As a nurse who's recently gone back to psych (my true love), I was totally taken aback by the type of training my state psych facility provides.
I'm a patient-first advocate, and always concerned for what's right for patients. Patient's should never receive any form of abuse. However, I feel there's a balance between patient's rights and the rights of the staff to be safe and free from abuse. At my facility (which is a state-run facility) I feel as though they've completely sacrificed the rights of the nurse and techs in favor of the rights of the patient.
I want to preface this with the understanding that we are assuming all verbal therapeutic communication, and early interventions are exhausted prior to crisis events.
Case in point:
Blocking a punch in any way if it's directed outward from the body (as happens in any karate tournament, 99% of the time without injury) is considered abuse as it MAY injure the patient's striking arm. There is a difference between assaulting a patient with a punch and a block, however the state does not recognize this difference. To me, this is extreme.
2nd issue:
Our state does not provide security personell for interventions. In Colorado, we had a designated security team trained in detaining, restraining, physical and mechanical restraints. BOTH staff and security would intervene and answer distress signals. (Mech restraints were the responsibility of the nurse ONLY, but they were still trained in application) This was back in 2005.
In my current state, there is no provision for security, and the staff is to intervene in any and all crisis situations. My unit is VERY acute, and we have physical altercations often.
Again, I'm all for "balance". I understand that we are not the patient, and are not psychotic, however I disagree with the idea that the training they provide (which is 2, 6-hour sessions) is enough to be proficient. And even if it WAS enough training, my opinion is that it wouldn't be effective even if one WAS an expert with years of experience in many crisis situations. (qualifier: I'm a black-belt level Jiu Jitsu, Mixed Martial Artist with years of self-defense training) Essentially, I feel as though it guarantees the staff member an injury...eventually.
Situation that makes me post this:
We had a tech fired for blocking a patient's arm using an open hand out-ward block. We all saw it, we all described it accurately to the investigative team. The patient bloodied the nose of the tech, and the tech NEVER used an offensive-based maneuver, just the block.
QUESTION for you all:
Is this the way it is at your facility? Are you state-run or private? Is this overly-progressive in your opinion? Please share you thoughts and experiences!
