A psychiatric clinical nurse specialist works with a defendant as a competency evaluator. A staff member asks, "Why are you spending so much time with that defendant? You spend one-to-one time and write volumes
Usually, we give defendants some medication and return them to court." Select the clinical nurse specialist's most appropriate response.
a. "My role is to be an advocate for the defendant, so I have to know him well and build a trusting relationship."
b. "My focus is providing intensive psychotherapy to ensure the defendant becomes competent before returning to court."
c. "The specialized assessments I make on behalf of the court require very lengthy and detailed interviews, so it takes a lot of time."
d. "I spend the time observing, assessing, and documenting competency, writing a report, and preparing expert testimony for the court."
ANS: D
The competency evaluator has to determine the patient's current competence to act on his own behalf during his trial; without competency, the inmate cannot stand trial. Determining competency goes well beyond the mental status, functional, and risk assessments most psychiatric nurses are accustomed to and are very complex and time-consuming. A complete formal report is prepared for the court and all pertinent details addressed in anticipation of questioning by officers of the court. The evaluator represents the court, not the patient. Interviews of the inmate are only a portion of the evaluator's work. Evaluators help the court determine competency but do not intervene to increase the patient's competency.
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