional training, so they are capable of handling the situations and noticing the signs of suicide. Mazza, Giuliana, and Puskar emphasize the idea of evaluating the safety of every patient during each encounter is very important (4). Trained professionals should never miss an opportunity to prevent suicide from occurring. There is also a need for professionals to understand what the soldier went through during active duty, but they must also fight the stigma that a soldier asking for help is a sign of weakness. In an article John McCarthy et al. agrees that professionals have to be capable of reviewing patients risk for suicide, but it requires a high level of clinical skill, and the ability to give soldiers a reason to trust (1935). Bossarte, Claassen, and Knox add that both the psychological and physical trauma connected to combat increases the risk for suicide (460). When soldiers are injured in war they are often medicated on the battlefield with drugs so they can return to the war as quickly as possible (McCarl 409). This can led to veteran’s dependency on drugs, or the idea that they need to suppress feelings and emotions and it is easier than dealing with them. The veteran coming home needs access to trained assistance at all times, but those assisting have to truly care and want to prevent anything bad from happening to the new veteran. McCarl mentions the situations when Randen, a soldier, seeks help numerous times from the VA, but he is sent home repeatedly without any help. Continuously seeking assistance is a cry for help and signifies the severity of the situation for that soldier (Mazza, Guiliana, and
From the patient’s standpoint, when they push their call button, they are hoping to get a response very quickly and get understandably upset when they are not immediately taken care of. From the staff standpoint, if a nurse or a nurse aide is already busy with something that can’t wait, the other patient is stuck waiting. There is only so much the staff can do. Below shows the unit specific information provided by GSMC on the responsiveness of hospital staff. They are slightly below the target rating for the year to date but are above their threshold achievement percentage (Good Samaritan Medical Center, 2016). With a conscious effort to get to the call lights as fast as possible and not waiting for someone else to do it, those numbers have the potential to
Alternatively if a call were to come in via text message, dispatchers would have to read the incoming text message, respond by text message, and then compile a report relaying the needed information to the responders. Plus, as Bleiberg and West (2014) mentioned, the call taking process is slower, sometimes there are critical questions that require urgent answers, but with text messaging there is a delay in the response compared to a live voice phone call. Once pictures and videos come into play there will be even more responsibility in getting those images out to the responders while still filling out the report and talking or texting with the caller. The new technology adds more layers that dispatchers will have to adapt and adjust to. In order to help with this concern, we would ask for public education with an emphasis on the importance of using voice calls whenever possible and text, picture, or video only in those extremely rare instances when those forms of communication are only
Conclusion…..”You don’t have to be a psych nurse to encounter patients experiencing psychiatric emergencies”. (Marlene Nadler-Moodie, 2010)
At my internship site, Harbor Oaks Hospital has its own Suicidal Ideation Treatment Center (“Suicidal Ideation Treatment Center in New Baltimore, MI,” n.d) that offers a number of services that would benefit those who are having thoughts of ending their life. During intake, a doctor or a psychiatrist would assess them before the nurse would examine the individuals’ symptoms. If they are at a high-risk of killing themselves and/or being hostile, then they would be placed into precaution (C. Ritchey, personal communication, May 24, 2018). For treatment interventions, the selections include art therapy, motivational interviewing, individual, group, or family therapy, didactic behavioral therapy, and pharmaceutical methods. There is also an incorporation
Looking at Roberts (2005) seven stages in the process of crisis intervention I had to establish if Sally continues to have suicidal ideations, asked about her suicidal thoughts and feelings, evaluated Sally’s psychological intent, asked about her suicidal history and took into consideration any risk factors such as social isolation, loss or
The chronic use and abuse of the 911 and emergency medical response system usually encompasses individuals who have social and health disadvantages. “Frequent users typically suffer from combinations of chronic medical diseases, psychiatric disorders, drug and alcohol dependence, in-home difficulties and homelessness” (Jenson, 2013) Theses individuals need specialized social work care and referrals. Prior to the soft ware and surveillance program identifying some of the frequent abuses in large emergency medical response systems was difficult, if not impossible. Reviewing countless medical charts and recognizing these individuals took a great amount time of the social workers.
Continuity is maintained by providing patients with individual team business cards prior to discharge that provided the phone numbers and names of the treating clinicians. Similar to what is done in my current practice with each provider has a team of nurses who work under them directly. Patients are provided with direct contact information to their provider's nurse so that when patients call they can avoid prompts and can reach their nurse directly in real time. This process allows patient easy access to their providers and allows for improved treatment follow up with providers they have already developed a rapport with. Due to this method implementation at the VA in Dallas, “outpatient mental health follow-up visits increased 41% from 138,047 in 1996 to 194,746 in 1998. The percentage of all mental health costs expended on acute psychiatric inpatient care dropped by 10%. Patient satisfaction surveys and focus groups indicate that patients like not having to establish a relationship with a new set of clinicians each time they move through some level of the care
I can properly ask what they are experiencing with communication tools I have been taught, I can calm someone in panic, I can work through delusions, and I can guide them to help. Mental Health First Aid training involves many different activities. The role playing exercises were the most educational in my opinion. Our trainer would simulate a panic attack and a trainee would have to assess the situation, listen nonjudgmental, give reassurance, encourage professional help and encourage self help. This information was taught with the acronym ALGEE which is the foundation of the class. My Youth Mental Health First Aid is aimed at assisting adolescents and young adults which was a 2 day training from eight o’clock to one o’clock each day while the Adult Mental Health First Aid which included the elderly was from eight o’clock to four o’clock all in one day. It was an amazing experience. My favorite and most impactful
Knowing to intervene by detecting warning signs is the first step to help prevent a suicide attempt. Being able to detect the warning signs could be as small as paying attention to of how they speak, act and their overall outlook in life. If the patient is hospitalized, make sure the patient is close to the nurses station where the patient can be easily monitored by all coworkers. Make sure the room is safe. First, remove any objects that could be used by the patient that can cause harm to themselves or others and ensure that the patient does not have any medications on them. When giving the patient their medications, check to make sure they have been swallowed. (Guptill, J. (2011).
Those who are covering for medical professional and keeping a watch over suicidal tendency patient need to be properly educated and should be provided with proper guidelines. Slight neglect on their part can have grave outcomes.
I would not force my client into talking if they aren't ready but discuss when their comfortable whenever they are ready in disclosing. Since I am aware of my background of suicidal and know what could be done to help those with suicidal tendencies I would do everything I can to help my client feel protected and safe. I would ask my client more about them and find out if their situation because I would not want them at risk of harm. Therefore, my awareness and reflection will not influence my work with a client that is suicidal. I will strive to assist helping the client to make sure they are not harming themselves, when did the suicidal thoughts begin, do they have a safety plan created, who they have in their support system, and what they can describe to me they like to do as their interests. All of this would be beneficial to me when assisting the client when finding out that they are suicidal since they are the one at risk of harm. I would try not put my influences of my past assist working with the client. Since I truly believe that each one person that comes in that seeks help deserves a chance turn their life around. Also, I wouldn't want them to feel that their personal experiences of religion and culture will intervene with our relationship when they disclose to me that they feel this