Cert Hearings: “And Then the Demons and Robots Came In.”

“Scott…Registered Nurse,” introducing myself into the tape recorder. I couldn’t help but remember my first unsupervised certification hearing. The hardest part was keeping my composure. Let me paint the picture first. Stick with me.

If you didn’t know already, in psych, there are things called a 5150, 5250, etc. I won’t go into too much detail about them. But, these are essentially “involuntary holds,” people can be placed on based off of 3 criteria: (1) Danger to others, (2) Danger to self, and (3) Gravely disabled. Feel free to Google celebrities who have been placed on such holds. I’m sure you’d find it entertaining.

Certification hearings come into play, basically when a doctor feels the need to hold a patient for a longer period of time. It’s pretty straight forward; a judge/legal officer would come in and decide the fate of the patient.

My first unsupervised certification hearing started at 1000, sharp. Before I walked into the room and sat down, I told my lead mental health worker to watch the unit; make sure nothing went down, while I was away. You can never be too careful, I suppose. The legal officer then took out his tape recorder, pressed record and it began…”This is the hearing for blah blah blah…based on criteria blah blah blah…would all members in the room please state your name and relationship to the patient…starting to my right..”

“Blah blah…MSW (social worker),” “Scott…Registered Nurse,” “Blah blah…patient,” and “Blah blah…Patient Advocate.” The judge would then allow the facility (the social worker and myself) to present the case, followed by the patient offering a rebuttal. Again, it was pretty straight forward. I was representing the doctor and answered all medically related inquiries. So essentially, I just sat there and talked about the medications the patient was on. With that said, the social worker did most of the talking.

Throughout our time presenting the case, the patient kept calm and cooperative, waiting for his chance to speak. A huge factor, when presenting in front of the judge. It’s like going into a job interview. If this patient started acting a fool, we’d have the case in the bag.

I was amazed by how well the patient kept. I was sure he was going to win. He kept his composure and answered all immediate questions appropriately, when prompted by the judge. Our criteria for holding the patient was slowly deteriorating.

Judge: “Now, would blah blah blah (the patient) like to add or say a few words?” This was it. His moment to shine. The patient expressed his rebuttal for ways to take care of himself…how he was going to get food and shelter, etc. I looked over to the social worker and raised my eyebrows. I knew she was thinking the same thing…”we lost.”

The patient elaborated even further and expressed no intentions to harm others, etc. Again, his composure throughout the hearing was a huge deciding factor. The patient continued to explain how he was wrongfully placed on a hold and how our stories about his behavior were completely wrong and misunderstood. The patient was nearly there to victory.

And then he said, “It was the demons and robots who came in me! They told me to do these things. They came out of the tree and went inside of me.” #Crash #Burn.

At that very moment, it was me who was struggling to keep their composure. I stared at the patient in the eyes and nodded to all his comments. The patient went on to talk about how the robot and demon appeared in his home to tell him that he had to pick up a parcel from the store and then light the fire. I glanced at the judge and saw that his face was getting red. Hell, I felt my face getting red too. And if there was one thing my supervisor taught me to do, during the hearing, it’s not to laugh. I had to start looking at the damn ground and twiddling with my thumbs.

The patient lost the hearing on the account of “danger to self.”

I realize that I’m a little immature and really shouldn’t find these things hilarious. It’s actually really sad that these patients really don’t have any control of their own minds. But, I thought it was hilarious. Lol. Most of the time, you wouldn’t have to worrying about losing a case. The patients would normally shoot themselves in the foot anyway, when they start talking.

Later on that day, the doc who was on the case came in to discuss the hearing with me. I shared the story and he had his laugh too, sharing a few about some of the hearings he had to attend. He ended our discussion by asking me…”What do you think reality is?” I paused for a second and looked around the room for the answer…

“I suppose it’s whatever the person believes it to be,” I replied. “Exactly,” he said. “But, who is to say which reality is right or wrong? We’re all players in the game called life, until our mind is no longer our own. An altered state of reality is inevitable for everyone. We should be thankful that the majority of people believe and think the way we do.”




Author: nursesarereal

My nursing professor once said that keeping a journal, over time, will allow me to see growth. In myself? I’m not sure yet. I’m hoping. I like to believe that nursing school saved my life. Maybe I’ll have some fun doing this. Cheers.

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