Psychiatric Emergencies from Brian Fonnesbeck
Psychopharmacology Updates: Know Your Patient’s Medications
- Choose antipsychotics, antidepressants, antianxiety (Benzodiazepines), sedatives, mood regulators
- Anticipate and treat side effects
- Design medication protocols for different disorders
- Solve legal implications related to psychopharmacology
Keep Your Patients and Your License Safe: Tips to Decrease Risk
- Medication – voluntary vs. involuntary
- Physician orders and unit protocols
- Seclusion and/or restraints
- Licensed and unlicensed staff: Utilization, training, comfort
- Specific training for seclusion/restraint and suicide prevention
- Screening and searching of patients and visitors
- Decreasing liability through charting, staffing & supervision
Trending Issues: Your Changing Responsibilities
- Opioid Epidemic
- Intoxication vs. withdrawal
- Drug seeking
- Narcotic and benzodiazepine antagonists
- Increase of Suicides
- Approved assessment tools
- Interventions including safety plans
- Prevention utilizing 1:1 supervision
- A BH/Psychiatric Bed is Not Available
- Commitment process
- Standards against jailing psychiatric patients
- Scarcity of psychiatric beds
New Skills to Address Your Patient’s Acute Psychiatric Symptoms
- Scenario 1 – The patient is suspicious, resistant to treatment, fluctuates between anger and fearfulness
- Determine whether delusions or hallucinations are influencing thoughts and response to staff
- Distinguish between intoxication, mental illness or organic impairment
- Try out effective use of simple directions, presenting reality and giving choices
- Choose intervention and/or medication based on presenting symptoms
- Decide when/if restraints or seclusion become necessary
- Scenario 2 – The patient is hyperactive, impulsive, hypersexual or assaultive, becomes angry about staff intervention, refuses meds, is not eating or sleeping
- Distinguish behaviors due to mania, delirium, intoxication, or organic impairment
- Modify environment and decrease stimulation to increase safety and decrease behavior
- Scenario 3 – Patient is anxious to a panic level, fight or flight behaviors, manifesting high blood pressure, pulse, sweating, and increased respirations
- Distinguish behaviors due to anxiety disorder, delirium, dementia, or intoxication/withdrawal
- Modify environment, decrease stimulation, 1:1 supervision, toxicology/drug and other lab screens
- Keep verbal to minimum but explain procedures, give choices and observe/supervise
- Choose appropriate medication
- Decide if/when restraints and or seclusion necessary
- Scenario 4 – Patient fluctuates between calm, manipulative, passive behavior and demanding, angry, physically threatening (drug seeking)
- Assess for personality disorder such as antisocial personality, borderline personality or narcissistic
- Set and keep limits
- Assign same staff and keep consistency between staff and shifts
- Avoid medication but increase personnel or security
This digital seminar is currently on pre-order meaning that the video will not be ready until 2-3 weeks after the program has taken place.
Crises are never scheduled, convenient or easy. But they do happen, and you will face them. Imagine if you could come to work knowing that you and your co-workers would be able to confidently manage the most unpredictable and dangerous patient behaviors. In one career-changing day, you can learn the latest, safest, and best practices for the psychiatric emergencies that can take place in your non-psychiatric work setting.
Brian Fonnesbeck, an expert Psychiatric Clinical Nurse Specialist/Nurse, understands well the types of challenges that healthcare professionals encounter in the emergency department, the med/surg floor, long-term care… in practically all settings/departments, there are opportunities for patient and family interactions to suddenly go frighteningly wrong.
You’ve heard the horrific stories… and perhaps have a few of your own!
- Healthcare professionals attacked, bit, scratched, kicked, hit – while simply trying to deliver patient care
- A nurse was taken down and arrested for refusing to allow an officer to do a blood toxicology on an unconscious patient.
- Inpatient behavioral health beds are just not readily available, which means you may find yourself responsible to provide time-consuming and challenging psych care in a setting or on a floor that isn’t well equipped to meet such needs
- Situations dramatically worsened by ETOH, drug addiction, TBIs, delirium, dementia… and the out-of-control family members/visitors
Brian will provide you with actual solutions to all these challenges! Crisis prevention skills, medication updates, how to protect your own safety, effective verbal interventions and the emerging new trends to get ready for.
Full of practical tools and tips, this recording will teach you how to make crisis situations more manageable, overcome your worries and improve your readiness to handle psychiatric emergencies related to violence, alcohol/substance abuse, suicide risk, dementia, agitation… and more!
You already know that these high-risk situations open up the possibility of legal risk… the growing risks are taking place due to short staffing, inadequate training, outdated policies, and sometimes just honest mistakes made during extremely stressful and challenging moments.
Confidently walk away with new insights to be able to protect your own safety, your license, your liability risk… and ultimately explore strategies that will allow you to more effectively provide the very best care to patients experiencing a psychiatric emergency.