Assignment : Practicum Journal: Voluntary and Involuntary Commitment

PMHNPs may find themselves working in a wide variety of settings—each having their own unique challenges and inherent legal issues. For instance, what do you do in your state of practice when you are providing a therapy/treatment session and a client reports active suicidal ideation? What do you do if you are covering inpatient psychiatric consults and are called to see a patient in the ICU who overdosed on prescription medication requiring intubation? What do you do if you are a PMHNP on an inpatient unit and a client who admitted themselves on a voluntary basis suddenly states that they have decided to sign themselves out of the hospital so that they can go home to kill themselves? These are just some of the legal questions that PMHNPs must know the answers to specific to their state of licensure/practice.

In this Assignment, you investigate your state’s laws concerning voluntary and involuntary commitment. You also analyze a case to determine if the client is eligible for involuntary commitment.

Scenario for Week 7 Case:

You are a PMHNP working in a large intercity hospital. You receive a call from the answering service informing you that a “stat” consult has been ordered by one of the hospitalists in the ICU. Upon arriving in the ICU, you learn that your consult is a 14 year old male who overdosed on approximately 50 Benadryl (diphenhydramine hydrochloride) tablets in an apparent suicide attempt. At the scene, a suicide note was found indicating that he wanted to die because his girlfriend’s parents felt that their daughter was too young to be “dating.” The client stated in the suicide note that he could not “live without her” and decided to take his own life. Although he has been medically stabilized and admitted to the ICU, he has been refusing to talk with the doctors or nurses. The hospital staff was finally able to get in touch with the clients parents (using contact information retrieved from the 14 year old’s cell phone). Unbeknown to the hospital staff, the parents are divorced, and both showed up at the hospital at approximately the same time, each offering their own perspectives on what ought to be done. The client’s father is demanding that the client be hospitalized because of the suicide, but his mother points out that he does not have “physical custody” of the child. The client’s mother demands that the client be discharged to home with her stating that her son’s actions were nothing more than a “stunt” and “an attempt at manipulating the situation that he didn’t like.” The client’s mother then becomes “nasty” and informs you that she works as a member of the clerical staff for the state board of nursing, and if you fail to discharge her child “right now” she will make you “sorry.” How would you proceed?

Learning Objectives

Students will:

• Evaluate      clients for voluntary commitment
• Evaluate      clients for involuntary commitment based on state laws
• Recommend      actions for supporting parents of clients not eligible for involuntary      commitment
• Recommend      actions for treating clients not eligible for involuntary commitment

To Prepare for this Practicum:

• Review      the Learning Resources concerning voluntary and involuntary commitment.
• Read      the Week 7 Scenario in your Learning      Resources.
• Research      your state’s laws concerning      voluntary and involuntary commitment.

The Assignment (2–3 pages):

• Based      on the scenario, would you recommend      that the client be voluntarily committed? Why or why not?
• Based      on the laws in your state, would the      client be eligible for involuntary commitment? Explain why or why not.
• Did      understanding the state laws confirm or challenge your initial recommendation regarding involuntarily committing      the client? Explain.
• If the      client were not eligible for involuntary commitment, explain what actions you may be able to take to support the      parents for or against voluntary commitment.
• If the      client were not eligible for involuntary commitment, explain what initial actions you may be able to take to begin treating the client.

Describe the processes that take place during a typical hospitalization, or emergency department visit for a consumer under the ACA. From admission to discharge, including aftercare, rehab, and acquisition of medications; address the differences, with the same experience from before the ACA was passed into law?

Assignment Expectations: How will students be successful?

• Length:
  • 1500-2000 words (6-8 pages); answers must thoroughly address the questions in a clear, concise manner 
• Structure:
  • Include a title page and reference page in APA style
• References:
  • Two scholarly references are required; you should include the appropriate APA style in-text citations and references for all resources utilized to answer the questions

Think of a time when you were involved in building team synergy. Consider the following in your discussion: 

•What was happening at the time? 

•Which of the nine practices did you exhibit? (SEE BELOW)

•Were there other things you did to support teamwork? 

•How did you know your efforts were successful? 

•Would you have done anything differently, looking back? 

•What are the benefits of a team working together? 

•When (if ever) is conflict within a team productive? 

•What factors can contribute to role confusion and conflict among health care professionals?  

Write a succinct initial post of at least 150 words. Demonstrate clarity of thought and precision in writing. Support your discussion with at least two references other than the required readings.

