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Discussion 3

A PMHNP resource hub for ER psychosis assessments, featuring case dialogues, schizophrenia evaluation tools, de‑escalation strategies, involuntary hold protocols, and acute medication management guidance.

Daniel Miller
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Discussion 3.1: Assessing a Person in Psychosis** Margaret has presented to the ER due to fear that she is being poisoned.A full medical work-up has been completed by ER physician and there is noevidence of poisoning. The ER doctor consults me to come and complete apsychiatric assessment as it appears this patient hasa pre-existingdiagnosis of schizophrenia in her chart.ER physician reports that Margaret lives in a supported community withstaff on-site due to her history with noncompliance and difficulty managingher schizophrenia. It is also reported that Margaret stopped taking herantipsychotic medications 2 weeks ago when she initially had concerns ofpoisoning and her paranoia has continued to escalate. She is currently on1:1 supervision in the ER as an elopement risk and a danger to herself andothers.**MEETING WITH MARGARET**Hi Margaret, my name is Ashley. I am a psychiatric mental health nursepractitioner, and I have been asked to come meet with you. Can you tell mewhat is going on and what brings you to the emergency room today?Margaret: I really don't know what is going on, the staff where I stay justdropped me off here and left me.PMHNP: Do you know what would have caused them to feel the need tobring you in?Margaret: I know they are the ones trying to poison me, I am sure this isjust their next step to getting rid of me.
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Psychology

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