Pt beats another to death at one of our clinical sites - Unsafe for students???

[rad sugar]

http://www.cfnews13.com/News/Local/2010/4/1/fight_in_psychological_ward_leaves_man_dead.html?refresh=1

http://www.myfoxorlando.com/dpp/news/seminole_news/040110patient-involved-in-psych-ward-fight-dies

at a local psych hospital, one patient beat another patient to death. this is so sad and i really feel awful for the families involved. that said, this really raises some questions for me about our safety as nursing students.

my school does our psych clinicals at this hospital, on the exact unit where this happened. About a month ago we had a really bad night there where some patients having manic episodes all became very aggressive, and as students we did not feel safe. We told our clinical instructor we didn't feel safe and after an hour or so on the unit, she begrudgingly let us take a break early.

A week later, when a different clinical group was at that site, she told them that I was a real "drama queen."

I asked the professor in charge of the lecture portion of psych if we could take some class time to talk about clinical. It was during this discussion that I found out i was called a "drama queen" and the instructor felt our group in whole was overreacting somewhat. I didn't really care much about the petty name calling... but what really bothers is me is that I legitimately feel unsafe when we have to do our shifts.

The professor basically told me to get over it, and deal with it... because that's what real nursing is. She tried to make it seem as if I was discriminating against psych patients. Someone made the comment, "if they were cancer patients, would you say the same thing?"

I think its total BS. I'm not trying to provide a lower quality of care because of the patient's Dx and because of what unit I'm in - I just think that personal safety at the clinical site is a reasonable expectation.

I get so frustrated when I'm told to just deal with it, because that's what real nurses do. "real nurses" also have a lot more options than I do as a student:

1. "Real Nurses" have badge access to leave the lockdown unit. If I am stuck in an unsafe situation, I am locked in.

2. "Real Nurses" can give PRN chemical restraints and have access to the drug dispenser. Students may only talk to patients.

3. "Real Nurses" who work on the unit have been trained in take downs, and know how to tackle and restrain patients per the hospitals policy. Nursing Students do not receive any training like this before clinicals.

4. "Real Nurses" are trained in therapeutic technique learned through evidence-based teaching that can help de-escalate a situation. We were thrown into psych clinicals during our first week of lecture without any knowledge of therapeutic technique as it pertains specifically to psych nursing.

5. "Real Nurses" know the hospitals code system and how to use the phones. I have no idea how to even call room to room, each hopsital that we go to uses different codes and has different phone systems.

The bottom line is that these clinicals are required, and my teacher told me that she and the school are NOT ultimately responsible for my safety, the hospital is. While she hopes nothing bad happens to me or a fellow student during clinical hours, we have to recognize that this is a real hopsital, with real patients and we cannot predict or guarantee any behavior or outcome.

.............

If you go to school in the area - do you do rotations at South Seminole? What do you think about it? Is it safe?

What is your school policy about student safety at clinicals?

What do you think about this whole situation?

[elkpark]

Go ahead and flame me, but I agree with your instructor(s).

[rad sugar]

Go ahead and flame me, but I agree with your instructor(s).

i'm not going to flame you... but your reply is really vague. can you elaborate?

what aspects do you agree with the instructor(s) on? that we should just "get over it?" do you think that safety on a unit is a reasonable expectation? or do you just think this is the norm and we should be okay with it?

i understand that different units have different norms and risks... we do psych rotations at several facilities and this is the only site at which we (collectively, as a class) have reported feeling unsafe.

its not the psych part that i have a problem with, its the lack of safety measures.

[talaxandra]

I understand why this makes you apprehensive, and also why your instructor is not worried that you'll be unsafe. Would it help if you knew the phone codes etc? I'm sure the staff in the unit would be happy to tell you what they are, as well as how to summon assistance of you need it.

[sharpeimom]

i worked virtually all of my nursing career in psych. you do assume a greater level of responsibility for your own safety when you work psych, because it your patients didn't have problems, they're otherwise healthy and they'd be home.

don't wear earrings, necklaces, bracelets etc. they can be grabbed at. with some patients, we didn't even wear our watches. we pinned them in our pockets. never turn your back on a patient or let yourself be backed into a corner. don't close the door to a patient's room when you are in there.

remember you can't out argue or out discuss someone with bpd. be firm and consistant.

there are many shifts when there is a very fine line between you and your patients... as one old man said to me once, "i used to have papers proving that i used to be sane. did you?"

while always being on the alert, you will relax as you are with psych patients more.

kathy

shar pei mom:paw::paw:

[canoehead, BSN, RN]

I think RNs are expected to get right into the aggressive and dangerous situations. As a student you are observing, and should move to a safe spot if a patient loses control. Remember that in most cases students are not the object of aggression, it's usually staff or families. You also get a few breaks as students, patients with any orientation to reality are more likely to forgive mistakes when you are learning.

[LocoCocoaStudentNurs]

If I were you, I would be skeptical of this facility and always be on your highest alert. What frightens me about this incident is that the facility failed to notify the police that there had been an assault on one of their patients. To me, that gives the appearance that they were attempting to cover up the attack and avoid media attention. Hopefully, the authorities will call them to task over this. That being said, it would lead me to question how motivated the management is to protect their patients, staff, and visitors and how much more interested they seem to be in protecting their income stream.

Basically, I question their integrity and whenever that's the case, you need to be vigilant.