Question

You are working on a newly opened observation unit in the hospital. Recently there has been an overflow of suicidal clients awaiting placement at the psychiatric facility. The staff recognizes there is not a fully developed policy on how to safely care for a suicidal client. Working together with case management and other staff nurses, you have been asked to create policy recommendations. Your recommendations should include:

• How to create a safe environment
  • Considerations or actions needed when a client is admitted or discharged
  • Considerations or actions during the client’s admission (length of stay)
  • Identify allowable and restricted personal items for the client
• Expectations of client monitoring
  • Describe the requirements of how the client is to be monitored, how often, and by whom.
• Nursing Considerations
  • Expectations of nursing interactions when dealing with suicidal client
  • Required documentation expectations
  • Describe the roles of CNA, LPN, RN

Answer 1

answer:

Safe environment

- maintain the environment to prevent stimuli that provoke the suicide of the patient

- Do not allow the room of the patient to close from inside the room

- The entry and exit of the ward should be closed and one security guard should be present in that part

- The environment should be free from the equipment or glass or sharp articles that may lead to injuring the patient's self by using that equipment.

- Do not leave any medicine or drug at the patient bedside because the patient may ingest in overdose to suicide.

- Do not leave the patient alone, always one person should be there along with the patient like a family member or caregiver.

- provide a calm and quiet environment.

- use only unbreakable items, cord, etc

During the admission

- Assess the severity of the mental condition

- oriented the patient and the family member to the surrounding of the hospital

- Educate the rules and regulations to follow during the hospital stay

During the admit and discharge

- Do not allow the patient to stay alone

- provide counseling frequently

- Administer the medication on time and check whether the medication already swallows or not.

- provide diversional therapy, group therapy, play therapy, occupational therapy to the patient.

- During the discharge, explain the medication to be taken to the patient and the family member.

- Advice the family members not to keep the patient alone at home also.

Restricted items

- restrict to keep the medication or drugs at the patient bedside

- do not keep any sharp items near the patient side

- Do not allow to keep any breakable items in the room of the patient.

Monitoring

- Monitor the patient's behavior frequently hourly by the nurse and the caregiver should stay continuously with the patient.

- monitor the medication intake and observe whether it is swallowed or not.

Nursing consideration

- Assess the condition of the patient

- assess the risk of suicidal ideas

- Listen to the feeling and thought of the patient

- Do no use any facial expression or negative reinforcement to the patient

- Do not allow the patient to stay alone.

- provide counseling

- Documentation of the behavior of the patient, medications, reaction of the patient, etc. to the nurse's notes.

Roles of CNA

- to help the patient in performing the daily basic care like bathing, dressing, eating, exercising, etc

Role of LPN

- they are the licensed nurse who provides care, medication, vital signs checking, collection of samples, reporting the status of the patient to the registered nurse, etc.

Roles of RN

- provision of a wide range of patient services

- provision of holistic care, preventive care, primary care, etc

- Education of the patient and the family members regarding the condition and the treatment

- Documentation in the nurse's notes.