Ever feel like a hotel porter ?

[chad75]

My first job out of school was working on a psych unit at one of the biggest hospital out here in Arkansas. The unit consisted of PICU which was a locked down sterile enviorment, then we had an open unit for the more stable patients.

Nurses rotated working picu, and the open unit. I HATED working the open unit, it was quite honestly a hotel. Patients would come and go at their leisure, free to roam the hospital or wherever else, quite a few times patients would go down to their car, drive to the convience to pickup cigarettes/booze/smoke a joint and god knows what else. They were only supposed to be gone 30 minutes at a time, but we all know how that goes they would basically sign out and in a ledger that was at the nurses station and the only time we looked at it is if we needed to administer a med or something and couldn't find the patient.

They had to have a physcian order for Building and grounds, and the psychiatrist would gladly write the order, but then when he/she came up to round on the patient and they were not there he/she would have a conibtion fit. Patients were also permited to get cafeteria passes, basically it was a 6 dollar cafteria certificate so they could choose their food from the cafeteria versus the regular hospital supplied trays.

It turned in to a virtual hotel, patients HATED leaving, especially a our homeless ones. There was no real theraputic enviorment, half the patients opted out of group therapy etc. I think the unit was there just as a place that the hospitals/physcians could leech more money out of the insurance companys etc.

Eventually the instituted new rules (after I left) I am told by friends that still work there because insurance companys were refusing to pay based on the fact that if they were stable enough to be in such a non-acute enviorment they were stable enough to go hom lol. Has anyone worked at a similiar facility? In the last five years I've been working psych, I've never seen anything like it again.

[sanakruz, ADN]

Ive never heard of anything so foolish in my entire life! guess thats why it's history. As soon as I read the first few lines of your post I started thinking like a UR nurse"How can they possibly justify in-pt stays,then....":chuckle

[TitaniaSidhe]

Sounds like a VA Domocilliary!

[teece3]

I've been a psych nurse for a long time and that's been one of my biggest gripes. I don't have any trouble with treating people well but a little discomfort (not torture or anything quite that dramatic ) goes a long way to getting them out the door and back to reality. I've told patients that I'm not a short order cook, a bellhop or a cruise director. Some are offended and others just laugh. I think how a unit "feels" in regards to providing a therapeutic milieu (I really hate that term!) or a hotel depends on the facility philosophy and how the staff function as a team. It was amazing when we would set limits and expectations how those that were the most comfortable started heading for the door.