How does your unit ensure staff/patient safety?

[worrywart01]

Back again with some questions for anyone willing to offer some advice.

Recently started working as a MHW at a free standing acute care psych facility. I am on the most acute unit--an all male, 26 bed crisis stabilization unit. I really enjoy working there so far and I could totally see myself working there as an RN when I finish school.

Staffing on our unit consists of the charge nurse who typically gets 1-2 patients, 2 RN, 2 LVN all with 6 patients each and then myself and another MHW. The daily routine for MHWs consists of daily vitals and basically just ensuring patients are safe with q15 rounds. The only part of my job that makes me nervous is admissions.

Admission process begins when patient comes into the unit and I get a full set of vitals and their height and weight. I have them sit down and sign paperwork and then I have them remove their shoes, take off their laces and socks, empty their pockets and then I have to scan them with a metal detector.

Patients are allowed to have their own clothes on the unit (something I don't agree with), so that means I have to search all of their stuff. I've seen other MHWs just do a quick and dirty search, but I have a type-a personality when it comes to certain things, and I don't feel at ease unless I've done a thorough search of belongings. I check pockets, waistline of clothes, turn socks inside out to make sure no razors or anything is in there, and even run my fingers across seams of pants/shorts to make sure nothing is hidden. Am I going overboard by doing so?

Does anybody have any advice on how to speed up belongings checks while still being thorough? I just feel bad at times because some patients bring in all of their life's possessions and the admitting RN has to wait for me to finish before they do the skincheck on the patient. My coworkers are really nice, but I feel like they don't take patient safety very serious sometimes so I don't really get straightforward answers when I ask their opinion on things such as this.

[Davey Do]

check pockets, waistline of clothes, turn socks inside out to make sure no razors or anything is in there, and even run my fingers across seams of pants/shorts to make sure nothing is hidden. Am I going overboard by doing so?

Not at all.

Does anybody have any advice on how to speed up belongings checks while still being thorough?

"Practise provides opportunity for possible improvement."

I applaud your perspective, your concern, and your method, worrywort. Patient and Staff safety is the priority. More of us should be like you.

Keep on keeping on.

[MrChicagoRN, RN]

It sounds like you are doing a great job.

What may speed things up is having everyone change change into gowns for the skin check. The tech can then go through the clothing thoroughly. But only allow them to have 2 sets of clothing (or whatever is agreed on by the unit). Everything else gets locked away until discharge. After the skin check they get dressed again (unless they need theyre clothes washed first. And they should be dressed as they are neither prisoners nor bed-bound patients, so they need to be dressed and maintain as close to a "normal" routine as possible.

It will require a change of unit rules, but I think this would help with both safety, and speeding up admissions