Should I have to deal with this?

[designer-mommy, BSN, RN]

I work in a psych/substance abuse facility, but I think this question is a better fit for the psych forum. So, here it goes:

I struggle with my job A LOT. To say I hate it is an understatement. I don't feel like a nurse doing what I do. I feel like a legal drug dealer. About 90% of my patients just want free meds, and they make that fact well known. Anyway, something that happened last week just upped the ante and changed my job's status from "unbearable" to "completely unsafe and I need to get out of here ASAP." There is a 6'5" patient who is well known to cause TONS of problems and escalate very quickly that came onto my unit once again. He was there for psych problems but we were using the alcohol withdrawal protocol because he drinks also. Well, the ball was dropped two times and it could have cost me my life. About 15 minutes after my shift ended the patient went up to the peer support staff and handed him a fairly large pocket knife. He told him that he was keeping it in case he got depressed enough to slit his throat and then proceeded to say that he was thinking about "slicing up" the previous peer support because he didn't like how he treated him. He also said that he had a box of razor blades in his backpack that had been sitting behind the peer support's desk for hours and hours with easy access. Had this man decided to use that knife on us I wouldn't be here right now. He is huge. Why wasn't this knife found/confiscated on the crisis unit before he came over to my unit? And why wasn't it found by my peer support guy when he transferred over? Several people dropped the ball and it makes me angry.

I already don't feel safe at my job. I have 16 patients on my unit and it is just me and the peer support guy on my shift. That's it. Now I have this experience weighing heavily on my brain and it isn't helping. I can't just up and quit. I have four kids and a sick husband, so yeah, we need the $$. Trust me, if I didn't need the money I would have quit months ago. I can't even tell you how many times I have cried about not wanting to go to this job. It's just horrible. The only good thing about my job is that my boss/coworkers are pretty awesome.

I guess my question is this...should I have to put up with this as a psych nurse? Are psych nurses supposed to feel afraid of their patients? I'm terrified every single time I clock in. I have a great poker face though, and I don't let my patients see it. I still treat them with dignity and respect even though this job is sucking the soul right out of me. Thanks for reading my novel. I appreciate any input you all have!

[caliotter3]

If you truly do not feel safe, then perhaps it is time to resign. Nobody needs the stress and the danger.

[icuRNmaggie, BSN, RN]

Your coworkers are slacking and your patients are bringing in lethal weapons. Two people detoxing a 6 and half foot male pt.

It is unsafe for the staff and the patients. It's ridiculous and someone is going to get hurt. Start applying elsewhere now.

[MrChicagoRN, RN]

No, you should not be made to feel unsafe. what is management's reaction?

The unit should protocols in place to screen for contraband. Those items should have have been caught.

in my dept every patient is screened for contraband and comes from the ER in gowns, with their belongings segregated until searched. Patient is also searched "skin check" before allowed to enter the common areas of the area, or their room.

i hope an incident report is generated for each occurance. Paper trails (preferably electronic ones) help create accountability, and generate change.

[Farawyn]

You need the money, but if you get sliced up by this giant the point is really moot. Get out now.

[Graduatenurse14]

I worked in a child/adolescent psych hospital as milieu therapist (peer support staff is the same, I think) and we had two of us on the unit at all times. The RN's were outside the locked unit but in and out all of the time and all patients were checked and wanded before being admitted to the units during Intake/Admission.

There needs to be more staff on the unit! That ratio isn't safe at all!! They need to do a much better job of checking their belongings in the beginning!! That's crazy!! It's for their protection as well as the other patients and staff.

In this case, I really think that anonymous phone calls/letters/emails to the bigwigs of the facility/State/County/OSHA/JC/whoever else you can think of. Someone may very well get killed at that place!

Remember this- when working with very vulnerable populations- mentally ill, substance abusers, inmates, etc. - the onus on the facility to keep them safe is very high, the consequences for staff that allow harm to come to them can be harsh. It didn't used to be this way and there was a lot of egregious neglect and abuses so these populations are very well protected now in the US.

Please be careful!! Good luck to you, I mean it.

[VivaLasViejas, ASN, RN]

That whole scenario sounds like a nightmare. One nurse and a tech for 16 patients?! What kind of hospital staffs like that? It's very dangerous for all concerned, and the fact that the patients aren't screened properly is scary indeed.

When I was in the hospital recently, we had two nurses on days/eves for the 8 of us, and at night there was one nurse and a tech. I also don't understand how a patient can get a knife into a psych unit. I remember not even being allowed to bring in my own pillows, and the bag my husband brought in for me was searched thoroughly and the bag itself locked up until I was discharged. (I never did quite figure out how a tote bag with small handles could be considered a threat.....but then, I'd never seen someone hack at his wrists with the business end of a toothbrush either, and I did when I was inpatient.)

In the OP's position, I would seriously consider finding another job, fast. The level of staffing and the lack of protection for staff and other patients are horrendous. Best to "git while the gittin's good"!

[icuRNmaggie, BSN, RN]

I just want to ask the OP would you put your child or another family member in that situation.

Of course you would not put them in harms way, so don't do it to yourself.

You would be much safer working in a county jail and the benefits are better than the hospital by far.

I would transfer to dietary security or housekeeping or work at Market Basket before I would risk my life like that I truly would.

[psychnursie]

1 nurse and 1 peer support for 16 pts? we would have 2 nurses and 3 techs for that. that sounds totally unsafe!

[Davey Do]

What MrChicagoRN said....

Also:

Document the situation and present the documentation to Administration as changes need to be made. If you continue to feel unsafe, give your Notice.

Unemployment Benefits will be awarded to you based on the Fact that your Working Environment is an Unsafe one.

[lifelearningrn, BSN, RN]

No, you should not have to deal with this. What will your four children and sick husband do if you are killed or seriously injured? You need to look out for your own well being here too... I'm sorry you're struggling so much at work, I think it's time for you to start looking for something else, asap.