Psychiatric Inpatient Preparedness

[TheVitalRN, MSN, RN, CNM]

As an Inpatient Psych RN, I need to hear back from others about what your protocols are currently in terms of COVID-19 and if you have access to PPE at this time, etc... Any information would be helpful. TY!

[LaurenJulia]

We're seeing a serious reduction in new admissions lately at my hospital. My floor actually has been shut down for low census and we're down to one acute adult floor and one geriatric floor. When I last worked about five days ago we had stopped allowing visitors and a security guard was positioned at the door asking everyone screening questions. More could have changed, but as of last week we were still holding group therapies and communal dinning. PPE's were being kept by the supervisor and given out as needed.

[hppygr8ful, ASN, RN, EMT-I]

We stopped allowing visitors a week a go and our adolescent unit has a pretty low census. We ran out of bleach wipes and hand wipes two days ago (mainly because staff are stealing them to take home.) Initially we were told we would not be allowed to wear masks of any kind and if we were that worried about catching the virus we should take a leave of absence. Well a bunch of nurses called off. Now we can wear a mask but we have to provide our own and they won't tell us to take it off. We still have communal dining on the unit - but no cafeteria dining. We are individually screened going in and going out.

[JTravelsTheWorld, RN]

So we were told to not wear masks. I have to get very close to all patients and do frequent temperature checks. Not only am I worried about my safety, I am worried about patient safety. I interact closely with all patients and I’m concerned about transmitting the virus if a patient or staff member has COVID-19. I reached out the management, and they said there is a national mask shortage. I understand that, but I think they are putting people at risk by not letting one nurse wear a mask. Any constructive thoughts on how to approach this issue? I can’t not work because my husband’s work was deemed non-essential and shut down with no pay.

We are keeping a low census and keeping rooms open to place patients who may have been exposed to COVID-19 in. Especially the roommates of someone who is symptomatic. No visitors. Our food service is not entering the building and only providing cold meals. We are taking extra measures for wiping down community spaces. Temp and sx checks every 6 hrs.

[adventure_rn, MSN, NP]

5 hours ago, JTravelsTheWorld said:

So we were told to not wear masks. I have to get very close to all patients and do frequent temperature checks. Not only am I worried about my safety, I am worried about patient safety.

I hear your concern, but this kind of mentality is part of the reason for PPE shortages. Given that there's so little PPE to go around, it needs to be prioritized for symptomatic and confirmed cases instead of using it on everybody 'just in case.'

[Naturally Brilliant, BSN, RN]

Ours hasn't changed too much. There's security officers wearing masks that do forehead temperature checks before we get into the building. A house supervisor showed us how to use the special equipment to gown up and whatnot on, and if/when we get a Coronavirus patient they'll be housed in the recreational area far from the units. The census has dropped a lot, which is nice. I think I saw one co-worker who had a mask on him, and he didn't even keep it on his face consistently. But most of the workflow is identical. We can't do UberEats, Doordash, etc. to get food from outside overnight - we have to drive and go get it from outside - which kind of sucks, but it's not that big of a deal since I've been bringing food from home, anyway ?. I'm kind of burnt out about listening to Coronavirus at this point, if I get it I get it, so I've emotionally moved on.

[TheVitalRN, MSN, RN, CNM]

Thanks everyone! As of today, we have screeners at all entrances of the hospital taking temps of everyone (it's only employees as there are no visitors as of about 1.5 weeks ago) and asking screening questions. We have two adult units--both have very (very!) low census. We do not have groups but our therapist are trying to run them by zoom (we allow patients to have their phones on our units!) We also have no psychiatrists, except for a resident, because the psychiatrists are doing rounds and meeting patients via zoom. We do have a sort of protocol in place in case a patient develops a fever and/or other symptoms. What does everyone think about the low census numbers? I feel like this is going to exacerbate peoples' anxiety and depression, not to mention the fallout from the economy....we have had a couple of admissions related to job-loss/depression/SI. I am thinking those will really increase. I think my hospital is doing a good job in this ever-changing situation. I do want to save the PPE for critical care, but I worry about asymptomatic transmission and giving it to my husband. Thanks for all of your feedback.