Nursing Policy for American College of Emergency Physicians

Questions: 1. What are the actual/potential Medical Issues?2. What are the actual/potential Legal issues?3. What are the actual/potential Ethical/Moral issues?4. What are the facts?5. Evaluate Alternative Actions.6. Test your Decision.7. How would you respond if you were in this situation? Explain and support your stance. Answers: 1. What are the actual/potential Medical Issues? The actual medical issue is the inadequate medical resources to care for the patient since there is potential psychotic. The potential aggressiveness of the patient poses the risk of destruction of property and injury of staffs. Information on his medical history indicates the possibility of assault to medical staffs. Moreover, the patient is on no admit list (ACEM, 2008). 2. What are the actual/potential Legal issues? The potential legal issues are violation of client right for admission in the hospital and involuntary examination. On the other hand, medical staffs have right to good working condition without life threatening conditions such as assault and abuse. The legal issue is failure to attend to patient at Baker Act receiving facility (UFHealth, 2016). It is clear to note that the patient was already diagnosed with bipolar disorder and there is enough evidence that the patient is mentally ill which is defined by the Baker Act. 3. What are the actual/potential Ethical/Moral issues? It is ethical to dismiss the client politely based on the potential dangers associated with the client after assessment (Pande et al 2010). Firstly, the patient is potential injurious to both the medical staff and the system. Secondly, there is possibility that patients emotional or mood changes may cause him to destroy the facility and this is not necessarily harm to the hospital but also to the community in general. Thirdly, containing the patient in the facility is expensive since there are few staffs to care for him. 4. What are the facts? Based on the medical history, client documented information and behaviour the client poses risk to both the system and our life as medical staffs. I know that admitting the patient into the facility will automatically lead to conflict with the hospital management since he is in no admit list. Equally, I dont know how to dismiss the client as there is possibility of assault when he realized that there is no treatment. The option left is to give the clients some fast medication before sending him away to avoid any aggressive behaviour while sending him away (Zeller and Ashley, 2014). 5. Evaluate Alternative Actions. a. Dismissing the patient in polite was will ensure least harm to staff with minimal stressful working condition for nurses. Though the law requires patient detention, it is too risky to detain him since we have enough evidence to prove his potential aggressive behaviour (UFHealth, 2016). b. Examining of the client before dismissing him is the client right. On the other hand, the client is dismissed without admission to avoid any disturbance and assault of the staff. c. Examining the client before discharging him away will treat all people fairly the client need medical attention while calm. The action need not to trigger the emotional change in the patient to avoid aggressive behaviour. d. Medical assessment of the patient with intention to contain their right mind is good for his life. As the patient still remain calm it is good to asses him and send him away as this will also give the medical staffs avoid collusion with the management. Consideration of all implications and the outcome of my decision embody the character strength of my value. My decision to discharge the patient after a short assessment is aiming to treat the patient with fairness while protecting my working condition from both law and hospital management. e. I am legally bound to involuntarily admit and provide the required medical examination to the patient. The consequence of not following the Baker Act is facing the court charges if the matter is reported to the court. According to Baker Act reporting center, the Baker Act should be enforced by nurses, health professionals and physicians (Bret et al 2013). f. It is the policy of the hospital not to admit those patients with potential abuse of the services and the facilities. This policy is not legal since it clashes with the Baker Act that provides that any individual with mental disorder be involuntarily examined at the baker act enforcement facility. On the other hand, the hospital policies are ethical since it cites the necessary dangers associated with patients on no admit list. 6. Test your Decision. I would comfortably explain my decision to my mother since I believe it is the best decision. Man in the street also needs to know the situation and all the implications of my action and these I will critically explain to that man in the street. During television interview I will explain the scenarios and how to go about it. Suppose the man in the case study was my brother, the decision will be different since Baker Act allows the families to provide emergency detention with people with mental illness (UFHealth 2016). If the nurse assaulted was my sister or brother I would not admitting him to the facility politely. 7. How would you respond if you were in this situation? Explain and support your stance. I would first asses the patient to get enough evidence that the patient is mentally ill and determine the possibility of admitting or not admitting based on the information I obtain. I would dismiss the patient in a polite way to avoid any aggressive behaviour leading to assault. According to Bret et al 2013, it is worth not admitting the patient because he is dangerous to both staffs and facility. It is equally expensive to admit the patient since there are inadequate medical staffs to care for him in case of psychotic behaviors. Reference American college of emergency physicians (ACEM) (2008), Psychiatric and substance abuse survey. Iriving, TX. ACEP Ltd. Baker Act Reporting Center Bret, S. et al (2013), Repairing Mental Health System: News and Perspective. Mesdscape Psychiatry News: WebMD, LLC. Pande, N et al (2010), Boarding of Psychiatric Patients. Health Affairs Journal: 29(8): 16-17. PubMed. UFHealth (2016), Baker Act. University of Florida: Florida, US. University of Florida Health Science Center. Wolf, A. (2008), Psychiatric Crisis Unit. Journal of emergency nursing: 34(2): 45-49 Zeller, S., Calma, N. and Ashley, S. (2014) Boarding of Psychiatric Patients. West Emergency Med Journal: 15(1). Assessable at: https//www.ncbi.gov/pmc