PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice.
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Write My Essay For MeIn this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.
Scenario for Week 7 Case:
You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?
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Learning Objectives
Students will:
Evaluate clients for voluntary commitment
Evaluate clients for involuntary commitment based on state laws
Recommend actions for supporting parents of clients not eligible for involuntary commitment
Recommend actions for treating clients not eligible for involuntary commitment
To Prepare for this Practicum:
Review the Learning Resources concerning voluntary and involuntary commitment.
Read the Week 7 Scenario in your Learning Resources.
Research your state’s laws concerning voluntary and involuntary commitment.
The Assignment (2–3 pages):
Based on the scenario, would you recommend that the client be voluntarily committed? Why or why not?
Based on the laws in your state, would the client be eligible for involuntary commitment? Explain why or why not.
Did understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing the client? Explain.
If the client were not eligible for involuntary commitment, explain what actions you may be able to take to support the parents for or against voluntary commitment.
If the client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.
SAMPLE SOLUTION
As a Psychiatric Mental Health Practitioner Nurse (PMHNP), the primary objective is to ascertain that the clients under one’s care are in a position to take care of themselves without posing a threat to themselves or those around them (Wesemann, 2019). If they are found to be a possible threat, the nurse should advocate for them to be committed to a facility.
In the scenario involving the 14-year-old client, it would be in the child’s best interest for him to be committed voluntarily. Several reasons would support this decision. The first being that there is the …will not have to bear the burden of having to constantly observe their loved-ones movements. The family would also be spared from the possibility of witnessing or having to deal with any uncomfortable and …
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Thirdly, encouraging the client and his parents to be committed voluntarily will ensure that the child cooperates fully with the nurse and team at the facility. It will also provide a feeling of moral support … to understand and evaluate the client’s state of mind. Therefore, establishing if the child would be likely to repeat the action once released…
According to the state laws, for a PMHNP to treat or commit any patient under the age of 18, they have to receive consent from the parents or guardians (Mannekote et al., 2019). Since the child … the constraints provided by law, the medical team is not authorized to commit or treat the patient despite their professional view on the situation. They are obligated to acknowledge and obey the mother’s opinions. However, the parent’s decision can…
Several actions can be undertaken to support the patient and the parents, even if they are against voluntary commitment. The first action would be to ensure that the child receives visitations from …the services of a nurse who can watch over the child constantly throughout the day. This will also play a big role in preventing …
The third action would be to involve the parents and family in the treatment process, especially in the therapy sessions. This would help the PMHNP understand what may be causing stress to… to understand the steps they can take to ensure that their son is well taken care of and avoids any scenarios that may cause him to end his life. Lastly, the parents and the nurses assigned to the child’s care should ensure that the…
In the case where the parents are in favor of the commitment of the child to the facility, several actions would provide support for their decision. The first action would be to allow frequent visitations in the facility. This would help in providing comfort not only for the client but for the pare… in ensuring that the stressful settings are avoided altogether, especially in the home environment. Lastly, committing the child in the facility, whether voluntarily or involuntarily, will help in giving the parents and family peace of mind as pertains to the mental health of the child. As he receives…
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