Non-ER Psychiatry Calls

[prominence]

anyone know of any psychiatry residency programs where the psych residents do not take psych call directly from the ER? (i.e. instead the psych resident works up the patients after the patient has been admitted from the ER to the inpatient unit)

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[prominence]

bump

 

[atsai3]

anyone know of any psychiatry residency programs where the psych residents do not take psych call directly from the ER? (i.e. instead the psych resident works up the patients after the patient has been admitted from the ER to the inpatient unit)

I have a hard time understanding how this kind of setup would work in practice. Who would make the decision (in the ER) to admit the patient to the psychiatry ward? The ER resident?

-AT.

 

[Anasazi23]

Maybe what he means is that there is a dedicated CPEP or psych ER with attendings or residents doing ER shifts. Admissions get sent to the floor, with the on-call floor resident re-examining and putting in orders, etc.
?

 

[prominence]

i meant programs where the ER attending contacts the psych attending to get permission to dump/admit the patient to the psych unit with preliminary admission orders, until the psych resident covering the weekend sees the patient in the morning. Obviously, the ER knows a suicidal or schizophrenic patient belongs to psychiatry, if they are medically stable.

 

[OldPsychDoc]

i meant programs where the ER attending contacts the psych attending to get permission to dump/admit the patient to the psych unit with preliminary admission orders, until the psych resident covering the weekend sees the patient in the morning. Obviously, the ER knows a suicidal or schizophrenic patient belongs to psychiatry, if they are medically stable.

Our hospital works a bit like that...except they skip the "contacts the psych attending to get permission" part.
An empty bed is taken as implied consent for admission from our ER, the residents and moonlighters do the initial work-up, and we attendings do the formal admission the next day.

 

[whopper]

At my own program UMDNJ-Atlantic City--after 10 pm (or earlier if nothing's going on in the ER), you can leave for home. However you are still on call. If the ER needs anything, they beep you and you do orders over the phone. This includes covering the crisis center in the ER, and the inpatient psyche ward.

About 1/3 of the time you are barely interrupted after you go home, 1/3 of the time you get a moderate amount of calls but you can still get a decent night of sleep (about 5 hrs or more). 1/3 of the time you just get beeped all night.

 

[Solideliquid]

At my program we have a dedicated staff of LCSWs who monitor the ER and direct admits 24/7 (THANK GOD).

They bascially get called to the ER for any 300.9 pt (psych). They then do an initial interview and assessment, if the pt does not qualify for our unit, they are sent elsewhere (violent, non-voluntary, etc). If all conditions can be met, the LCSW finally (nooooo...) pages the on-call intern to come to the ER, perform a full H&P and admit if we feel it's necessary.

Usually, they only call us if they strongly feel the person should be admitted, and 90% of the time we agree.