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.

I really appreciate everyone's feedback. Since I'm still new to the unit, my director came up to me the other day and had asked how everything was going and I had asked if we could go somewhere to talk and I was able to explain to her what had happened. She told me that she really appreciated the fact that I came to her because she now knows how seriously I take my work and she can trust that I'm going to be very thorough going forward. Huge relief. With that said, since screwing up, I've been so nervous about making mistakes! The unit I work on is a 26 bed crisis stabilization unit and our census is always full. Every once in awhile we get a patient that less acute, but 90% of the guys are very acute and suffering from poorly managed bipolar, paranoid schizophrenia, etc and I would say about half are conserved or in the process of being conserved. All of this boils down to the fact that these guys are super sneaktired and very unpredictable. Just this week alone, we had ano admit that had a bag of meth in his anal cavity and fished it out of the toilet when he had a BM. Subsequently, we had a couple of manic patients high on his butt method. Had another patient try to strangle himself with the elastic portion of his boxers and had another patient get cigarettes and a lighter from a visitor (we think) and was smoking with a few patients in their bathroom. Imy totally comfortable with all of the aspects of the job except for admissions. Patients come in sometimes with all of their life's possessions and I get nervous that I'm not going to catch something small like a razor blade and then have that turn into a staff member getting hurt or patient. Patients are allowed to wear their street clothes onto the unit (which I don't agree with) so long as they don't have any type of draw string, etc on them. That means if a patient has 30 outfits, I have to sit there and go through everything and this leaves the floor short handed as the nurse has to wait and the other MHW is left with the other patients by themselves. Those of you that have done admits in this type of setting, what are some tips/tricks that will allow me to be thorough but will also allow me to manage my time and get back onto the unit?

I had thought about calling, but I didn't know how to voice my concerns without coming across very strange (which I'm sure is what is happening now). I have this strange urge to.confess what happened to someone because it will be one of those weight off my chest sort of things, but it will be a week since it happened by the time I go back to work at which time both patients could potentially be discharged anyways.

I do agree that I'm being a little over the top, but only because I would feel HORRIBLE if something were to happen. Apparently an RN is supposed to do a skin check when the patient comes back, but that was never done either. As far as the patient's go, one was being discharged the following day and the other was not DTO, he was just saying off the wall things that caused him to be admitted in the first place. and going forward, I will most definitely be more thorough. When I first admit a patient, I check all their belongings, make them take off their shoes and socks and carefully wand them. This was the first time I had a patient coming back onto the unit and I guess I didn't think much of it since they had been in the custody of the cops for the duration they were off the unit.

Anyone?

fellow workers of the dark side, I am new to this realm of patient care. I recently started working as a mental health tech on a locked crisis unit for a private psych facility. I really enjoy the work, but one thing I am still so paranoid on is when I admit a new patient and have to search them and make sure they are not bringing any contraband onto the unit. A situation I had on Thursday at work was when we had 2 patients return from court. The patients were allowed to put their shoelaces back into their shoes for court and they were brought to the courthouse via a sheriff's van with 2 officers. When said patients returned from court, I brought them back to the unit with another RN and was informed by a co-worker that I needed to wand them and make sure they didn't have anything. So, I took their shoelaces, put them in their contraband bag and then asked each of them to empty of their pant pockets. One patient had our hospital lotion and the other had his soft cover bible which had been allowed on the unit previously. The metal detector we use on our unit is extremely sensitive and will go off for the slightest bit of metal (i.e. buttons on pants, zippers, etc). One of the patient's was wearing a zip-up hoodie that had 2 small pockets on each side of the chest and when I scanned the patient, the detector went off but I assumed it was because of the zipper and I didn't pat down pocket! and I feel like an idiot. The floor was hectic and I just assumed that since these patients were in the custody of cops, they weren't going to be able to have contraband on themselves, so the thought of patting the pt. down never crossed my mind and the thought of not having them take off their shoes never crossed my mind. I didn't really think about it until like 10 minutes later when my OCD personality started kicking in and so I went to the patient's room (they were out in the day room) looked in his jacket pockets and didn't find anything. But I still was freaking out. I thought about telling the charge nurse, but I didn't want to come across as sounding like a complete basket case. It was towards the end of my shift, so I clocked out, but I have not been able to stop thinking about the worst case scenario. and when I say worst case scenario, I mean patient killing themselves or another patient, stabbing a co-worker, etc. I was scheduled to work the next day and wanted to casually bring up my fears to someone at work as sort of a "haha, hey guys, guess what I'm totally freaking out about", but I was called off d/t low census and I'm not back for another 2 days. Am I making this out to be a bigger deal than it actually is? I have this strong urge that I need to confess what I did to someone at work and it is making me feel like I am losing my cool. what would you guys do in my situation? Should I say something? how should I word it so I don't come across as being a weirdo? should I let it go and enjoy my Sunday afternoon? Please don't read this and blow it off. I will take any comments, criticism, advice. Anything to make me stop feeling so paranoid.