Veterans Affairs Psychiatry Service
Telephone Numbers:
Official Pager: 440-562-0461
Nurse 1) 440-562-0137
Nurse 2) 440-562-0457
Weekends/Holiday: 440-562-2194
Psych ER: Extension 6042


Handles Psych Related emergencies off hours or if you cannot reach the consult team.
Psych Consult calls from the UCC should be directed to Psyche ER.
Suicide Precaution Orders:
1) Please refer to the handout under suicide order set.
2) 1:1 observation does not mean “sitter.”
3) When prompted, make sure to order a Consultation for Inpatient Psychiatry Evaluation
a. Enter the team pager
b. Make sure include the reason
Every day 1:1 assignments are reviewed by the psychiatry consult team.
1) Patients should be seen once a day.
2) No reassessment is necessary if <12 hours from last.
SUICIDAL/HOSTILE BEHAVIOR PRECAUTIONS ORDER SET
If a non-psych ward inpatient has SI/HI, please use this order set to ensure that proper suicide/hostile
precautions are set:
1) Go to orders tab. Click “Add New Orders” on L-side menu. New window pops up. Select “Order
sets.”
2) New window pops up. Scroll down until you see “Suicide/Hostile Behavior precautions.” Click.
3. Three-step order set will appear:
a) First, choose Hostile or Suicide Precautions.
b) then choose “safety tray” for precautions.
c) Last, an option to place a Psychiatry consultation-liaison consult will appear.
Pink Slip:
1) Pinks slips can be completed by any licensed physician or psychologist. Not by social workers or
case managers. Police can usually fill one out, but they do NOT fill them out at the VA.
2) Also ensure that patients need to be assessed by psychiatry
3) Involuntary holds patient for 72 hours; Any longer requires a Probate (court order).
4) Also serves as an admission to inpatient psychiatry
 Psych ER has pink paper otherwise the ward should provide slips.
 Attachment included with pink slip form
Indication for Pink Slip:





Permits withholding patients for psychiatric reasons not medical.
Allows for further assessment of the patient’s safety.
o When acutely suicidal
o Or has a known history of psychiatric illness requiring inpatient treatment and
evaluation.
Example of Pink Slip recommendation includes:
o Patient is acutely suicidal and requires further assessment for safety.
o Make sure to include any significant psychiatric history.
Those that are acutely agitated and threat to staff and themselves
o Allows police to Detain the patient
When documenting the implementation of pink slips, do not use the term “the patient
pink slipped”, rather state that the patient lacks capacity and cannot leave the hospital.
Capacity Evaluation:
Those that lack capacity cannot leave the hospital such as those delirious/demented



Scenario that often occurs that prompts capacity evaluation from psychiatry such as the “patient
wants to leave AMA”
You as the medical provider can determine capacity. Four elements must be present
1. The patient should understand their condition and treatment
2. Have an Appreciation of Risks and Benefits
3. Rationally Manipulate the information
4. Express Choice and be consistent.
Full capacity evaluations for guardianship are to be requested by Clinical Psychology.