A Patient Who DOES NOT Belong in Minimum Security!!

Specialties Psychiatric

Published

Hey Everybody,

Was wondering if anybody else has experienced something like this before: I work in a minimum security psych ward. We are an SLP or social learning program, that uses a token economy. There is one patient on this ward who belongs in intermediate security at the very least, for several reasons. He has polydipsia and has gained 10lbs in just over an hour, but our treatment team leader won't let us remove him from the fountain when he guzzles, and even if we did try that he is so violent that someone would get hurt. Almost everyday he pushes his way into our token store and takes whatever he wants, and once again if anyone tells him no, he swings at them or lunges for their leg and tries to bite them. He has been referred to intermediate security twice before, and the team leader is reluctantly referring him again. The people who make these decisions are never on the wards and aren't the ones who have to get the crapped knocked out of them whenever this patient goes off. The reason this worries me so much is that for most of the time that I work I am the ONLY male in the entire building. I don't mean to sounds sexist because I'm sure there are a lot of women who could kick my a$$, but with this guy I'm usually the only one who can deal with him until more people get to the ward to help, and even then its a real struggle to restrain him. His treatment plan is a joke and gets changed all the time or not followed very closely because all of the aides are afraid of him and we aren't staffed well enough to deal with him.

Does anyone have any suggestions that would be useful at his upcoming transfer hearing? This is very frustrating because right now he pretty much runs the ward.

Thanks for letting me vent.:angryfire

Thanet

126 Posts

Specializes in Mental Health.

Record, report.

Record, report.

Record, report.

Add incident reports, injury reports, untoward incident reports, near miss reports, restraining reports, medication reports, dangerous staffing level reports and anything else that your hospital uses.

If your hospital/ward do not have these reports/forms... then introduce them.

Use e-mails to your senior nurse/doctor or whomever.

LEAVE a 'paper trail' as it used to be called before the days of the internet.

THEN..

Record, report.

Record report...

Jerry99

18 Posts

There is a paper trail. Every time that he goes into restraints, hits somebody, or steals things, an incident report is filled out and a note is made in the team notes in his chart. That is what makes me so mad, the higher up see that this has been going on for some time now. I guess they just want to wait until someone gets hurt really bad, because it's sure not going to be them because they're in the offices all day.

Thanet

126 Posts

Specializes in Mental Health.
There is a paper trail. Every time that he goes into restraints, hits somebody, or steals things, an incident report is filled out and a note is made in the team notes in his chart. That is what makes me so mad, the higher up see that this has been going on for some time now. I guess they just want to wait until someone gets hurt really bad, because it's sure not going to be them because they're in the offices all day.

The last time this happened on our ward the consultant ended up in A&E (ER) having stiches in his head... so did three nurses with stab and laceration wounds.

The patient ended up (via the courts) in a high secure unit. The judge was not complimentary towards our senior nurses.

The powers to be NOW listen to what we say and read our paper trails.

Record, report. Record, report.

fgoff

256 Posts

Specializes in ER, Teaching, HH, CM, QC, OB, LTC.

If this parient assaultive you can press charges. Notify your supervisor and call the autorities to make the report to them.

We have similar inappropriate placements on our rehab wards.

Try to have al the staff work together so no-one is ever alone with this guy is you are not already doing this.

Oh and if he is stilling can't the facility press charges for thief?

Good luck!

fgoff

Jerry99

18 Posts

I don't think that we can press charges because he has already been found NGRI and has a guardian. I've been told that once someone has been declared NGRI or permanently incompetent that its pointless to press charges.

DavidLCPCCSADC

26 Posts

While he may be inappropriate at this level of care, his behavior must have some payoff values and current treatment may be reinforcing behaviors rather than modifying them. Can he articulate any personal short and long term goals for himself? Does he have any sense of future,....any sense of personal meaning & purpose?

He could be viewed as a PIA or as a professional challenge....it's all in the framing.

+ Add a Comment