Involuntary Commitment Issue

[PAEMT]

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Hello, I have a question that will may determine if medicine will be my career field or not (Assuming I will get accepted.) I was an EMT and I grew to absolutely despise involuntary commitments. To avoid any specific details, I had some very unpleasant experiences with the issue. I really would not like to ever do that to someone in my career. Is there any possible way to avoid committing someone through rotations/residency? Thank you.

 

[costales]

Emergency certificates can only be signed by fully licensed physicians, not med students or residents.

 

[DGCT00]

Hello @PAEMT ,

From one EMS provider to another, I can tell you I've had those experiences too. I had a terrible call in which I had to put an elderly Cambodian man in handcuffs and transport him to the ER against his will because his wife (his healthcare proxy) was upset that her dementia-ridden husband was yelling at her. Language barrier, dementia, healthcare-proxy -- we had to take him to the ER. That call sticks with me and if I could go back, I think I would have done things differently.

But calls like that were so, so infrequent. In my 8 years in this system, I've dealt with a lot of psych patients. Involuntary commitment may sound unreasonable but if you come of the mindset that people in psychological distress can be helped, then it's understandable. I've dealt with psychological illness in the field and even in my own family and though no one wants to be committed involuntarily, their stability and happiness is worth the short period of distress they're put through. (In my opinion.)

I want to be an ER physician. Psychs are going to be something I deal with on a daily basis. Unhappy people are the ones who want to take their lives. My hope is that when these patients come into the ER, I'll be able to find a way to change their unhappiness so that they can enjoy their lives.

Just a thought.

 

[PAEMT]

Hello @PAEMT ,

From one EMS provider to another, I can tell you I've had those experiences too. I had a terrible call in which I had to put an elderly Cambodian man in handcuffs and transport him to the ER against his will because his wife (his healthcare proxy) was upset that her dementia-ridden husband was yelling at her. Language barrier, dementia, healthcare-proxy -- we had to take him to the ER. That call sticks with me and if I could go back, I think I would have done things differently.

But calls like that were so, so infrequent. In my 8 years in this system, I've dealt with a lot of psych patients. Involuntary commitment may sound unreasonable but if you come of the mindset that people in psychological distress can be helped, then it's understandable. I've dealt with psychological illness in the field and even in my own family and though no one wants to be committed involuntarily, their stability and happiness is worth the short period of distress they're put through. (In my opinion.)

I want to be an ER physician. Psychs are going to be something I deal with on a daily basis. Unhappy people are the ones who want to take their lives. My hope is that when these patients come into the ER, I'll be able to find a way to change their unhappiness so that they can enjoy their lives.

Just a thought.

Thanks for the replies everyone. Interestingly, for me psych calls were pretty frequent. So frequently, actually they made up a good percentage of BLS calls and a few ALS. Anyway, I understand your argument, it's just something I don't want to go through again, but I'll keep that in mind it/when the time comes again. Thanks.

 

[medickdb]

Thanks for the replies everyone. Interestingly, for me psych calls were pretty frequent. So frequently, actually they made up a good percentage of BLS calls and a few ALS. Anyway, I understand your argument, it's just something I don't want to go through again, but I'll keep that in mind it/when the time comes again. Thanks.

You have to think about it as a patient safety thing, too. If someone is a harm to oneself or others, it may be in everyone's best interest. From what I've seen, the physician will usually try to get a family member to petition for involuntary commitment anyway. So, it's often a joint decision, but may need to be a sole decision depending on the situation.

 

[PAEMT]

You have to think about it as a patient safety thing, too. If someone is a harm to oneself or others, it may be in everyone's best interest. From what I've seen, the physician will usually try to get a family member to petition for involuntary commitment anyway. So, it's often a joint decision, but may need to be a sole decision depending on the situation.

That's a good way to look at it. I've got a long time to go before I'm going to be applying, so I'll try not to worry about it now. Thanks.

 

[HarryPlopper]

If the

Hello, I have a question that will may determine if medicine will be my career field or not (Assuming I will get accepted.) I was an EMT and I grew to absolutely despise involuntary commitments. To avoid any specific details, I had some very unpleasant experiences with the issue. I really would not like to ever do that to someone in my career. Is there any possible way to avoid committing someone through rotations/residency? Thank you.

The possibility can always come up and you need to be ready for it. It doesn't happen often but no it isn't always avoidable.

 

[Mehd School]

Emergency certificates can only be signed by fully licensed physicians, not med students or residents.

This certainly isn't true in my state. I handle emergency certificates with "Med School Name -- PGY-X" where the license # should be every once in a while.