Life threatening situation? Always call 112

Case studies POH-GGZ Emergency

by Inge Kramer – Inpractica and Corline de Groot – board secretary         

The POH-GGZ Emergency is available to HP De LIMES to provide support for mental health care requests that are not acute, but urgent. The POH-GGZ Emergency is used by the triage nurse, after consultation with the directing physician. The service is from 10:00 a.m. to 8:00 p.m. on Saturdays, Sundays and all holidays. The POH-GGZ Spoed works from home and reports in Topicus at a furnished home office. To give a look behind the scenes, examples of two cases that have been handled by the POH-GGZ Spoed.

The team
The Inpractica team consists of seven experienced SPV employees and also work within mental health care or at BuurtzorgT. As a result, there is a lot of knowledge of the social map. Before the start of a shift, the POH-GGZ Emergency calls in at both the Voorhout location and the Leiderdorp location, so that everyone knows who is on duty. Paula Bakker, Wilfred Bakker, Martijn van der End, Mariëtte Keizer, Sabine van Opstal, Tim Troost and Paul Zwetsloot are the POH-GGZ Emergency within the current team.

Case 1: 83-year-old man with suicidal thoughts (U2)
Telephone conversation with son. Patient has been in bed for three days, doesn’t want to live anymore, doesn’t see any prospects. Says he’s lost, he’s “sick in the head.” Son has been “talking him out of bed” for the past few days, but that doesn’t work today. Has no plans for suicide when asked.

83-year-old widower who, after the death of his wife two years ago, has gradually become gloomy and has been having increasingly suicidal thoughts for several days. Eats and drinks poorly, prefers to lie in bed, sleeps badly, feels tense and sees no perspective. Receives support from a son and some close family members who, however, have limited help to offer.

Action POH-GGZ Emergency:
-In the conversation with son and patient, it emerged that mourning and grief are the main reasons for what is going on now.
-Provided supportive contact, (to both father and son) psycho-education about grief.
-Make a plan for the day and go outside for a walk.
-Can make arrangements about waiting for an appointment with your own GP (appointment at POH-GGZ was already arranged).
-In collaboration with the directing physician, if necessary oxazepam for a few days in the hope of being a bit calmer.
-When calling back, son indicates that the patient has now gone outside with his brother to do some shopping. For today and tomorrow they will try to continue to offer contact with the patient. An appointment with a WMO consultant is also scheduled for Monday, sister-in-law joins in.
-If necessary, they will contact the out-of-hours GP service again.

Case 2: 53-year-old man with anxiety and panic attacks (U3)
This afternoon, the patient suffers from “attacks” accompanied by a burning sensation in the body, tingling, restlessness, anxiety and dizziness about every half hour. They will go away on their own. Somatics excluded by triage nurse in collaboration with directing doctor. No substance use. Indicates possible underlying unconscious tensions from a broken relationship two months ago, and stress as a bus driver where “sometimes something happens”. Not previously familiar with these complaints.

Action POH-GGZ Emergency:
In the conversation I offered a listening ear and a lot of explanation about the functioning of the body, especially in case of restlessness and fear.
-Explained panic attacks and “fear of the fear”. Patient recognized a lot in this.
-Reassured, supportive contact provided.
-Advice to seek distraction and relaxation. Connect with a friend.
-If the symptoms persist, will call again and contact your own GP for further care, possibly follow-up at the POH-GGZ in the day practice.

Both cases generally cost the GP surgeries time. By providing explanations and support by the POH-GGZ Emergency, a good quality of care has been created for this patient group.

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