How to undertake a suicide risk assessment in an inpatient setting

Summary

In the script, a patient named William expresses his desire to leave the hospital to retrieve personal items from home despite being under a care plan that restricts him from doing so. He insists he has improved and is no longer suicidal, but the staff, including a nurse and a doctor, are concerned for his well-being. They discuss his recent suicide attempt and his current mental state, which includes sleep disturbances, lack of appetite, and feelings of hopelessness. The conversation delves into his emotional turmoil and the staff's efforts to ensure his safety while respecting his autonomy.

Takeaways

• 🏥 The patient, William, is in a care facility and expresses a strong desire to leave, indicating he feels like his old self and needs to get some personal items from home.
• 👩‍⚕️ The nurse is initially hesitant to let William leave due to his recent suicide attempt and the care plan that states he should not leave until his next review.
• 🗓️ William insists on leaving for an hour to get supplements, clothes, and bathroom items, promising to return by lunchtime, but the nurse checks his care plan and reminds him of the restrictions.
• 👨‍⚕️ The doctor is involved in the decision-making process, concerned about William's welfare and the potential risk if he leaves unsupervised.
• 🧘 The patient mentions that practicing yoga and talking to someone named Kelly used to help him, but those options are no longer available.
• 🤔 William struggles with sleep, appetite, and concentration, indicating ongoing mental health challenges.
• 😔 The dialogue reveals that William still experiences suicidal thoughts and feelings of hopelessness, despite claiming to be over his previous suicide attempt.
• 👂 The doctor and nurse discuss William's progress and consider whether he is stable enough to leave the facility temporarily, showing a collaborative approach to his care.
• 🏠 There is a debate about whether William's request to go home is a genuine need for personal items or a sign of his mental state deteriorating.
• 💊 The script highlights the importance of medication and its timing in relation to William's mental state, as he has been on Sertraline for only three days.
• 🔄 The conversation circles back to William's mental state, with the doctor probing for clarity on whether he is still contemplating suicide, underlining the complexity of his situation.

Q & A

Why does William want to leave the facility?

William wants to leave the facility to get some personal items from home, including supplements, different clothes, and bathroom items, which he believes will help him feel better.

What is the nurse's initial response to William's request to leave?

The nurse initially refers to William's care plan, which states that he should not leave until his next review, and expresses concern for his well-being, suggesting that he cannot leave without the doctor's approval.

What does William mean when he says he needs to 'clear his head'?

When William says he needs to 'clear his head,' he implies that he wants to get away from the facility's environment, which he finds restrictive and reminiscent of his previous mental state.

Why does the doctor express concern about William's request to go home?

The doctor is concerned because William had recently attempted suicide, and the doctor needs to ensure that he is not going to engage in any risky behavior outside the facility.

What medication is William currently taking?

William is taking Sertraline 100 milligrams daily, which is an antidepressant medication.

How long has William been on the medication?

William has been on Sertraline for three days at the time of the conversation.

What is the doctor's final decision regarding William's request to leave?

After discussing with the nurse and considering William's current state, the doctor decides that it is safe for William to leave temporarily to get his personal items.

What is the nurse's role in William's care plan?

The nurse is responsible for monitoring William's condition, administering his medication, and ensuring that he follows the care plan, which includes not leaving the facility without proper review.

Why does William feel agitated about the care plan?

William feels agitated because he perceives the care plan as restrictive, and he believes that going home to get his personal items will help improve his mental state.

What is the significance of Kelly in William's life?

Kelly seems to be a significant person in William's life, and the mention of Kelly triggers emotional distress for William, indicating a possible relationship or past event that is affecting his current mental state.