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Voluntary Admission to Inpatient Psychiatric Units (Nursing)

by Brenda Marshall, EdD, MSN, RN

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    00:01 So what kind of treatment settings are there for inpatient care? When we think about inpatient care, if a patient is ill enough to be admitted into a hospital or a unit, it is for crisis stabilization.

    00:21 It is to observe this patient.

    00:25 It could be in a general hospital, it can be in a private hospital, it could be in a state hospital.

    00:34 The way they get into the hospital is through direct admission.

    00:40 And they need to be referred.

    00:44 It might be in an emergency department.

    00:46 So if you are working in ED, you might have the patient that comes in with a crisis.

    00:54 It might be in a crisis service, where the phone call comes in, where the person says I'm going to kill myself.

    01:03 Also, if you are working to in a hospital that is specifically for psychiatry, they may have a psychiatric emergency department.

    01:16 Or if you're working in a large hospital, they may have a separate emergency department just for psychiatry.

    01:25 Patients can be admitted voluntarily meaning they recognize there's a problem and they want to come in and they want to have our help to recover from whatever they're going through, or maybe involuntary.

    01:42 The patient lacks the insight to understand that they are now in a crisis situation, and they are going to either hurt themselves or hurt someone else, and they need to be admitted.

    01:58 The acute inpatient psychiatric hospitalization is intended for individuals whose thoughts and behaviors are posing a substantial risk, either to themselves or to others.

    02:14 This is really important to remember that we don't admit persons to the psychiatric unit.

    02:23 without understanding that level of risk.

    02:27 The information provided by the individual seeking treatment, and the information provided by the family or perhaps friends can be considered when determining the most appropriate treatment.

    02:41 What kind of setting do we want this person to be in? Is it a voluntary admission? Is it an involuntary admission? We need to take all of the factors into account.

    02:53 In either case, the person must be in need of inpatient care and treatment, and the facility must be suitable to provide such care and treatment.

    03:03 So this is an interesting situation that may come to your attention when you are working in the hospital.

    03:13 Because if you're working in an emergency room, and a person is coming in, they may be looking for voluntary admission.

    03:21 So a voluntary admission is when a patient or if the patient is a minor or is incompetent, which means that they have a person who is responsible for them, who has been chosen and now is court appointed as a guardian.

    03:40 So the patient or that guardian can go and sign for a voluntary admission.

    03:49 It is an acute inpatient psychiatric hospitalization.

    03:53 And it occurs when a person is going for this psychiatric evaluation.

    03:58 And the evaluating mental health provider and the patient together agree that the patient would benefit from being hospitalized.

    04:08 And the patient now meets criteria to be hospitalized.

    04:14 That patient is required to sign a consent form that documents the patient's rights and describes the inpatient hospital experience.

    04:24 So that's really important that if that patient needs to have a guardian.

    04:29 For example, if that patient also has an intellectual disability, and has a full time guardian, that patient is going to be having their rights explained and the hospital experience explained, but it will be the patient and the guardian that will sign and understanding that says, "This is why I'm being admitted. This is what's going to happen." And then by signing that form, that patient is agreeing to be hospitalized on a unit where the doors are locked.

    05:10 The psychiatric unit has the doors locked, the patient will not be able to walk off that unit.


    About the Lecture

    The lecture Voluntary Admission to Inpatient Psychiatric Units (Nursing) by Brenda Marshall, EdD, MSN, RN is from the course Accessing Acute Psychiatric Care (Nursing).


    Included Quiz Questions

    1. Health care providers can directly admit clients to psychiatric care with a referral.
    2. Inpatient psychiatric units can only accept involuntary clients.
    3. Clients must access a specific psychiatric emergency department in order to get admitted.
    4. Crisis services are unable to facilitate inpatient psychiatric admissions.
    1. A client who is known to abuse a prescription medication
    2. A client who has a chronic passive suicidal ideation and denies plan or intent to commit suicide
    3. A client who starts a fight and is intoxicated
    4. A client who starts to develop side effects from new antipsychotic drugs
    1. The client or guardian must sign a consent form prior to admission.
    2. The client is admitted to a special, unlocked psychiatric unit.
    3. It can only be sought out by the client
    4. It is not considered an acute psychiatric hospitalization

    Author of lecture Voluntary Admission to Inpatient Psychiatric Units (Nursing)

     Brenda Marshall, EdD, MSN, RN

    Brenda Marshall, EdD, MSN, RN


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