Duty of care in the emergency department

Abstract

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.

Examining Mental Health Act usage in an urban emergency department

“…It has been argued that MHA certification is often used with the belief that it provides some form of added medico-legal protection. 6 However, duty of care (or rather a breach of duty of care) is always the focus for any claims of negligence, not whether or not the MHA was used. 6 Providing training on de-escalation strategies and information on duty of care provisions could result in less stigmatising alternatives to MHA certification being used.…”

“…6 However, duty of care (or rather a breach of duty of care) is always the focus for any claims of negligence, not whether or not the MHA was used. 6 Providing training on de-escalation strategies and information on duty of care provisions could result in less stigmatising alternatives to MHA certification being used. After all, the decision to invoke the MHA is a serious measure, and a MHA certificate remains in a person’s medical record for life.…”

Duty in a Time of Disaster: A Concept Analysis

“…Duty is not only a social contract to care for patients, but also a responsibility to coworkers and to the profession (Wand, 2004; Wright, 2005). A common theme that emerges is the link between morality and one's sense of duty to others.…”

A conversation: Challenging the relevance and wisdom of separate mental health legislation

“…Mental health legislation in Australia varies in each state and territory. However, the framework and sentiment of each Act is fundamentally the same in relation to the ‘care, treatment and control’ of people with mental illness (Wand 2004). Broadly speaking, mental health legislation in most countries is based on similar principles as all governments are bound to international human rights law, and this includes the protection of persons with mental disorders (WHO 2005).…”