How does your department handle crisis patients?

[Loo17]

Hi, I am trying to come up with a plan to better manage crisis, psych, and ETOH patients in the emergency department where I work.

The department where I work is very busy and often the patients (3-8 on average) are grouped together in the hallway with one sitter watching over them while they are worked up to obtain medical clearance/sober up. I am interested to hear how other departments manage these types of patients. I am looking to make the environment safer as well as better protect their privacy. Space is at a premium so as I said the solution is often to place these patients in the hallway to free up the rooms for patients that need to be on the cardiac monitor and such. The hallway seems to be the worst place though because of all the traffic going by them, often escalating behaviors in ETOH patients and paranoid patients especially. Plus many SI patients feel like everyone is looking at them and judging them and often just want to leave.

So if your department does a decent job in managing these types of patients please share! i would love to make some changes for the better where I work.

Thanks in advance!

[MunoRN, RN]

Are you in the US?

[five_apples]

We have a holding/obs area and use it for both medical pts waiting for results & dispo and for psych/ETOH waiting for placement/sober. Each have their own room & sitter. If no beds in this area pt has to stay in big ER. Stopped having hallway spots long time ago. Thank you, Joint Commission, LOL

Well, as with all of our other patients, it depends on the acuity.

Generally speaking, they start out in the hallways, then ultimately get roomed, and finally get moved to a location with dedicated mental health workers. That progression can take many, many hours.

Anyone who's deemed DtO/DtS is restrained in a lap belt.

[AnnieOaklyRN, BSN, RN, EMT-P]

Haldol and Ativan!