should psych patients be held accountable?

[psychnurse01]

I work at an secure care adolescent psych unit. I was exposed to HIV infected blood by a patient who intentionally dug her finger nails into my arm when she had blood on them. I want to press charges but the county attorney will not accept the charges because she is a patient and I should consider this a hazard of working in this field. Am I wrong in wanting her to be held accountable.

[This message has been edited by psychnurse01 (edited January 25, 2001).]

[clive]

I can understand your anger,but I don't think that psych patients can be heald accountable for their actions. I guessit is true that tour accident was a work related incident. It is hard to say what really should happen here. Has this pt. ever done anything like this before? Is the patient usually overly agressive?

[donmurray]

Clive, it doesn't matter, nobody, but nobody, should have to work in an environment where being assaulted "comes with the territory!"

[Aerolizing]

I have very strong opinions on this topic. I worked in public hospital who had insurance contract for our local correctional facility (the work house we call it). We had many mentally retarded too.

I can't say strongly enough to PRESS CHARGES. I have been a nurse ten years in psych and know that there are people in the world who are just plain antisocial. Antisocials fill our prisons. There is a reason for that.

I have seen many many truly mentally ill folks who would never dream of being violent. It was a rare event that anyone would act out violently on our floor. I think we had a great staff which helps but we gave clear expectations to our patients that violence would not be tolerated. It was a part of our nursing assessment. We did have violent felons admitted to our ward and we did not take any chances with them. We had police holds on our unit locked in their rooms. We always used two security guards to enter their rooms to do patient care.

I think what some administrators don't realize is that some patients can't get into the right treatment programs because they are not court ordered. We had many mentally retarded sex offenders on our floor. What do you do with them? They can't play in my neighborhood, I don't want them. Prosecutors don't want them as they are labled incompetent. What do we do with them? They need to be court ordered into treatment programs which give them the choice of treatment or jail. Violent offenders need to be off of our streets.

If you subscribe to the NAMI newsletter, they will always write about how badly they feel for victims of violent mentally ill people but they always include that they feel bad for the mentally ill who were not being treated. Court ordered treatment ensures treatment. Ask NAMI. They don't want the mentally ill in jail. They want them treated. Sometimes, the only way to get a mentally ill, noncompliant person into treatment, against their will is with a court order. I hope I have not rambled here, it is late.

Diane

[Caro]

Hi

This thread has touched on one of my long standing gripes !

I have found the issue of patient accountabilty varies tremendously from hospital to hospital.The first Psych Unit I worked in had a policy that any patient who assaulted a staff member , visitor or fellow patient would be charged by the police immediately.There were no exceptions and the hospital pursued the matter on behalf of the individual who had been assaulted.

Certainly the majority of patients who were psychotic had the charges dropped, but it sent a clear message to the PDs and non-psychotic patients. Also having charges laid entitled the victim to seek criminal compensation - even if the charges were dropped due to the patient's mental state.

Interestingly , many patients reported feeling safer from aggression with such consistent management.All patients were made aware of this policy on admission.

Unfortunately the current hospital I work in believes that being assaulted is part of the job...unless you are a doctor, psychologist or social worker etc.

Nurses are expected to act as de facto bodyguards for medical staff - considering I'm a runty little creature most of the doctors and patients tower over me, so as a human shield I may not be all that useful !

Related to this issue is the lack of medical care available to nurses immediately following a serious assault - this has resulted in concussed staff being unable to make informed choices about immediate treatment options.

Caroline

[donmurray]

Hi, I thought the nursing unions were active in Oz?

[Caro]

Hi Don

You're right - the Australian Nursing Federation is very active !

We are currently working with the Union to get an acceptable outcome to this situation - unfortunately in this particular hospital many of the nurses don't believe in charging patients and management actively discourages them from pursuing charges.A nurse who went to the local police station to report an assault was told that they would not pursue charges unless the head of security at the hospital agreed to support the claim !!!!!

I'll keep you posted on any outcome.

Caroline