NoctuRNalED

What is your current process for these patients? Have they been searched by security for any potential weapons or contraband? Are they changed into hospital clothes? What stays in the room with them? The first and easiest step is to make sure that any potentially dangerous patient (whether it's to themselves or staff) has as little potential ammunition to hurt anyone. Who comes when the button is pushed? Our hospital panic buttons go to operator who notify hospital security and police so that no time is wasted by staff who may not have time to call police while dealing with a dangerous situation. Who responds from inside the hospital? ER staff, security, maintence? How quick do they get to you? If it isn't enough help or quick enough it would be worth it to ask management for an additional security guard to be staffed on the unit for only when a potentially dangerous patient is admitted. More than likely this won't be an option due to budget or staffing, but hopefully it starts a conversation about any extra staff that can be placed as a sitter for safety. Are these patients coming from ER combative or waking up after being given medications in the ER? If they don't come to you safely, then that should be addressed with the ER providers. Lots of questions, I know, but all facilities do something differently. It helps to know where your facility is at now to know what can be added to make it safer.

I get first name, last name and title of whoever I give report to on any patient that is being transferred. It's our ER policy that we document it, as well as documenting the first and last name of the accepting physician. Is it overkill? Perhaps but our hospital is super strict about EMTALA documentation and these are part of our required documentation. I've never had anyone not tell me their last name. I usually ask by saying, "Can I get your last name for my chart?" Never had a problem. Giving report to another floor in our hospital it's first names only and sometimes a last initial.

Satisfied staff is staff that feels like their opinions are valued. If your department doesn't already have a way for staff to formally submit issues and suggestions about how to improve things for patients and staff then your committee should start a suggestion box of some form. Then, make sure to update the staff on what becomes of their ideas and opinions. Our department does this in a monthly report put out by our ER staff committee andif an idea can't be done it gives the rationale as to why.