Essay On Psychiatry Emergency Room

As a nurse in a psychiatry emergency room, the staff must collaborate for the safety of patients and staff. There is a triage process that must be followed when a patient comes to the Psych ED, security takes any electronic devices, keys, purses, lighters, knives, wallets, etc. A nurse takes a mini-triage, which determines whether a patient needs to go to the medical ED side, if the patient is cleared to go to the Psych ED, the nurse must then decide whether to place the patient in a locked involuntary area or unlocked voluntary area. Any patient that goes into the involuntary waiting area must be searched, and go into a patient gown. Once there the patient must be seen by a nurse, then by a doctor. If a patient is agitated to the point of

I had a patient that was a threat to others, was not redirectable, and was refusing to come out of the bathroom. I informed the doctor that this patient was threatening staff, the doctor told me what to give; nurses usually collaborate to get security, additional staff, draw IM medications, etc. As another nurse and I were drawing up Haldol, Benadryl, and Ativan, the doctor peeked in and told us not to bother, that the patient was now calm. This patient was refusing all PO medication and was grossly psychotic. It did not matter if in that instance she was calm, she was a threat to staff because she had threatened them, and my note reflected this. When I gave report to the next shift, I warned them. The next day in morning report the evening/night staff reported that security was called and that this patient had to be medicated. This doctor does not understand, that if this patient had hurt staff, the doctor would be liable because my note stated that she was a threat and that the physician refused to medicate. This doctor was angry at me because I documented the facts, so

The staff knew the patient well, knew that she had a history of being violent, knowing the patient positively affects patient outcomes (Zolnierek, 2013). The Quality and Safety Education for Nurses Project has established nursing evidenced-based practice competencies which include: patient-centered care, teamwork, safety, informatics, quality improvement, and evidence-based practice. Some barriers to evidence-based practice include fixed tradition, with an inability to adapt; time constraints, inadequate education, resistance from nurses and doctors (Melnyk et al., 2014). In looking at the evidence that informed my nursing practice: this doctor was not trusting my judgment, even though I have been a nurse for 28 years, almost as many years as this doctor has been alive. She was resistant to teamwork, she placed staff at risk, and did not do what was best for the patient; Further, 30%-76% of psychiatric staff is assaulted by a patient at least once in