Question for psych nurses! - page 2

by Blue4me2, BSN, MSN, APRN, CNS | 5,098 Views | 20 Comments

Do you think it is safe to be alone with psych patients in an isolated area?... Read More


  1. 0
    are you alone with just one patient, or are there times there's more than one?
  2. 0
    no because you never can predict the outcome.Many times you are alone like giving injections, searching ,or evaluations and you need to be alert to the situation. Doctors set up their offices with escape routes its just a smart move to protect yourself from harm.
  3. 0
    I've been doing psych nursing for 6 years now; and ESPECIALLY in this specialty one should NEVER be alone with a patient. You put your health and your license at risk. Demand to have another staff member with you. Do you belong to a union? If so, the union needs to get involved. Have you brought up this safety issue with your supervisors? If not, do it NOW.
  4. 0
    Never. In our facility we are not allowed to enter a patient's room without another staff member either with us or standing at the door to watch. We also have cameras everywhere. They're not generally monitored except for a couple of areas (like intake), but can be re-played to prove or disprove an incident. Psych patients are incredibly good at lying and manipulation, and some can be very dangerous physically.
  5. 0
    I do not have a union where I work and I am an at will employee. I talked to the nurse manager and she says that she sees nothing wrong with the situation and it will be required that I work there. I'm expecting more of the same if I discuss this with anyone above the nurse manager as well.
  6. 1
    Then, my advice to you, Blue4me2, is to quit. Seriously. Your safety, both legal and physical, could be at stake here.

    I can't say this loudly enough---you are at RISK! So is the patient if something goes wrong!
    Meriwhen likes this.
  7. 2
    As a nurse who has spent the last ten years working in mental health, I have to say I agree with much of what Meriwhen suggests. It really depends. The same question can be generalized to being alone with ANY patient. There is a risk when you are alone with anyone you are treating. Is the incidence of assault higher on a psych unit then that of a general medical unit, yes. Is it higher then the risk on a geriatric unit, no.


    I think your gut has already answered the question though. Don't ever go against your gut, it's talking to you for a reason. Trust this instinct. Even with over a decade in psychiatry, I still wouldn't advocate for any type of mental health setting that has isolated areas where staff are expected to work alone. This is especially important when you are dealing with patients who have yet to be diagnosed or not had at least one risk assessment done. If there is no collateral information, assume there is a risk factor and protect yourself by working along with another staff.

    Good luck. I hope you get to experience some of the wonderful things I have working with this population.
    Topaz7 and Meriwhen like this.
  8. 0
    TOTALLY WRONG!!!! Completely dangerous and no one should be required to do this. Would you put yourself in this same situation with any random person? Nope! You could seek guidance from the board of nursing in your state. Although they can't mandate certain things, they may have documentation on situations like this and injuries to staff as a result etc. that could be used to levy some changes. You might also contact your state labor board and see what they say. These places wonder why they can't retain employees.......
  9. 0
    They are still people. Can they be unpredictable? Yes, certainly they can. I've worked for 2.5 years and thank the good lord never been assaulted or attacked and I always give my Pt's the respect of speaking with them in private. I think people forget that they are human too. Is there precautions you can take to protect yourself just in case? Yes. I always sit between them and the door, however I have closed the door with many patients and it has never been a problem. I guess that is a judgement call, I have always felt comfortable to do that. Other times I will keep the door cracked open. I will even sit facing the Pt, arms length away in a relaxed posture. This has never been an issue, in fact I have never heard of anybody ever being attacked/assaulted at my job while trying to do a 1:1 with a patient. I understand policies are different as I saw on another post not every state implements CPI. My facility does use CPI, and all staff are trained in it, so in the case of a Pt trying to attack us we do have some non-violent tools to utilize that allow us to get out of the situation and get to help hopefully. We also carry buzzers on us so that if a Pt does attack us we push the button and staff hear it and come running. Usually I can tell if a Pt is up for having a 1:1 discussion or whether they are too agitated and perhaps another time might be better. Do what makes you comfortable, I just know they teach us to approach Pt's this way and it has worked very well so far. Remember please, they are people too, they are just sick, they deserve privacy, respect, and the dignity of being treated as a human being who can have a conversation, not as a mass serial killer who you can't be around alone or that they don't have their rights still.
  10. 0
    I agree with you very much!! The risk of assault is not higher than that on a geriatric unit. I worked 8 years in geriatrics you get assaulted frequently with dementia patients, on the locked inpatient psych units I have only been attacked on the Dementia Psych unit, NEVER been attacked on the adult or child/adol units.


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