A patient is being transported to the local emergency department (ED) by the police. The nurse receives in
report that the man’s neighbors reported he was standing in the middle of the street, yelling out, waving
his hands, and acting “crazy”. When the police arrived, he would not speak to them and attempted to hit
them with a baseball bat. He was yelling, “Where is Jesus? I need to see Jesus!! All of you devil
worshippers need to leave me alone!!”
The police handcuffed the patient and transported him to your local ED. What law allows the police to
transport the patient to the hospital against his will?
What is the patient possibly experiencing right now? Reflect on how this patient possibly feels at this time.
The patient arrives at the ED at 1pm where you are working as an RN. The police bring the patient in and
assist him to a stretcher. What are the nurse’s next actions involving the police?
What are the nurse’s next actions involving the patient?
The police tell the nurse they suspect the man has been drinking or possibly “high on something”. They tell
the nurse the patient lives with his elderly parents. His parents reported they are scared of him and don’t
want him to return to their house. He is indigent and they can’t afford to support him anymore.
Based on the police’s input, what additional information does the nurse need?
Labs ordered include: CBC, CMP, U/A, EKG, RPR, HIV, Toxicity screen, and Chest x-ray. Physician also
orders: one on one observation. Vital signs: 128/86, P94, R24, T99.0
Patient continues with religious comments, disoriented, paranoid, isolative, appears to be talking to the
wall, grabs out as if petting an animal. His appearance is disheveled, apparent body odor noted, soiled
clothing, wearing multiple shirts and large coat despite it being 98 degrees outside. He is unable to tell the
nurse when he last bathed, doesn’t know his address, or medical history. He only knows his name. States
he is a messenger from God sent to rid the world of evil people with his magic baseball bat.
What is the probable DSM V diagnosis for this patient based on information presented thus far?
The patient’s parents return the nurse’s phone call and the nurse is eager to gather additional
information. What are the nurse’s most pertinent questions for the patient’s parents?