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drpardha

Help Reg Scenario Question

9 posts in this topic

Hi,

This is the situational question for a rotation. Can someone help me with it please?

A seriously disturbed and psychotic patient detained for treatment in hospital is concerned for the welfare of her dog that she has left at home. She asks if it can be brought to the hospital to visit her.

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A seriously disturbed and psychotic patient detained for treatment ....

I would say that some detective work needs to be done concerning the dog. We dont know whether this womans mental state is reliable . If the dog is a reality and if it is in distress , I would reccommend the RSPCA dog fostering scheme .

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If she lives alone, I would ask the patient if there is a friend, relative or neighbour who could look after the dog while she is in hospital. If there isn't, Social Services are obliged to pay for the dog to go into registered kennels while the patient is in hospital.

If there is evidence that the dog has been seriously neglected, then this would be a matter for the Animal Welfare team or the RSPCA.

Providing her psychotic beliefs don't involve her dog, there shouldn't be a problem with it being brought to hospital to visit her. Indeed, pet visits should be encouraged as stroking or playing with a pet has been shown to have calming effects. Pet visits also give patients something to look forward to.

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This happened on a ward I worked on. The patient's mum brought the dog over and the visit was supervised, but only after a lot of thought had been put in to ensure that this can be done safely.Given that for many a dog is as important as any family member the visit actually helped to calm and reassure the patient.

If the risk is too high and there is a relative/close neighbour, they may be able to look after the dog until a safe visit/discharge occurs.

If the risk is too high and no neighbour/relative, involve the RSPCA

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Dear Jimson & Evan,

I guess the shortlisting panel laid two cues which are in block letters below in the question:

A seriously disturbed and psychotic patient detained for treatment in hospital is concerned for the welfare of her dog that she has left at home. She asks if it can be brought to the hospital to visit her.

Does the answer change accordingly?

Thanks a million for helping this novice :)

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I am awfully sorry I forgot to add the question at the end of scenario i.e

What are the issues you need to consider as a junior doctor before you respond?

Thx again to all

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I have looked through my initial response and I quite like it as it is ! I do not propose any additions except to clarify that it's a balance between risk and the positive effect of the patient doing something that may reduce their agitation. It may also be an opportunity to draw a contract (eg 48 hours without incidents equals a visit from your neighbour and dog)

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I thought I just replied this, but now my reply seems to have disappeared...????!!!!!!????

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Oh, I see what's happened, I responded to same posting under Part 2 PMPs :)

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