9 Practices of team synergy:

1. Coordinating the patient-care team

2. Mentoring team members

3.Empowering lower-level team members

4. Advocating on others’ behalf

5. Managing conflict constructively

6. Listening actively to team members

7. Fostering a positive climate

8. Managing workplace stress.

9. Pinch hitting for team members.

Propp, K. M. (1999). Collective information processing in groups. In L. Frey, D. S. Gouran, & M. S. Poole (Eds.), Handbook of group communication theory and research (pp. 225-250). Thousand Oaks, CA: Sage

Triple Constraints

The term “triple constraints” refers to three universal restrictions that affect project management across virtually all fields, disciplines, and business sectors. These constraints are scope, time, and cost (or resources). In health care organizations, these constraints are especially relevant given the complex, interconnected nature of workflows; the urgent matter of improving care and outcomes; and the unfortunate realities of tight budgets and limited staffing. In addition, the Health Information Technology for Economic and Clinical Health (HITECH) Act and its meaningful use objectives have added even more requirements to projects undertaken in the health care field.

This Discussion focuses on project management in health care organizations. You explore how the requirements for meaningful use have complicated the implementation and conversion to a new informatics project. You also consider strategies for addressing and overcoming these challenges.

To prepare

• Review this week’s Learning Resources on triple constraints and project management. Consider how each of the three constraints relate to the implementation of workflow changes, technology innovations, and system upgrades in health care settings.
• Reflect on the article, “EHR/EMR: ‘Meaningful Use,’ Stimulus Money, and the Serenity Prayer” in the Learning Resources, and consider its relevance to meaningful use objectives and the challenges they pose for the health care field. Also consider your experiences with meaningful use compliance in your health care setting. How does meaningful use contribute to additional stress for organizations?
• Consider strategies and recommendations for organizations and nurse informaticists in accommodating meaningful use and triple constraints.

With these thoughts in mind:

Post by tomorrow 11/08/16 a minimum of 550 words essay in APA format with 3 references from the list below, addressing the level one headings as numbered below:

1)      An explanation of how each of the triple constraints (scope, time, and cost) relate to project management in health care settings.

2)      Describe how meaningful use adds additional complexity to project management planning.

3)      Propose at least one specific strategy that could be used to address meaningful use and triple constraints.

 Required Readings

Dennis, A., Wixom, B. H., & Roth, R. M. (2015). Systems analysis and design (6th ed.). Hoboken, NJ: Wiley.

•Review Chapter 2, “Project Selection and Management” (35–80)

•Review Chapter 12, “Moving Into Implementation” (pp. 377–397)

Lee, K. J., & Smith, R. M. (2011). EHR/EMR: “Meaningful use,” stimulus money, and the Serenity Prayer. Ear, Nose & Throat Journal, 90(2), E25–E28.

Retrieved from the Walden Library databases.

The authors outline the steps health organizations need to complete when implementing electronic health records to meet the meaningful use criteria. They argue that although the requirements are rigorous, they will result in more useful systems as well as qualify the organizations for government funding.

Overgaard, P. M. (2010). Get the keys to successful project management. Nursing Management, 41(6), 53–54.

Retrieved from the Walden Library databases.

This article compares the nursing process to the project management and process. It also presents the different phases of project implementation and the role the project manager plays at each phase.

Schifalacqua, M., Costello, C., & Denman, W. (2009). Roadmap for planned change, part 1: Change leadership and project management. Nurse Leader, 7(2), 26–29, 52.

Retrieved from the Walden Library databases.

Change leadership and project management are integral factors of implementing any new policies or structural changes within an organization. The authors of this article describe the key elements of leading change. These include such suggestions as developing a thorough business charter, business budget, business plan, a project time line, and providing the correct project tools.

Sugrue, M. D. (2010). Clinical leaders and the adoption of health IT. Nursing Management, 41(9), 18–21.

Retrieved from the Walden Library databases.

this article, the author highlights the importance of strong leadership in the adoption of HIT. The article outlines the steps of the transformational process and how these can be built upon to ensure the success of the adoption.

Haughey, D. (2011). Understanding the project management triple constraint. Retrieved from http://www.projectsmart.co.uk/understanding-the-project-management-triple-constraint.html

This web page explains the triple constraints of cost, time, and scope that project managers must work within. It also describes how the project manager maintains the balance between these constraints in order to meet organizational goals.

Write 5 sentences about each topic.

1. Value vs Morals

2. Negligence 

3. Critical Thinking

4. Two Bioethical Issues

5.  What are the goals of nursing?

6. Florence Nightingale 

7. What is the Nurse Practice Act?

8. Telehealth 

9. Isabel Hampton Robb

10. Medicare vs. Medicaid

11. Diversity

12. Delegation vs. Assignment 

13. Eye Contact

14. Three styles of communication

15. Three barriers to research in practice