The patient is a 25 year old female who presented to the ED Voluntarily for allegedly being held hostage in a basement of a house and physically and sexually assaulted. TTS assessed the patient on 2/11/18. TTS documented the patient was capable of signing voluntary admission. The patient denied suicidal ideation, homicidal ideation, and symptoms of psychosis. TTS reported the patient does not meet inpatient criteria or Involuntary commitment criteria, however Jason Berry, NP recommended the patient be observed overnight and evaluated by psychiatry in the morning. Ford Warrick, LPC, notified Dr. Osborne and nursing staff at Randolph Hospital ED of recommendation. TA staff was contacted by Maddie, Charge nurse, around 6pm who informed me that
Mrs. Hylton is a 45 year old female who presented to the ED via LEO under IVC by her therapist, Melanie, from ADS. Per documentation Mrs. Hylton denies suicidal ideation and homicidal ideation to nursing staff and MCM before the evaluation. She also contracted for safety with MCM. Dr. Horton requested a mental health assessment on Mrs. Hylton. Before the assessment Ms. Melanie and her supervisor Melissa were contacted. Ms. Melissa reports Mrs. Hylton verbally contracted for safety, however left before ADS could type up terms of verbal agreement. Melissa reports afterwards she was not aware of Mrs. Hylton symptoms of psychosis when speaking with her until being informed by Melanie of findings after conversation with Mrs. Hylton. Melanie upon
It was about three months ago I was working in the psychiatric emergency room when I inherited a patient from the night shift nurses. This patient was a 17 years old female with a history of bipolar and schizophrenia, came to the emergency room after having an altercation
The Alabama Educator Code of Ethics is designed for every educator in the state of Alabama. The Code must be implemented for the safety of students and educators. The goal of the Alabama Code of Ethics can be accomplished as long as all educators value the worth and dignity of all students, parents, and staff. There are nine Alabama Educator Code of Ethics and Standard 1: Professional Conduct, Standard 4: Teacher/Student Relationship and Standard 5: Alcohol, Drug and Tobacco Use of Possession are the most important standards.
Anthony is a 40-year-old Asian American male who presents on the unit from RRC-W. He is SMI designated and on COT. He is ACOT for non-compliance. Per clinical team, client has been ignoring his diabetic condition due to increase psychosis and delusions. His team believes once he is stabilized on medication, he will begin to recognize his diabetic condition. Upon arrival, client refused intake assessment and vital signs. He will benefit from meeting with provider to discuss medication
Per the previous therapist, referral form states, "Clt was hospitalized on 3/30/16 for panic attacks and suicidal ideations associated with ongoing bullying." Clt meets medical necessity as evidenced by the following impairments: Clt showed impairment at school as evidenced by making statements daily (i.e. 5x/week) to Mother that no one at school liked her and stating that she did not want to go to school. Clt developed symptoms in response to being bullied at school. Mother reports that Clt seems hesitant to engage with peers at her new school. Mother reports impairment in Clt at home in that Clt frequently seems sad and irritable and cannot get certain thoughts out of her mind (~4x/week) and is hesitant to speak with her about the bullying for fear that Mother will go speak with the school.
Mr. Farley is a 52 year old veteran who presented to the ED with a BAC of .42 and requesting detox treatment. Mr. Farley denies suicidal ideation, homicidal ideation, and symptoms of psychosis to ED staff. However, after initially denying suicidal ideation, upon discharge and sobering up from several hours in the ED and being given fluids, nursing staff informed patient he was up for discharge, at which point he asked for Ativan to help with his withdrawal symptoms. He was informed he would not be prescribed this medication and reasons why, he then expressed he could not be discharged because he was now a threat to harm himself. It should be noted Mr. Farley was seen 2 weeks ago and upon discharge reported the same. He expressed he was homelessness
I placed a call to Thomas, who was frantic, but extremely grateful that his wife was safe. After a period of conversation, Thomas related that his suffers from a psychosis metal condition. Thomas related that he checked himself out of the hospital and was unaware Margaret had taken her day’s medication. Thomas requested that I take Margaret to the local hospital for medical evaluation due to her detreating mental status. I then transported Margaret to Jefferson Hospital Crisis Center where I remained until evaluated by medical staff. Thomas was then notified of the hospital and his Margaret’s status. Thomas was very grateful and related that he was responding immediately this morning. No further police action
Alison Hymes fought for her patient rights; she was committed against her will. Alison sat in a small waiting room of a Virginia mental hospital; the morning of her recommitment hearing. She scribbled down her thought and list of arguments in favor of releasing her from Western State Hospital in Staunton, Va. She wrote everything down into her green composition book. Her notes included: Being at the hospital too long, and becoming institutionalized. Alison knew no one was going to listen to her. Ms. Hymes had six other recommitment hearings over the previous 17 months and repeatedly said the same thing at each one. A judge ruled that she was a danger to herself and involuntarily hospitalized her twice in three years.
