My first encounter with her was over the phone. The patient was depressed, crying, but did not want to come to the ER for treatment. I talked with her for about 15 minutes that day. I promised I would call her again in the morning.
The next morning I called her. She was glad to hear from me. I could hear in her voice the sadness, fear, tearfulness and anxiety. She knew to come to the emergency room for evaluation before being admitted into the psychiatric ward. This was necessary because she had significant co-morbidities, diabetes in particular, that required medical clearance before going to psych. We talked about what to expect going through the ER, and she agreed to go.
About three hours later, I got a call from her. She had been in the ER for two hours, couldn’t handle the wait, crying. I agreed to meet her in the hospital where she was. After talking with her for a while, she agreed to go back to the ER, and I escorted her there. I noticed she was displaying unstable emotions, from depression with suicidal thoughts to being aggressive with anyone around her for even the slightest thing.
I stayed with her in the ER. She was reluctant to get labs and urinalysis done. She said she didn’t like the nurse. I talked with the manager of the ER, who agreed to have another nurse draw the labs. After the labs were drawn, she was asked to give UA. She asked me that if she told me something would I tell anyone. I told her if what she told me was harmful to her or to others I would have to tell the doctor in ER or the mental health provider that would be seeing her. She began to tell me what had happened the night before. States she tried to commit suicide last night. States she had tried to overdose on street drugs the night before and had torn up one room in her home. States if they do a urine drug screen, they will see the street drugs she did.
Informed patient that attempting to commit suicide with street drugs is different than using drugs in an addiction, as she had in the past. Instructed to inform the mental health provider what she had told me, or I would have to tell them. I stayed with her until the mental health provider came. I told patient that I would check on her tomorrow. I read that she was admitted that night to an inpatient psychiatric ward. By 10 p.m. that night she was in four-point restraints and out of control. I knew the hour with her in emergency room was critical in keeping her from leaving the hospital and going home and doing something to herself or someone else. She states this is the first time in a long time that she felt like someone cared if she lived or died. She thanked me for looking at her as a person, not a drug addict.
