| Subject: |
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Re: Bi-Polar |
| Name: |
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Anne |
| Date Posted: |
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Sep 9, 05 - 1:54 PM |
| Message: |
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In my state with such a situation you basically have two options other then "sucking it up".
#1= You can make a determination over a 33-day period that your facility is not equipped to handle this idividuals medical/psych needs. This could as well include that your staff is not properly trained to meet the psych needs of this resident.
BUT be prepared to show why & in what ways you can't address the needs & the different things you have attempted to do.
While the "deciet" on the other facilities part can play a role in this course of action, it can not be the only reason to address your inability to meet the needs. After all, you did do (or should have done) an preadmission assessment & accepted the patient.
Around here, once you have done that & documented it all, you then have access to other resources via the county & state that generally aren't accessable to LTC residents.
#2= & this is where I'd begin while documenting the various things required in #1.
We'd contact the County Mental Health Crisis Line & stay on their backs like white on rice & get them to do the necessary assesments to either get the patient transfered to a more appropriate facility, committed, or a designated decision that your facility is not equipped/prepared/capable of providing the care this pt needs without placing the other residents at risk or reducing the care time available to other pts.
By regulations you can't "dump" the pt. You can't force them out without cause & even then there must be some attempt to relocate the pt. Verbally abusing the staff is not a reason to transfere a pt out (even though it sometimes shoudl be), but is the pt verball abusive to other residents or verbally abusive to the staff in a manner that agitates other patients?
If other pts get aggitated or respond adversly to this residents manners, then that is something that needs some serious consideration....the adverse effects on other residents that this one bi-polar residents presents due to their illness related actions.
So your administrator may be right for the time being...."suck it up" "deal with it" while you are getting the things into place so that you can get this patient to a more appropriate facility.
We all make bad decisions & hafta live with the consequences, just don't keep repeating the same "rushed" preadmit processes.
If it's down to the wire & you're not comfortable with making a deiciosn, turn it over to teh treatment team - if that means the resident has to wait a weekend, then they wait.
I use to work for a company taht had an "open (1-2-3)admission process". Basically, if the patient showed up at the door & either had orders or the orders had been faxed to us by the MD, we had to admit them - no preadmission work up or anything.
Made for some misiberal time periods & a high rate of staff turn-over as we ended up with the residents that no one else would accept.
I can't devulge the company's name, but they are a nationwide company & their facilities are all clearly identified as a "blank" Community.
Don't know if they still have that admission policy, but basically, if we had a bed available we could not turn away a prospective admission for any reason!
Good Luck! |
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