enclosed nurse's station

[margo123]

I work on a 13 bed acute care psychiatric unit. Our hospital seems to put the needs of the psych unit "last in line". We have a broad range of patients with diverse diagnoses. Lately, we've been admitting patients who have a history of violence and are acutely psychotic. None of our rooms have video monitoring and our nurse's station is wide open. We've had angry psychotic patients come in and throw our computers at us, march into the med room and demand medication, one of our physicians was knocked down, two nurses have been assaulted, etc. Our director says JCAHO standards do not allow for enclosed nurse's stations as it separates us from our patients too much. Have any of you ever heard this? I've caught my boss "glossing over the truth" before and wonder if this truly is a JCAHO standard. How are the units set up where you work?

[marylyn_91604]

Were you hit before, Titianaside?Is that why you posted the graphic question??

I still think it has more to do w number of staff,skill of staff and a person"s approach that relates to their getting hit.The nurses station is a secondary safety issue--Which was the focus of this discussion.

I think all safety issues have been blended into this one discussion.Maybe nurses out there dont feel safe??Yeah! Its an on going issue in psych,and I agree with the person who said skill level is key,also cohesiveness of staff and support of Administration,but thats probably another discussion.

[Wolfpax]

God Bless those psych RN's who DO have the staffing, I hope their DON's have the best of holidays but there are places that do not have staffing and what the heck!...an enclosed nurse's station is not too shabby a thing to have... I work on one and I worked when we didn't have one... all in all... I like it, when my young and virile brain damaged patient demanded to be let out for a smoke and wouldn't relate to verbal intervention, it was the plexiglass that broke not my nose, and my poor unfortunate hiv and hcv + patient that can't get a word out edgewise without spraying spittle all over your face on the medication line got the plexiglass and not me! When Im on the floor to care for one of the patients, I do not have to put away all the stuff on my desk because it will still be there when I get back, and when one of my guys wants to have a heart to heart, he can come on in to the nurse's station and not worry every other patient and their brothers will catch all or part of the conversation. Computers, printers, phones, monitors, plants etc... do not have to be drilled to the desk and bolted up so tight Houdini couldn't get at it to prevent someone with anger management issues rearrainging the office furniture and all the other lovely things that can happen when you work with emotionaly challenged, impulse disordered, perspective altered, cognitively skewed and behaviorally rearrainged patient groups with the occasional odd antiChrist or demon spawn thrown in for yuks.

I love this stuff, wouldn't go back to regular nursing no way, this type of nursing is waaay better than an E-ticket ride, and my nursing staff is the best I've ever worked with, I do not worry about wether or not my back is covered... but even with the best of equipment and best of staff and best of intentions... spit happens and isn't is nice to have goggles on when it does?

[TitaniaSidhe]

Originally Posted by windynights

If you are fearful of working in a psychiatric facility with an open nurses station, how do you feel about being out of the nurses station, interacting with the patients? I don't understand how you could be uncomfortable in the nurses station and not uncomfortable being in the milieu with the patients.

Actually the above statement made by windynights in a previous post in this section lead to asking the question I did. In that statement the implication is that if one is fearful of working in an open nurses station then one must also be fearful of interacting with ones patient population. At least that was what I got from reading the above statement.

Myself yes I have been assaulted way back ohhhh maybe 14 years ago when I was brand spanking new to the field & fresh out of school, also without fear of any situation I might add. I was punched in the face with a closed fist about 5-6X by a Paranoid Schiz patient, totally without provocation or forewaring. I had 2 black eyes & ongoing trouble with my TMJ joint. There have been other minor incidents of being slapped, kicked, various liquid substances throw on my person, spit at, furniture throw my way, pushed, etc. but none such as the one I mentioned above. Verbally, oh if I had a nickle for all the profanity I have had directed my way or threats of bodily harm well let's just say I could retire right now. I asked the question simply b/c the above statement sounded to me like one that would have been made by a person who had never been assaulted. I was simply curious & given the response recieved I guess I got my answer, thanks. In truth I did not mean to be insulting to you windynights, take that as you wish I have no control over your feelings. Verbally assaulting you was not my intent.

Minky aka wolfpax, ah my friend perhaps you have phrsed your response a bit more diplomaticly than mine....lol but then you know how I am. You rasied some excellent points with the humorous blend that only the truely gifted can. Staffing would be wonderful would it not. Tonight as you know they left me with 2 NA's & myself and a census of 16. Yes, well the 2 they left me with are worth their weight in gold, hopefully the night remains quiet & if not we shall just to as best we can

[xmaxiex]

It never fails to amaze me the lengths we will go to make a pt feel at home , comfortable . But if a nurse is uncomfortable with a situation , being safety , staffing ratio's they are pushed aside and sometimes even ridiculed by other nurses. If we the nurses are not safe and able to do our jobs who will take care of these pt's?