Wednesday, August 09, 2006

Medical Clearance

The CDMHPs (basically like mental health cops for the county) call us and screen patients in before they send them over. We have to make sure we can handle the patients needs - there are certain things we don't do being a psych hospital (dialysis for example). If someone hasn't been in very recently we ask the CDMHP to send them for medical clearance, which means they get sent over to the local hospital to make sure they haven't got a serious medical problem causing their mental status to change.

me: we're going to need medical clearance on her before she comes here

MHP: no need for that, she's fine

me: she hasn't been in the hospital in months and you're saying she's off all her meds

MHP: but she's ok, she looks fine.

me: whats her blood pressure - you say she's got HTN (among other things)

MHP: I'll have to check around the home and see if anyone's taken her blood pressure lately (shuffling noises.. muffled words...) They say she's taking her thyroid pill but she doesn't have anything for HTN, so she is fine. Even if you send her into the hospital she's not going to let them do any tests or draw blood or anything. She's only going to cause problems there. She's in a very bad mood. She's going to be extremely difficult.

me: (speechless)

me: would you like me to call my nurse manager and verify that I am following the corect guidelines in this case?

MHP: no, no... we'll send her.... it's just going to be a bother for her.
Posted by HypnoKitten at 6:20 AM

Blogger Heeds, at 10:14 AM  

yes, cuz us poor wittle nurses at the hospital have never dealt with a MH medical clearance before. oh no the patient is in a bad mood, what shall we do.

Blogger HypnoKitten, at 10:38 PM  

I know!! *jeez!*

At the ED they did a CMP, CBC, UA and vital signs on her and sent her over. No biggie.

It may sound like a waste of resourses, but some of our patients haven't had PO intake for days (food is poisoned, food contains demons, whatever reason) and have been off ALL of their meds (diabetes, thyroid, HTN, HIV, you name it...)and maybe doing drugs and their body is completely out of whack.

We can't evaluate them ourselves for medical clearance because we'd have to actually admit them to do any work-up on them (EMTALA)


Blogger PaedsRN, at 5:35 PM  

"She looks fine", ha. Famous last words if I ever heard them...

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