Suicide in Psych Ward - page 2
Something terrible happened over the weekend at the hospital I do clinical at. A man (who just so happens to be a neighbor of mine) had been severely depressed over the farm accident death of his 11... Read More
Feb 24, '03Occupation: RN Joined: Apr '02; Posts: 2,065; Likes: 48thanks for the update....sad indeed
Mar 4, '03Occupation: Psy RN Joined: Nov '02; Posts: 6I worked in psy for years and every patient is stripped searched coming on to the unit, even if they have been in police custdy, I no this is uncomforatble for the patients but it is safety for all, the staff and the other patients ,we have taken knives and drugs from patients i don't no of any guns ever making it to the unit, and we take the shoelaces for 24 hours, which i am not sure does any good because there on semi private rooms so they can get shoe laces from there roomate , the other reason we do a seach is for any maks and brusies because a lot of false claims get made once a patient is in our facility and that is our documentation when they arrrived with these bruises, exp when they have been in police custody and have resisted arrest, the handcuffs and shackles can leave some nice bruises.
Mar 4, '03Occupation: RN - College Health Specialty: Geriatrics/Oncology/Psych/College Health ; Joined: Jun '02; Posts: 6,584; Likes: 70All patients are required to change out of their clothing intoand have their clothing searched (no body cavities, tho!) Unfortunately, since visitors come in who bring patients lighters and other contraband, and we don't search THEM, it's kind of a futile exercise...
We do daily contraband checks of the entire unit, but not of the patients themselves.
One unit had a pt nearly hang himself with a belt that *should have* been taken away as he was on suicide precautions. Now everyone who goes there has to wear scrubs during their entire stay.
Mar 4, '03Joined: Oct '02; Posts: 1,671; Likes: 3like the post above
we take all clothing and wash it
give pts pjs
do not cavity search
a gun on a mental health unit is too horrible
even police can not bring their's through our locked door
Mar 4, '03Occupation: Nurse Joined: Oct '01; Posts: 12,715; Likes: 2That is a sad story Kristy, I missed it back in Nov., thanks for updating.
Mar 6, '03Occupation: Lecturer Joined: Nov '02; Posts: 78; Likes: 1I must admit that the idea of nurses having to strip search patients horrifies me! How are you expected to build up any sort of a relationship with someone who you've subjected to such an ordeal? I understand the rationale behind it, and perhaps I am coming from a UK perspective, where guns are not so freely available, but this seems one security measure that would best be left in the hands of security staff.
Mar 6, '03Occupation: CCU RN Joined: Sep '02; Posts: 1,039; Likes: 10Missed the story too til now. Just wanted to say that story is just so sad. My prayers are out there for that family.
Mar 6, '03Occupation: Nursing student Joined: Nov '02; Posts: 389; Likes: 10The gun emily_mom mentioned, a "berringer (sic)", is probably a derringer.
Derringers are small, single- or double-shot guns. Unlike a revolver or semi-automatic pistol (like a Glock or Colt 1911), they do not have a magazine and do not have a slide; this means that between each shot, the derringer must be opened up and the cartridge(s) (bullets) dropped in. Some have two barrels, one over the other, and two separate triggers. Derringers usually have very short barrels and no sights; they are meant for use at close range on something you want to kill (and plan to kill with one shot).
The common trait is that derringers are small, sometimes 3" in length or less. Very few are manufactured today since they're not particularly useful or accurate, but they were widely manufactured through the 1950's and there are lots of functional antiques out there.
My guess is that even if this patient had been searched, he might have been able to conceal a small derringer. Even a metal detector might miss a really small one.
Just thought this might help everyone understand how a gun could get into a hospital.
Mar 6, '03Joined: Jul '02; Posts: 3,872; Likes: 18It probably was a derringer. I don't know guns and have no desire to. All I know is that it was very small.
