BERT Activation & Responses
Describe when & how a BERT should be activated.
When a patient is irrational, yelling, unable to re-direct, hallucinations, elopement, or staff concerns. Call 1-1111.
First stage of behavioral escalation.
Anxiety
What level of defensive behavior is, "Do you even know when the doctor will be here today?"
What is information-seeking question?
A court order that means the patient has to be evaluated by a psychiatrist.
96-Hour Hold
You start feel nervous and your heart rate increasing.
Take a slow deep breath
Name all job roles that are BERT Responders.
House Manager, Stat RN, SLS/SLCS, Charge RN, Primary RN, & Security
The patient throws an IV pump at you.
Risk Behavior
"Are you even old enough to be a nurse?" is an example of?
What is a challenging question?
BONUS: how do you respond?
A court appointed individual that makes decisions for you.
Guardian
Intervention used when you feel yourself getting angry with the patient.
TAP YOURSELF OUT! Enlist the help of your teammates, do not say something that you do not mean.
The BERT call results in behavioral restraints. To locate the restraints, where would you go?
Linen cart
Tension reduction looks like the following.
Crying, Apologizing, Ashamed, Embarrassed
A patient curses at you "You can't #$%King make me ______."
What is Refusal
A patient is suicidal with a plan to jump into traffic and is attempting to elope.
prevent them from leaving, call a BERT
The meeting after the BERT intervention is complete.
Debrief
Security arrives to the unit after a BERT activation, what should the nurse do?
Remain engaged with the interaction
A patient is shouting, "You cannot make me do this, Do you even know what you are doing?"
Defensive
"THIS IS TOTAL BS!!! I DEMAND TO SPEAK TO A SUPERVISOR RIGHT NOW!!" is an example of what type of defensive behavior
What is release?
When you are concerned for the safety of an individual but they are not yet on a 96 hour hold?
page psychiatry, in the meantime implement "Incapacity Precautions"- used to be Medical Hold
When you see your BERT teammate struggling with the patient interactions.
TAP THEM OUT. "You have an urgent call on line 9" Friends don't let friends say things they don't mean!
What are the medications for an override for a BERT activation?
Haldol and/or Ativan
What concept can appear in Defensive Behaviors and is the last level of crisis development?
What is Tension Reduction?
Floyd threatens to kill your kitten if you do not take him out of restraints and bring him some oxycodone immediately.
What is intimidation?
A patient wishes to leave. They are not taking their blood pressure medications properly and you are concerned they will die when they get home, but they are understanding of the risks.
AMA
Communicate respect, appears non-threatening and maximizes safety.
Supportive Stance