EMERGENCY PSYCHIATRYEMERGENCY PSYCHIATRY--

MEDICAL COMPETENCY MEDICAL COMPETENCYTHE PSYCHIATRIC CONSULTATIONTHE PSYCHIATRIC CONSULTATION

EMERGENCY PSYCHIATRYEMERGENCY PSYCHIATRYSTANDARD OF CARESTANDARD OF CARE

ALWAYS SAME STANDARDALWAYS SAME STANDARD LAW ACKNOWLEDGES:LAW ACKNOWLEDGES:

EMERGENT CIRCUMSTANCESEMERGENT CIRCUMSTANCES REQUIRES REASONABLE EFFORTSREQUIRES REASONABLE EFFORTS NEED TO ACT BEFORE ALL FACTS INNEED TO ACT BEFORE ALL FACTS IN

RISK KNOWN REQUIRES PLAN RISK KNOWN REQUIRES PLAN PLAN REQUIRES ACTIONPLAN REQUIRES ACTION

DECISIONSDECISIONS

IS PATIENT PSYCHIATRIC?IS PATIENT PSYCHIATRIC? WHAT DO YOU NEED TO KNOW?WHAT DO YOU NEED TO KNOW? WHO KNOWS IT?WHO KNOWS IT? DOES PATIENT NEED HOSPITALIZATION?DOES PATIENT NEED HOSPITALIZATION?

VOLUNTARY OR INVOLUNTARY?VOLUNTARY OR INVOLUNTARY? IF YOU DECIDE NOT TO ADMIT:IF YOU DECIDE NOT TO ADMIT:

DOES PATIENT HAVE COMMUNITY SUPPORT?DOES PATIENT HAVE COMMUNITY SUPPORT? WILL PATIENT BE SAFE UNTIL FOLLOW-UP?WILL PATIENT BE SAFE UNTIL FOLLOW-UP?

DO YOU HAVE REPORTING DUTY?DO YOU HAVE REPORTING DUTY?

CHARTINGCHARTING

CHART LESSER INTERVENTION MORE CHART LESSER INTERVENTION MORE THAN GREATER ONETHAN GREATER ONE

DO YOU NOW 6-O’CLOCK NEWS RULEDO YOU NOW 6-O’CLOCK NEWS RULE LAW SAYS NOT CHARTED, NOT DONELAW SAYS NOT CHARTED, NOT DONE ALWAYS COMMENT ON COMPETENCY ALWAYS COMMENT ON COMPETENCY TIME YOUR NOTETIME YOUR NOTE

MEDICAL COMPETENCYMEDICAL COMPETENCYPSYCHIATRIC CONSULTATIONPSYCHIATRIC CONSULTATION

COMPETENCY PRESUMED IN EMERGENCYCOMPETENCY PRESUMED IN EMERGENCY IF NOT EMERGENCY, “ESTABLISHED IF NOT EMERGENCY, “ESTABLISHED

CUSTOM”?CUSTOM”? LPS DOES NOT AUTHORIZE MEDICAL RXLPS DOES NOT AUTHORIZE MEDICAL RX A PATIENT REFUSAL IS INCOMPETENT IF:A PATIENT REFUSAL IS INCOMPETENT IF:

UNABLE TO RESPOND KNOWINGLY AND UNABLE TO RESPOND KNOWINGLY AND INTELLIGENTLY TO QUESTIONS ABOUT RXINTELLIGENTLY TO QUESTIONS ABOUT RX

UNABLE TO PARTICIPATE IN TREATMENT UNABLE TO PARTICIPATE IN TREATMENT DECISIONS USING RATIONAL PROCESSESDECISIONS USING RATIONAL PROCESSES

UNABLE TO UNDERSTAND INFORMATION ABOUT UNABLE TO UNDERSTAND INFORMATION ABOUT THE RECOMMENDED TREATMENTTHE RECOMMENDED TREATMENT

THE PSYCHIATRIC CONSULTATIONTHE PSYCHIATRIC CONSULTATION

IF REFUSING, PT MUST BE TOLD ALL RISKSIF REFUSING, PT MUST BE TOLD ALL RISKS DO GOOD MSE (PROBATE 811)DO GOOD MSE (PROBATE 811) DETERMINE FOLLOWING:DETERMINE FOLLOWING:

DID PATIENT COMMUNICATE DECISION?DID PATIENT COMMUNICATE DECISION? WAS DECISION BASED ON CONSENT WAS DECISION BASED ON CONSENT

INFORMATION?INFORMATION? IS THERE MENTAL STATUS DEFECT?IS THERE MENTAL STATUS DEFECT? DOES THE DEFECT EXPLAIN THE REFUSAL?DOES THE DEFECT EXPLAIN THE REFUSAL?

WRITE NOTE SUFFICIENT FOR PETITIIONWRITE NOTE SUFFICIENT FOR PETITIION IF INCOMPETENT, BURDEN ON PCP TO ACT.IF INCOMPETENT, BURDEN ON PCP TO ACT.

SHC ETHICS POLICY SHC ETHICS POLICY GUIDELINESGUIDELINES

INFORMED CONSENT WHEN ADULT INFORMED CONSENT WHEN ADULT PATIENT LACKS CAPACITYPATIENT LACKS CAPACITY

IF PATIENT HAS APPOINTED SURROGATEIF PATIENT HAS APPOINTED SURROGATE

IF PATIENT HAS NO APPOINTED IF PATIENT HAS NO APPOINTED SURROGATESURROGATE