Sep 23, '03Occupation: RN,BSN acute locked psych admissions in Veterans Hospital- nightshift charge nurse Joined: Apr '03; Posts: 230; Likes: 8You know I really have to make more of an effort to visit this board more often. I missed this thread & am sad I only now read it. I myself a year ago had a suicide on my shift on my unit. We found a man hanging from shoelaces in the bathroom during Q30min. health & safety rounds. Of course working night shift this is the most opportune time for this sort of thing, quiet with less people about & such. We managed to get a pulse & BP back but no breathing. He had been without for too long & was clinically brain dead. Family terminated life support shortly after...it was EXTREEMLY disturbing to walk in & find someone like this, I still have trouble going down there on the night shift as I can still sometimes see him... Years ago things were much more stringent regarding safety. No shoelaces, no radios or any such thing with a cord, no glass bottles of aftershave or such, no belts, no neckchains, no sweat pants with laces, even no eyeglasses. We once had a patient remove the lense from his eyeglasses & slit his throat in his bed during the night. Unfortunately with all the new patient rights & privileges there also comes greater risk for harm to & from the patients. Hospital have now become reactive rather than proactive as they should be. All new admissions are searched-strip seached with police presence upon admission. Clothing is washed as they sometimes sew drugs into the hems. No body cavity searches however even though this would be beneficial with known drug addicts as they secret paraphenelia in a condom in their rectum. I have taken countless sorts of weapons from new admissions- ice picks, knifes, brass knuckles, metal pipes- you name it I have taken it but never a gun has made it to the unit on a patient. Being a federal facillity there are not even guns allowed on the property unless it is our own police which are carring them & even then they are not allowed to bring them onto the unit in which I work. Fortunately for me I have the privilege of working with all very experienced long term psych employees. Unfortunately I have seen so many horrible things over the years...rapes, 2 hangings, DOA on train tracks (just 2 miles from our hospital) slit wrists, throats--drinking any numbers of things mainly rubbing alcohol or cleaning chemicals. I have perhaps seen more incidents then many who have worked with me, I suppose I am just lucky eh? One thing I can say is that so much can happen in such a BRIEF amount of time. If someone truely wishes to die they will find a way to do so & the gesture will be big not small like scratching ones wrists with a plastic knife or such. We can only do but so much. Searching on admission although embarassing is necessary most especially in psych. There is a VERY fine line between suicidal & homocidal, never ever forget this as most likely a very depressed patient will hurt you as well as hurt themselves- personal experience there again. I do however find the hospital at fault for the gun thing, I do believe you stated the man was admitted to the psych unit yes? Par for course is that all psych admissions are searched THOROUGHLY before entering the unit. The whole purpose of admission to psych in the first is to maintain a safe environment for care, as humanly safe as possible so searching is a given. Sure you could leave it to the police however our hospital policy also gives nursing the right to search with police presence, we find what they miss...Safety is a big issue in nursing all around. Prob the most unsafe being the ER & fast runner up would have to be psych. Maternity also but they have tightened security in this area as of late. Assaults happen in all areas however so one must always be aware. I find it is always the patient you least expect to hit you that will. Yes I have been hit too many times to count but only 2X that was black eyes bad.
Sep 24, '03Occupation: Psychiatric Nurse Practitioner Joined: Feb '01; Posts: 24I can't believe that a person that despondent was able to get by police and ER staff and was able to make it to the floor with a weapon!!! From a legal standpoint .... the patient shot himself and died because a thorough search was not done. (Had a thorough search been done the gun would have been found). The patient's death is a direct result of neglect by the police and the ER people. How is it the a depressed and suicidal patient made it to the unit in his personal clothes without being thoroughly searched by the police and ER personnel and made to change into hospital clothes?
It has also been my experience that regardless of how safe you make the environment, a patient who is truly desperate enough to want to die will make an attempt and will often succeed. Staff cannot be with the patient ALL THE TIME !!! (There are patients who will tell the sitter they are going to the bathroom and will drown in a sink full of water). There is a significant advantage to admitting a suicidal patient to a restricted setting where he will be more closely observed, but no inpatient unit is suicide-proof. Had the patient not shot himself in this manner, he most likely would have found another way. It is absolutely horrible to be on the shift when this happens, but a determined patient will find a way and will take the earliest opportunity to act. I know that, if I were the nurse on that inpatient unit, I would be asking "How did he get this far into the system with a gun?"
Sep 24, '03Occupation: CEO Joined: Sep '03; Posts: 24Originally posted by psycorn
the other reason we do a seach is for any maks and brusies because a lot of false claims get made once a patient is in our facility and that is our documentation when they arrrived with these bruises, exp when they have been in police custody and have resisted arrest, the handcuffs and shackles can leave some nice bruises.
Sep 26, '03Occupation: Associate Manager ED Specialty: 10 year(s) of experience in Trauma/ED ; From: US ; Joined: Sep '03; Posts: 1,182; Likes: 636I know I'm coming into this conversation late but my question would be about the information disclosed...isn't this some kind of breach of confidentiality? I don't know maybe I'm just paranoid with all these knew HIPPA regulations. I know the name isn't given but if someone knew the parties involved I'm sure they could figure it out...Just a thought.