This is a very realistic scenario in a number of settings whether acute care or skilled nursing facility. This highlights the importance of educating patient care assistants of patient’s rights. Many ethical and legal issues arise in this case. The patient was subjected to false imprisonment as you mentioned in your primary post. The patient was contained to one area against their will. No matter the mental capacity, a person “has the right to move freely without hindrance” (Pozgar, 2016, p. 84). This was negated when the CNA placed the patient in their bed, and moving the bed to a position which would cause “hindrance” to the patient exiting the room, an “unreasonable way of escape” (Pozgar, 2016, p. 84). This could pose many threats
My colleague and I received an emergency call to reports of a female on the ground. Once on scene an intoxicated male stated that his wife is under investigation for “passing out episodes”. She was lying supine on the kitchen floor and did not respond to A.V.P.U. I measured and inserted a nasopharyngeal airway which was initially accepted by my patient. She then regained consciousness and stated, “Oh it’s happened again has it?” I removed the airway and asked my colleague to complete base line observations and ECG which were all within the normal range. During history taking my patient stated that she did not wish to travel to hospital. However each time my patient stood up she collapsed and we would have to intervene to protect her safety and dignity, whilst also trying to ascertain what was going on. During the unresponsive episodes we returned the patient to the stretcher where she spontaneously recovered and refused hospital treatment. I completed my patient report form to reflect the patient's decision and highlighted my concerns. The patient’s intoxicated husband then carried his wife back into the house.
Ethically, I feel all the psychiatrist involved should have done a little more investigating into Phillip Jablonski background. Mr. Jablonski and Ms. Kimball informed Dr. Kopiloff that Jablonski served five years in prison for raping his wife and four days prior to attending the session he attempted to rape Kimball’s mother. I feel this information alone deserved a little more attention from Dr. Kopiloff because Jablonski is definitely displaying a pattern of his lack of respect for women and violating your personal space. Another issue which should have brought up red flags and gave Dr. Kopiloff cause for concern is the fact that the police described the same situation to Dr. Berman who failed to relay the message to Dr. Kopiloff. The level of urgency regarding the safety of others and their clients at this hospital does not seem to be high. Ethically, Dr. Berman and Dr. Kopiloff should have formally informed Kimball of their concerns regarding Jablonski’s recent, current, and vague and uncommunicative demeanor. Both doctors were formed not only by local police also the client himself of his violent tendencies and they still were reluctant to act, and only suggested Jablonski voluntarily hospitalized himself.
The provision states, “Respect for human dignity requires the recognition of specific patient rights, particularly, the right of self -determination. Self -determination, also known as autonomy, is the philosophical basis for informed consent in health care. Patients have the moral and legal right to determine what will be done with their own person; to be given accurate, complete, and understandable information in a manner that facilitates an informed judgement; to be assisted with weighing the benefits, burdens, and available options in their treatment, including the choice of no treatment; to accept, refuse, or terminate treatment without deceit, undue influence, duress, coercion, or penalty; and to be given necessary support throughout the decision-making and treatment process (nursingworld.org)”. Ms. Rogers cannot even get to this point because of the resident refusal to treat her. There could many things going on with her. She could have pancreatitis, gallbladder issues or many other diagnosis related to her abdominal pain. She won’t know until a physician does a full workup on her. She obviously wants to be seen or else she wouldn’t have come to the ER. She knows something is not right is she is staggering in the hospital. She has rights as a patient to be seen by a physician. I think is the resident doesn’t want to evaluate her then the ER nurse needs report that person and go find another physician to do the job. I would also talk to the house supervisor about the situation so it could be reported to administration. Doctors go into medicine to help all people, not to pick and choose who they want to
As an EMS educator, you may be called upon to wear many hats by your students. Many of these students have no prior experience within the EMS community, so they will look to you as a mentor and role model. It is very important for an EMS educator to acknowledge their role in helping the students recognize the responsibility placed upon an EMS provider. Within this responsibility lies the world of ethics. I personally believe that although ethics cannot be taught, I do believe ethics can be learned and mimicked, and the EMS classroom is the perfect venue to begin the introduction of ethical thoughts and actions.
Code of ethics act as a promise to protect and support the safety of individuals in society, supports as a leading light it help the supporters of an occupation, resolve ethical problems and act as a protector the community. A code of ethics discloses and conserves the current viewpoint professionals on in what way to make ethical decisions. It stresses importance on obligation to moral values and vital beliefs. Application of a code of ethics helps us to guarantee that members of the profession will be accountable for their actions. It helps us to learn about the responsibility we have for ourselves, our colleagues and to the social structure of the profession. It is essential that the present and future psychologist should be aware of the formal ethical codes of practices in psychology. The American Psychological Association (APA) developed this formal Ethics Code which demonstrates the approaches to the psychologist about logical, educational, and clinical behaviors to be followed while working as a licensed person. By applying the ethical code a psychologist can identify ethical issues, interrelate with others professionally. This can inhibit and solve ethical dilemmas, and he /she will be able achieve their professional protagonists and responsibilities.
On the week of 6/28/17 to 6/30/17, I conducted individual sessions. During my individual session, I did a check-in with the client who disclose suicidal ideation the previous week. The client stated he felt good. He talked about his experience at the facility he was admitted to. He discussed what he learned while he was there and we discussed how he can utilize the information he learned. One thing I am concern about is the client is missing schedule appointment to see his therapist. After reviewing his file, I learned he had an appointment schedule for that day. The client did not know he missed the appointment. I spoke with my field supervisor about the concerned I had my concerned and the importance of speaking with the father about the