security guards?

  1. To those who work in psych hospitals or on psych units; Do you have a security team available other than your coworkers? I have been working as a charge nurse in a psych hospital for the last few months. I just don't feel like there is much backup should things go wrong. I have seen and been part of the response when a "code" is called and its not impressive. Staff have been seriously injured by patients at the hospital where I work, but the administration is opposed to having a security guard or two on staff insisting that would not be appropriate for our type of "milieu". Caring words aren't enough though and our crisis training was laughable. If this 250 pound psychotic guy puts another nurse in a headlock, how am I and a couple small, middle aged female techs going to help her? Because of my small size, there is a chance that I would have to stop a patient who was intent on hurting a coworker in a manner that would probably hurt the patient. Harming a patient would be a tragic nightmare not to mention a career wrecker. Shouldn't an 82 bed psych hospital shell out for a security guard position?
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    Joined: Sep '05; Posts: 25; Likes: 11


  3. by   p0969
    I work in a VA medical center. We are fortunate in that we have a VA police dept. in house. When a code is called they are quick to respond. Usually if it reaches the point of the police coming up to the unit the patient is probably going to go into seclusion or restraints. Sometimes just the presence of the police is enough to calm a hostile patient. A unit the size of yours should have resources to call upon when necessary. Even with police present we have had staff injured. The police are there for back up and will intercede after all else fails.

    Since our psych unit is in the hospital we also have the resource of other hosp. staff. If we call a "code purple" we have people from the other units also respond in addition to the police. Many times this show of force is all it takes to get the patient to cooperate.

    The safety of staff members should be a priority. One serious injury to a staff member is one to many.

    I am 6' 3" tall and weigh 260 lb. so I do not have too much of a problem with hostile patients but I have seen them take advantage of female staff.
  4. by   psychnurse870
    In regards to your question about security guards, in the 6 years that I have worked psych, I have never worked in a facility (including one for forensic patients) that has had security, other than the nursing staff. The local law enforcement do respond quickly, when needed. One of the units actually backed up to the state police office. True security could help, but it could also cause more problems. As you mentioned, some are concerned about the milleu. Would the patients open up and communicate with you if they were paranoid and they saw security on the unit. One suggestion we made in the past was for plain clothes security, but in a field where budget is everything and it is hard to find the money for new nurses, this was out of the question. I guess that it will come down to proper training. If, as you said, your training was a joke; contact your administrator and express your concerns. This may step on some toes, but that does not compare to the safety of the patients and employees
  5. by   RN(MH)

    We never had security in the Mental Health unit I worked in, although the general hospital and A&E Department did have. All the staff were concerned about this especially the night shift. The only security we had was our nursing colleagues. Security staff could be an advantage, but only if they fitted in with the unit, and quite often those with severe Mental Health Problems are paranoid about those in uniform, particularly the police, and the police do not always know how to handle these clients. So if the security staff had the right training in restraint and mental health issues, it could work. Funding was also another issue as always there was never enough funding for the mental health units to have security
  6. by   PsychRN45
    Actaully, we have female security guards but she doens't get involved in the codes or restraints. She'll show up and document who was there for the paperwork and debrief.

    When a code is called, either full on code or a silent code, a lot of guys show up along with a few females. Mainly the females who show up are RNs to call the MD. We're supposed to have an assigned Code Green Team at the beginning of each shift but our hospital is so small that any available male will pretty much show up.

    At our main champus, which is a medical hospital, they have a Code Green Team and Security which is trained to handle these situations.
  7. by   sicu1
    I know I'm late in getting in on this but....I work in an acute psych unit and we use the hospital security guards. Sometimes a show of force works. I know some of you handle this stuff on your own but sometimes it's nice to have backup when you've got a psychotic patient going after staff and/or other patients. Whether voluntary, 72 hour hold, 14 day hold, temp conservatorship, or perm conservatorship it doesn't matter; some just don't want to be here. I just don't like it when a patient looks right through you and while coming towards you.
  8. by   MALE*RN*777
    Security only helps when requested. They do respond to all codes but look for prompts from the charge nurse and unit staff before putting hands-on.
  9. by   karynfrances
    We are a 22 bed unit attached to a small general hospital, we have use of security when someone pushes the duress alarm or to prevent a situation by using a show of force. Our security also look for prompts from nursing staff in these situations. Our security guards also wander through the unit at different times of the day so the clients see them as less of a threat. We have also had training in how to restrain clients when necessary ( but as for follow up refreshers and practice, bad luck!).
  10. by   epg_pei
    We have just been issued a new "Code White" protocol, which rather than make the process of crisis management more effective and efficient, will actually encumber and slow adequate response. Previously we could page overhead for all male staff to assist in a crisis. We will now have to call for "security" who are currently assigned to parking lot attendance and information services. These individuals will attend the unit, assess the need for further assistance and implement as appropriate (male staff, occasionally 1 orderly on nights I believe, and/or police via 911, hope they're not too busy.)

    Meanwhile, I will potentially be taking a beatdown from a pt while my colleague who is not big or strong enough will be clearing co-pts from the area, "engaging uninvolved patients in diversional activities in an area removed from the situation", etc. The debriefing phase looks very nice though, I'm glad they want me to be able to "express my feelings." I will probably have to write out my feelings as my jaw will likely be broken in several places. Assuming my arms aren't broken too.

    When it's all said and done the hospital is willing to "consider changes in current policies or procedures." Which is not the same as actually doing anything. Wiggle words from someone who doesn't know or doesn't care :trout:

    I love psychiatry, and the chance to help people live well with mental health challenges. But I never signed up to take a beating, or be a guard. This sort of thing happens once in a blue moon or less, but when it does happen I need help, not a BS policy and protocol.
  11. by   NewYorkGirl
    I'm a senior year nursing student (I graduate with my BSN May 08) and I just started working as a Mental Health Worker at an inpatient psychiatric hospital. I'm working with preteens and adolescents.

    Yesterday we had 10 restraints and seclusions. There is no security, and most of the staff are females like me who are smaller than the patients.

    I seriously have been feeling like I'm going to get physically hurt if I continue to work at this place. Getting tossed around by an angry 15 year old boy is not my idea of fun

    We learned techniques to take down a patient safely and restrain them, but this hospital only restrains patients with hands, no soft restraints or anything like that - so you have to literally run out of the room and slam the door shut with the kid jumping up after you and chasing you as you run away.

    I was wondering if working at an alcohol rehab might be a little less frightening? if anyone has any experience with inpatient alcohol and drug rehab nursing I'd be interested in your experience with safety issues...