When I do a psych transfer, there are 3 questions I always ask the nurse: why is the patient here, are they violent, and are they going to jump out of the back of my ambulance (flight risk). everything else I will get from the chart or from the patient.
they told my partner (not me) that they were inappropriate questions and somebody needs to stop me. My partner wasn't in the room when I asked the question, and he listed off a couple of the things I said that was consistent with what I asked that bothered them, but he said there was more, and that he couldn't remember.
without knowing your experience or your partner's, I would say you should ask your partner if he thought the questions were wrong.
When I walked into the room, I introduced myself, verified she was the right patient by asking her name and checking her name tag/bracelet, and asked the patient how come they where here.
all very valid questions to ask. you might know what the hospital is telling you, but it doesn't hurt to ask the patient.
The patient was a minor so I asked if the parents were present. They were also mad that I asked this. My partner said there was something about child protective service, or something, so maybe that's why. I still thought it was a reasonable question.
excellent question, but it should have probably been asked of the nurse first. that can be a trigger for a problem. but if the nurse doesn't know, and the patient is a minor, someone needs to sign consent, so the question is valid (if the nurse doesn't have a good answer).
I asked if she had any intention to hurting herself or others, did she have a plan, and if she did, how she planned to do it. When I asked, she said she really didn't mean it, it was the heat of the moment, no plan. She just told somebody that she wanted to die.
all legit questions. it's called getting a history of present illness and events leading up to the incident. I would have asked the same.
She is stressed out about school. I asked what grade she was in, and then asked if finals were going on and if that's why she's stressing?
ehhhh, that's a little personal (asking about how her finals were), but it's simple conversation. would I have asked it? no. would I have dragged you out of the room for asking? no.
This was while the nurse was going in and out of the room, and the security guard sitting in front of the entrance of the room the entire time.
so they witnessed the whole thing, and didn't think it warranted an immediate chat with you either in or outside of the room. or they did think it warranted an immediate intervention, yet didn't do anything about it directly. me thinks the former.
By then my partner said "I need to speak with you right now." and signal me to come over. He told me that the nurse and security (security sits in front of the room to make sure 5150s don't try to escape, hurt themselves, or others) said that I was asking "inappropriate questions", and that I need to be stop, I am not a psychologist, and it's not my place to ask these questions.
sounds like your partner was a jerk. My old partner and I had an unspoken rule: we back each other up against anyone else, provided we didn't do something completely against the rules. we might disagree in private (and frequently did, only once where we needed the supervisor to intervene), we defended each other when someone else said we screwed up. Sounds like you and your partner weren't like that.
I think the nurse was trying to get me out of the room the entire time because she said "I'll give you a report outside of the room in just a moment", and I told her "Oh, my partner will actually take your report. He's hunting for you right now." She didn't like my choice of wording "hunting" either he said (like I said, they clearly complained cause he wasn't in the room when I asked these questions).
get the information from the nurse before you make patient contact. you might gain some important information about the patient, which is useful to know. even better. have her give you the report, than your partner can receive a more thorough report.
The reason I was asking these questions instead of him was because usually the EMTs here do an assessment by asking "Do you have any headache, dizziness, nausea, vomiting, shortness of breath, pain, chest pain?", they'll check vitals, lung sounds, and CSM in all extremities, and to me, that's not even really an assessment. If my partner is not present and paperwork is not ready, I'll try to do an assessment, and then I'll give a report to my partner before we start transporting (by the way, they trained us to report to our partner, but usually only AO questions, the list I told you with headache, dizziness, etc...., and if we see anything obvious like a g-tube).
wow, you do a more thorough exam on a psych transfer than I used to. not a bad thing mind you, just a statement.
I was pretty bummed because not only was one person mad, but two people where mad (the RN and security guard). To my partner, they made it sound like I was out of control. Neither of them spoke to me or stopped me (maybe cause they are too polite), and talked very negatively to my partner about me as if I was his problem, like a pet almost (that's how I felt), and they smiled at me the entire time. He didn't tell me it was the security guard too either until after the call ended, cause when I stopped, I just waited by the patient on the gurney while waiting for my partner, and the security guard and I talked too, and he was really friendly with me, and I just felt like he was being a phony to me instead (well, really being professional by still smiling and stuff at me).
The security guard doesn't count. who cares if they are mad at you? if you were mad at the actions of security, do you think they would care? the RN is a little different, but definitely not something to be bummed about.
I was really bummed with this call afterwards. I felt like I really screwed up. How bad am I really am if I couldn't even tell I was doing a bad job during the call? Had nobody told me, I would've continued to think I was doing the right thing.
if that's the worst thing you do, be great full. wait until you kill someone.
Perhaps my partner felt I over stepped his role too
ehhhh
He was also telling me about the previous call, he didn't like that I told the parents about HIPAA either. We require a signature so they know their information is suppose to be kept a secret, but that their signature is giving us permission to tell that information to their insurance company so we can bill them rather than sending the bill to the family directly. If they don't sign, a bill will be sent directly to their address instead. He said that I need to be a people person, and just tell them that it's for keeping their info a secret (only tell them half of it, whether they sign or not, I am gonna keep the info secret).
do some research on what HIPPA really is. it's probably one of the most misunderstood and erroneously quoted laws in healthcare.
TL;DR Anyhow, in short, tell me how bad I did. What I could've done to improve. If you work IFT, what kind of questions do you ask a psychiatric hold patient. What's involved in your assessment? Does it change for pediatric patients?
I've done worse, you will be fine.
the only thing I would have gotten is a quick report from the nurse. sometimes they can give you information that can prevent you from pressing a hot button issue. but other than that, you did fine, don't let it get to you.
