The Cat Came Back

The patient arrived from a rural St Elsewhere to see our social worker. He had disclosed to his friends during their weekend getaway that he had been having some vague thoughts of suicide. Thus his friends brought him to the local Emergency Department, and they had in turn referred to his home hospital in the city for a full assessment.

The social worker arrived, did his assessment, arranged for out-patient follow-up, and sent the man on his way. All very routine.

The ward assistant took the chart after discharge and began filing it away. "Umm - does this paper mean anything?" she asked the charge nurse, and presented her with a form from the original hospital indicating that the patient was required to have a psychiatric assessment prior to discharge.

Whoops.

The patient whose suicidal plan was to jump from a moving vehicle had just been sent home by taxi, and without pschiatric clearance!

The taxi company was phoned, the taxi turned around, and the now very annoyed patient was returned to the hospital for a complete exam.

An hour later the patient was cleared by pschiatry to follow the original plan set up by the social worker and was again sent on his way.

This time he made it all the way home.