Ch. 3 Ethical and Legal Issues in Mental Health Nursing

Ethical issues in mental health nursing

• the right to treatment

• the right to refuse treatment

• the right to the least restrictive treatment and alternative

HIPAA Exceptions

• tarasoff laws: is a PT comes in expressing plans to harm or murder someone else the provider is obligated to report it

• suspected child or elder abuse

Times when treatment can be performed WITHOUT informed consent 

• PT is not mentally sound to make their own decisions and treatment is needed for safety 

• PT is a child

Until when does a PT have a right to refuse treatment?

What can a doctor do to override the refusal?

• PT can refuse unless they continuously show that they are a danger to themselves or others

• Dr. can write a Riese petition which lists out why PT needs to be forced to take meds

What should you check and what are some concerns when a PT is in restraints?

Nursing considerations?

• check vitals, skin integrity, mobility/ROM, and circulation

• Concerns are remember the PT needs the bathroom and food and water

Nursing Considerations:

• use judgement to determine if restraints should be taken off or not

• Assess every 15 min. 

• 1:1 monitoring 

What are the types of restraints?

Chemical 

• Obtain order first them administer (B52)

Physical 

• admin first then order

• 2/4 point 

• walking 

• For adults: expire in 4 hrs

• For kids: expire in 2 hrs

Types of Holds

• 72 hr (5150)

• 14 day (5250)

• 30 day (5270)

Types of Hearings

Probable Cause Hearing

• determines if PT has probable cause of staying in the hospital 

Riese Petition Hearing 

• Determines if patient is able to say no to refusing medication

Libel

WRITTEN defamation of character

Slander

verbal defamation of character