00:01
Now, when there's an involuntary
psychiatric admission.
00:06
Now, involuntary means
the person says,
"I don't want to be in the hospital.
00:10
I don't think I need
being in the hospital."
A healthcare provider
can seek to have a patient
admitted involuntarily.
00:20
An involuntary admission to an
acute inpatient psychiatric hospital
occurs when the patient
doesn't agree to hospitalization
on the locked inpatient
psychiatric unit.
00:32
So a mental health professional,
and we usually say a 2-Pc.
00:38
It's a 2 physician certificate
is required to do this against
the will of the patient.
00:46
So the physicians, the psychiatrist
evaluate the patient,
and see and determine if the patient
has a diagnosable mental illness
and is at risk of harming
themselves or others,
or is unable
to care for themselves.
01:04
And in that case, the patient
is involuntarily admitted.
01:11
Before that patient is able to
be discharged from the hospital,
even before the next admission,
they must have a court hearing.
01:21
This is a legal document,
that the patient has been
put in this hospital
for his or her own safety,
or the safety of those around them.
01:33
So the criteria for admissions
are legal standards,
under which it is the court
deciding whether or not
the admission is necessary,
and oftentimes whether the
person can even be discharged.
01:49
And hospitalized patients still
retain their rights as citizens.
01:54
They are not losing their rights,
they are not being
"locked up" in prison,
they are being admitted
to a locked ward
and oftentimes
a double locked ward,
which I will talk about.
02:08
They are still citizens.
They can still vote.
02:11
Their safety and their rights
as a patient have to be balanced
with their rights as a citizen.
02:23
So mental health facilities
have written statements
of patient's rights,
as well as the applicable
state laws.
02:30
And it's important to remember that
these laws are state determined.
02:37
And so a patient's right
in a specific hospital
depends on what state
that person is in.
02:44
Whether or not they are in
New Jersey or Connecticut
or Iowa, or California.
02:51
We as nurses need to know
our nursing practice
rules and regulations,
which is also state.
03:01
We also need to know
what the laws are
that protect persons
with mental illness.
03:09
Patients have the right
to treatment.
03:12
Patients have the right
to refuse treatment.
03:16
So they can say,
"I am not taking my medication."
There is no time that we are allowed
to as nurses treating a patient
with psychiatric problems
in an inpatient setting.
03:30
There is no time
that we are allowed to violate
their human rights of the refusal.
03:36
In the event that
it is deemed unnecessary,
it is not a nursing judgment that
overrides the patient's will.
03:44
It is either a court judgment,
or it is the physician
designating the fact that
this patient right now
is in imminent danger
of hurting themselves or others.
03:59
Our respect for our patient,
and oftentimes
the therapeutic relationship
that we develop with our patients
eliminates the need to have these
kind of serious interventions.
04:16
But there are times that will arise
where the court or the physician
may have to make that determination.
04:26
Patients have the right to the least
restrictive environment.
04:31
And so unless it is really
deemed that they are
someone who might hurt
themselves or someone else,
you wouldn't want to put that person
in a double locked ward.
04:45
They have the right
to informed consent.
04:48
And what does that mean?
Well, if we have to do surgery,
if we are thinking of
doing any procedure,
that procedure needs
to be explained to them,
and they have the right
for informed consent.
05:03
That means that the
patient has been provided
with a basic understanding
of the risks, of the benefits,
and of any alternatives to the
thing that we are offering them.
05:17
The person must voluntarily accept
the treatment that we are providing.
05:22
We don't force them to do
what we want them to do,
they must accept
the treatment voluntarily.
05:32
And to be effective legally,
it must be informed
in the general physician
or advanced practice provider.
05:39
We have to give them
that information.
05:44
And we must obtain that consent.
05:47
We have to cosign,
we have to say yes.
05:49
I'm here.
I'm seeing this person consent.
05:53
Now, one of the hospitals
I worked at,
we also had a video.
05:58
And why would you think
we might have a video?
Because with some of our patients
afterwards, they would say,
"That is not my signature.
I never consented that person."
If especially,
if they're paranoid,
"That person wrote my handwriting,
and that's not me."
So in those situations, we actually
videotaped the signing of consent.
06:21
So that when and if we had
to go to a court of law,
which oftentimes you may be
brought into a court of law,
you actually have the
information that demonstrates
that you got consent.