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Questions and Answers
What does informal admission allow a patient to do?
What does informal admission allow a patient to do?
What is a defining characteristic of voluntary admission?
What is a defining characteristic of voluntary admission?
Involuntary admission is primarily used when a patient:
Involuntary admission is primarily used when a patient:
Which of the following statements about emergency hospitalization is correct?
Which of the following statements about emergency hospitalization is correct?
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Why is voluntary admission preferred over other types of admission?
Why is voluntary admission preferred over other types of admission?
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Who can authorize the detention of mentally ill persons in emergency situations?
Who can authorize the detention of mentally ill persons in emergency situations?
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What is often required for the voluntary admission of minors?
What is often required for the voluntary admission of minors?
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What key aspect enhances the freedom of both psychiatric nurses and patients?
What key aspect enhances the freedom of both psychiatric nurses and patients?
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What is the primary purpose of short-term or observational hospitalization?
What is the primary purpose of short-term or observational hospitalization?
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How are patients admitted for long-term hospitalization?
How are patients admitted for long-term hospitalization?
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Regarding the dangerousness of mentally ill persons, which statement is correct?
Regarding the dangerousness of mentally ill persons, which statement is correct?
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What is a characteristic of conditional discharge?
What is a characteristic of conditional discharge?
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What distinguishes absolute discharge from conditional discharge?
What distinguishes absolute discharge from conditional discharge?
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Which of the following is NOT a type of discharge mentioned?
Which of the following is NOT a type of discharge mentioned?
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What is required for an involuntary patient to be released from hospitalization?
What is required for an involuntary patient to be released from hospitalization?
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How often should a patient's status be reviewed in the context of involuntary hospitalization?
How often should a patient's status be reviewed in the context of involuntary hospitalization?
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What is a judicial discharge?
What is a judicial discharge?
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Which right allows patients to communicate privately with people outside the hospital?
Which right allows patients to communicate privately with people outside the hospital?
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What does the right to informed consent imply?
What does the right to informed consent imply?
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What does the right to privacy ensure for patients?
What does the right to privacy ensure for patients?
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What right enables patients to keep personal belongings in the hospital?
What right enables patients to keep personal belongings in the hospital?
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Which right allows a patient to demand a psychiatric examination by a physician of their choice?
Which right allows a patient to demand a psychiatric examination by a physician of their choice?
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The right to employment states that patients can:
The right to employment states that patients can:
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What is required for a patient to exercise their right to informed consent?
What is required for a patient to exercise their right to informed consent?
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Study Notes
Legal and Ethical Aspects of Psychiatric Nursing
- The legal context of care is important for psychiatric nurses, focusing on patient rights and the quality of care.
- Civil, criminal, and consumer rights of patients are established and expanded through the legal system.
- Psychiatric nurses must be familiar with the legal provisions of their state of practice, enhancing the freedom of both nurses and patients, leading to better care.
Hospitalizing a Patient (Admission)
- There are three major types of admission: informal, voluntary, and involuntary.
1. Informal Admission
- Entry and release from the hospital is orally requested by the patient.
- Patients are free to leave at any time, even before treatment is completed.
- They may be asked to sign themselves out "against medical advice" (AMA), but it's not mandatory.
2. Voluntary Admission
- Admission is through a written application by the patient or their guardian.
- The individual agrees to receive treatment and follow hospital rules.
- Individuals may seek help based on their personal decision or medical advice.
- This is preferred because it is similar to a medical hospitalization, reflecting the patient's acknowledgment of problems and their active participation in finding solutions.
3. Involuntary Admission
- The patient did not request hospitalization.
- It's necessary when a person is a danger to themselves or others due to a mental disorder or when they need psychiatric treatment.
A. Emergency Hospitalization
- Necessary for patients who are acutely ill, primarily to control an immediate threat to self or others.
- Duration is 48 to 72 hours.
- Police officers, physicians, and psychiatrists can authorize the detention of those who are a danger to themselves or others.
B. Short-Term or Observational Hospitalization
- The primary purpose is observation, diagnosis, and treatment of individuals with mental illnesses who pose a danger to themselves or others.
- Admission is through a medical certificate from two physicians, confirming mental illness and need for treatment.
C. Long-Term Hospitalization (Indeterminate or Extended)
- The purpose is extended care and treatment of mentally ill persons.
- Admission is through judicial or administrative action or medical certification.
- It lasts for an indefinite time or until the patient is ready for discharge.
Dangerousness of Mentally Ill Persons
- Most mentally ill persons are not dangerous to themselves or others.
- Studies show that the incidence of violence among psychiatric patients is similar to that in the general population.
- Only certain mental disorders and circumstances can lead to violence.
Discharge of Mentally Ill Patients
- Voluntary patients have the right to demand release, and can only be brought back if they agree.
- Involuntary patients do not have the right to demand release except under court order or when medical certification shows improved condition.
- Patient status should be reviewed regularly.
- Committed patients who leave secretly can apply for another commitment hearing.
- Hospitals have the obligation to notify the police and these patients often return home or visit friends and family.
Kinds of Discharge
- There are three kinds of discharges: conditional, absolute, and judicial.
1. Conditional Discharge
- Usually requires outpatient treatment for a specific period to determine the client's compliance with medication and ability to reintegrate into the community.
- It allows for gradual integration into the community.
- The hospital can issue an absolute discharge if the patient has adjusted well.
2. Absolute Discharge
- This is a final discharge that occurs when the patient can function well in the community.
- Patients who haven't improved, but unlikely to in the future, can receive absolute discharge.
- Contacting families or guardians to arrange care is necessary.
3. Judicial Discharge
- Patients or their families can appeal a hospital's discharge decision if they feel it's not appropriate.
Patient Rights
- In recent years, the legislative acts have supported the civil and personal rights of the mentally ill.
1. Right to Communicate
- Patients can communicate with people outside the hospital, hold telephone conversations, and send unopened letters.
2. Right to Keep Personal Effects
- Patients can keep their clothing and personal items in the hospital considering storage space.
3. Right to Religious Freedom
- Patients have the right to follow their religious beliefs.
4. Right to Be Employed
- Patients, when possible, have the right to work.
5. Right to Education
- Parents can exercise this right on behalf of emotionally or mentally challenged children.
6. Right to Independent Psychiatric Examination
- Patients can demand a psychiatric examination by a physician of their choice.
7. Right to Privacy
- Patients have the right to keep some information confidential.
8. Right to Informed Consent
- Physicians must inform patients about proposed treatments and obtain their consent.
- Nurses often are responsible for ensuring appropriate consent processes
9. Right to Treatment
- Important factors in psychiatric treatment include patient preference, religious beliefs, family impact, potential side effects, and prognosis.
10. Right to Treatment in the Least Restrictive Setting
- The goal is to maximize personal freedom, autonomy, dignity, and integrity in treatment decisions.
- Rationale for using seclusion or restraints must be documented.
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Description
Test your knowledge on the legal and ethical aspects of psychiatric nursing, including patient rights and types of admission. This quiz covers essential information about informal, voluntary, and involuntary admissions, along with the implications for psychiatric care. Understanding these concepts is crucial for ensuring quality care in nursing practice.
