Wand Timothy
Royal Prince Alfred Hospital, Missenden Road, Camperdown, NSW 2050, Australia.
Int J Ment Health Nurs. 2004 Jun;13(2):135-9. doi: 10.1111/j.1440-0979.2004.00315.x.
This paper explores issues that relate to the management of deliberate self-harm in the emergency department (ED) from a New South Wales perspective. A scenario that is typical to the ED is presented to illustrate the dilemma that nurses face and the implications for clinical practice. Confusion and concern regarding the treatment and detention of this type of patient in the ED can often result in the inappropriate use of the Mental Health Act. It is preferable for clinicians to be aware of the treatment options they have under duty of care rather than relying on the unfounded reassurance provided by scheduling a patient under the Mental Health Act. Communication and negotiation skills are highlighted as attributes that clinicians must develop and enhance to effectively manage difficult presentations to the ED.
本文从新南威尔士州的角度探讨了与急诊科蓄意自伤管理相关的问题。文中呈现了一个急诊科常见的场景，以说明护士所面临的困境以及对临床实践的影响。急诊科对这类患者的治疗和拘留方面的困惑与担忧，常常会导致《精神健康法》的不当使用。临床医生最好了解他们在照护职责下所拥有的治疗选择，而不是依赖依据不足的保证，比如将患者按照《精神健康法》进行安排。沟通和谈判技巧被强调为临床医生必须培养和提升的特质，以便有效地处理急诊科的棘手情况。
