Re: ER being taken over by behavioral health patients Originally Posted by Whispera 
I hope the OP isn't saying psych patients should stay out of your ER or that they don't need to be watched. I hope the OP is saying the system just needs an overhaul. I'm not fond of the patients looking for "three hots and a cot" but that in itself is a tremendous problem...imagine being willing to be in the hospital in order to get a meal and shelter?
That being said, if your emergency department requires 1:1 for suicidal patients (and it should--imagine what might happen if someone succeeded in suicide while there--it DOES happen!), it seems the management needs to develop a new plan so everyone can get the care that's needed. How about psych nurses or social workers evaluating patients, calling the psychiatrist or talking to the ER doctor, and getting the psych patients admitted more quickly? I did that job in an ER for a long time. Lots of places have such a nurse. It keeps the psychiatrist from having to come inand seems to be very helpful.
I absolutely want to help the patient's who truly need help if they are considering suicide. I don't want to help the same john/jane does who are at the ER 2 or 3 times a week who act like they are reading from a script and already have their bags packed because they want to stay like it's a hotel. And when they don't get what they want they simply lash out and go on rampages creating a unsafe environment for me. That's my frustration, but thatnks for your thoughts and ideas.
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