Addressing Safety Issues

[Davey Do]

I came into work the geriatric psych unit Friday night and my work wife Eleanor asked me if our supervisor, RoofElmo had telephoned me during the week. "No", I told her, "I only get calls from telemarketers, so I turn my phone off when Belinda and I are at home". "Well", Eleanor replied, "RoofElmo got ahold of me and told me not to leave the NS door propped open. It seems that Risk Management was reviewing monitor videos and saw that we had the NS door propped open with a waste can. So, don't prop the door open!"

Last week I told a story in a thread about Bob, a psychotic schizophrenic who was on 1:1 for behaviors. Basically, last Friday, I relieved the tech watching Bob, while he was in the quiet room which is right next to the NS, for a few minutes while I attempted to administer him his meds. Bob spit his meds out and spilled water on the floor. I went to clean up the spill, Bob grabbed me and we both went down on a mat. Bob sang, "I've got the world in my hands!" while I called out for assistance.

The event looked something like this:

I was able to get Bob to let go of me and go to the door of the quiet room to find none in the hall. The doors to both the NS and the community room were closed and locked, so no one could hear my cries for help, even though there were two staff members in the NS!

So I propped open the NS while I was in there so as to not have the situation repeated. If I'm in the NS, I want to be able to hear what's going on out in the hall!

I relayed the situation and my actions to Eleanor. As always, she gave me great deference and said, "I don't care! We are going to leave the door closed because they're watching us on the video monitors and addressing safety issues!"

"Oh oh oh oh", I retorted, " I'm sure Risk Management also saw me on the video monitor tapes being attacked by a patient and are addressing that safety issue!"

[GrumpyRN, NP]

Yeah, that sounds about right. Got to tick those boxes.

Anyway, you being attacked by a patient is outwith risk managements scope of practice. As long as doors are not wedged open

Love the drawings Davey.

[beekee]

Eh, they probably only have cameras on that door. They know where the REAL safety issues are!

[LibraSunCNM, BSN, MSN, CNM]

Good grief! The rules at your facility are setting every employee up for seriously dangerous situations. Between this and having to act as the door or whatever, I don't know how you do it!

[Davey Do]

14 hours ago, beekee said:

Eh, they probably only have cameras on that door.

Oh no beekee- there are camera monitors everywhere, except of course, places like the patient rooms, showers, etc.

I am well aware where each camera is located and will sometimes use them to my advantage when dealing with an agitated or aggressive patient.

There is also a big screen monitor in the NS that will show each area monitored by camera. Back in '03, when I first started at WRMC, there was only one camera on the whole unit that monitored the area outside the entrance doors. A little monitor, smaller than a bread box, sat in a corner of a counter in the NS.

Here's a sketch of the monitor screen and the area monitored from one of my journals of the time:

Big Brother has always been watching, his view has expanded, but he sees only what he wants to see.

[Davey Do]

13 hours ago, LibraSunCNM said:

Good grief! The rules at your facility are setting every employee up for seriously dangerous situations. Between this and having to act as the door or whatever, I don't know how you do it!

Thanks for the empathy, LibraSun.

In an attempt not to sound too big headed, I think I "do it" by prioritizing and focusing on what's important. Patient care and subsequent documentation are at the top of the list, along with the safety of both patients and staff. Noting and carrying out doctors' orders is important. Everything else is merely accoutrement.

One of the reasons why staff regularly run around like the proverbial chickens is because they allow administration to dictate what's important. From my perspective, administration is made up of a bunch of kids running around putting out fires.

I could go on and on, but then I'd be like the old man in this comic: