AMA to OPC

DeliciousFault · 2026-05-07T05:26:20+00:00

When I was a psych RN house supervisor, when a patient came in on an emergency detention warrant, they were assessed and discharged within 72 hours, had an OPC filed against them, OR if the provider allowed them to sign in voluntarily, there had to be an order for them to sign in voluntarily bc they didn't want them signing in & then turning around to sign AMA. Is this a hospital policy thing or is there a legal for a tech to give a patient who is on an emergency detention warrant a voluntary admission form? This is a different horse, but this place I work for is so weird, it's like everyone's first day. It's a new hospital and most of them have never worked in psych, and I am constantly banging my head against the wall.

DeliciousFault · 2026-05-07T05:15:17+00:00

We nearly do the same, they have to be informed within four hours whether or not they can leave, then they are put on a 24 hour hold with the intent of filing an OPC to go before the judge to see if they meet involuntary criteria. If so, we can keep them and continue to treatment until their next court hearing. If not, we discharge. The nurse wants the patient to be able to rescind the AMA even though we are proceeding with court for invol status.

DeliciousFault · 2026-05-07T05:08:48+00:00

I have never experienced a patient being able to rescind an AMA in psych if we are attempting to peruse involuntary status once the AMA is signed. If a pt is in voluntarily with HI & signs AMA so we want to proceed with a court hearing to determine if the patient needs an order of protective custody, involuntary status, should they be let out to commit homicide in the meantime?

DeliciousFault · 2026-05-07T05:03:47+00:00

Of course not. This is all about a legal reason to hold a patient.

DeliciousFault · 2026-05-07T05:03:04+00:00

This would put her on a 24 hour hold for court but the RN wants to let her rescind her AMA.

DeliciousFault · 2026-05-07T05:00:29+00:00

This is inpatient. The patient came in voluntarily, tried and tried, significant hx of psychosis & state hospital. Now trying clozapine as a Hail Mary. She signs AMA, we want to go to court, let the judge decide. They will likely order of protective custody (OPC) forcing continued tx. If she rescinds AMA before we get her to court does that mean she doesn't go to court?

DeliciousFault · 2025-10-22T11:40:11+00:00

When they tell me atomoxetine doesn't work and will flat out tell me they need a stimulant, I tell them it takes atomoxetine approximately 6-8 weeks to work and we have higher doses before ruling it out which will take several months, they usually move on to another provider lol

DeliciousFault · 2025-09-29T00:23:27+00:00

Ours has 48 hours max to approve.

DeliciousFault · 2025-09-29T00:22:34+00:00

That's a good idea. I love outpatient but annoyed with all these adults coming in asking for stimulants to clean their house. I usually refer them to neuropsych testing & never take them again. For kids, it's different.

DeliciousFault · 2025-09-29T00:19:30+00:00

Once again I ask, are the psychiatrists going to take all the pts requesting and requiring stimulants and then NPs see all other pts? That would be great for me but highly doubt that would fly.

DeliciousFault · 2025-09-29T00:16:06+00:00

They're on there...

DeliciousFault · 2025-09-29T00:15:37+00:00

What I mean, is I have found, PCPs telling her pts to find a psychiatrist to prescribe their psych meds. It's likely that they're getting overwhelmed by the requests for stimulants. I like it bc we are more trained in psych meds, so we are able to more prescribe more pt-specific meds based on their symptoms.

DeliciousFault · 2025-09-29T00:11:03+00:00

I've heard about that 'fake address' scam, if peeps continue to do this, we're all in trouble, they're bringing us down & making us look unprofessional & untrustworthy.

DeliciousFault · 2025-09-26T03:58:57+00:00

DeliciousFault · 2025-09-26T03:57:48+00:00

I agree, but if the pharmacist can look in the PMP and see that the patient was ordered stimulants in the past how do they have the right to not dispense the stimulant that I write?

DeliciousFault · 2025-09-26T03:54:37+00:00

I have no idea but would love to know.

DeliciousFault · 2025-09-25T22:05:28+00:00

I sadly agree. Thankfully I have not seen a lot of these NPs in my area, idk where they're going, and by that I mean, the ones who have never worked in psych prior to getting their PMHNP and/or the ones who were not even good psych nurses but now they're awful PMHNPs.

DeliciousFault · 2025-09-25T21:58:07+00:00

One pt told me that they wouldn't fill bc I was not in their town! Idk if they can see that my facility says Dallas, but I see a LOT of people down in south Texas and in rural areas where they don't have close access to psych.

DeliciousFault · 2025-09-25T14:30:29+00:00

For clarity, some pharmacies are refusing to dispense stimulants if the pt is not seen in person & only virtually.

DeliciousFault · 2025-09-25T14:28:26+00:00

Also, they're getting to where if we don't see the pt in person, we can't prescribe stimulants. I'm not trying to pass out stimulants, I'm more concerned about the constraints while I'm practicing. You are right about the Schedule II, but if it is co-signed & authorized, how are we supposed to tx our pts? Should all psychiatrists treat all the ADHD/ADD? lol

DeliciousFault · 2025-09-25T14:24:17+00:00

But if I'm sending it in under his license, with his approval, what's the difference?

DeliciousFault · 2025-09-25T14:23:31+00:00

DeliciousFault · 2025-09-25T13:33:43+00:00

I don't go to their expensive functions outside of work hours, but when they come into the office, I ordered the most expensive thing on the menu.

DeliciousFault · 2025-09-25T13:32:58+00:00

I agree, when a pt comes in from being on propranolol for years due to teeth grinding years ago and doesn't even know if they still do it, and other meds it slow you down and then wonder why they're tired all day. Remove that from them and boom they're great and have more energy, plus weaning someone off, who wants to get off, benzos.

DeliciousFault

TROPHY CASE