Any ACT nurses out there?

Oh.. your ACT team sounds lovely. We have 6 Social workers, .75 Psychiatrists and 1 RN to 75 patients. It is too much!

I'm new to ACT- 3 months so far. I've been a psych RN for a decade, this seems to be a really good fit. We have 80 clients. 1 MD, I am the only nurse, 10 CM's. The psychiatrist and I do not carry a caseload. I have 51 clients on injectables- generally if they are court ordered they are. 2 ppl on clozaril. We do have a few ppl on no meds though. We have a transitional housing unit that is owned by an organization that assists homeless SMI ppl in finding and keeping homes. Some are there for a few weeks, a few have a lease. We also have a number of organizations that help with finding housing for homeless regardless of sobriety.

I go with the MD a lot to give injections or do assessments, and the rest of the time I go with a Case Manager. I haven't been there long enough to do home visits by myself but in a month I'll be able to.

That leads to one of the things I've wondered. Is it the norm for nurses to go on their own. I know the case managers do. I've worked inpatient and correctional and we never are alone with our patients for everyones protection. This is a different type of nursing though. What are the policies of your organization to maintain safety?

We definitely go on home visits ourselves. I started doing that, oh, 3 weeks on the job LOL. We are pretty on top of how our clients are doing though. We have treatment team every morning where we go over how everyone has been doing over the last 24 hours and staff schedules for the day so in theory we all know where the rest of the staff is going to be for the rest of the day. If its clear someone isn't doing well or they are just in an unsafe living arrangement we don't go alone. We also have a safety check in at the end of he day. The only times I have really felt on my guard is visiting clients who live in this sort of flop house hotel downtown. Many of our community agencies have spots there that they put people who would be homeless otherwise in. I have never been worried about any of the clients there, other residents is another story. I WISH we had crisis beds in our county. That would be awesome. The larger agency I work for has residential beds though, which is a different program. We also have supported housing which some of our clients are in. We also have a pretty good relationship with the housing authority here, and they are pretty good at placing our clients with public housing or sec 8. As soon as they are approved for SSI, we are usually quickly able to get them into housing somewhere.

I'm considering working on an ACT team as my first RN position. I would love to hear from people that work on ACT teams, what they like about their jobs, and what they feel makes someone a good fit for an ACT team!