Due to insufficient staffing, I worked three different psych units in two shifts. But maybe more about that later...
Saturday I was scheduled on the geriatric psych unit with two non-licensed staff members. No big deal, as there were only six patients, but it meant that I had to do all the VS, nurse assessments & charting, pass meds, plus oversee the direct patient care.
Near the beginning of the shift, there was an "all available staff" code called for a patient behavior. Unbeknownst to me, a therapist working as a tech left the unit and went to the code. A tech working in the locked community room informed me of this.
When the therapist tech returned, I informed her that she needed to allow the RN to make the decision if she should leave the unit. I said that I would not have advised that, as she was not available. We needed her to cover the hall for patients not in the locked community room.
Two points of contention reared their ugly heads: 1) The therapist tech said she took her "stuff" to the NS on her way out of the unit and the (off going) nurses should have known she was leaving, and 2) she was told two staff members were to be in the locked community room at all times.
First, I informed the therapist tech that I was the RN on the unit after shift change. Secondly, if two staff were in the community room and I was in the NS/med room, all staff would be behind locked doors and the patients in the hall could not be directly monitored.
Well, one thing led to another and, basically the therapist tech refused to follow my assignment, walked off of the unit and said she was going to talk with the house sup. I ended up propping the community room door open with a chair and asked the tech to station himself in the community room and make the 15 minute rounds on the other patients, which he did.
I immediately informed Mandy, the house sup of the situation, and although she was dealing with staff injures due to the patient behavior, got me another tech in a short amount of time. Mandy suggested that I email my supervisor, RoofElmo, and inform her of the situation.
I sent an objective report of the situation, noting that two of the patients not in the day room were bed-bound, incontinent, non-med compliant and psychotic. I added this as a postscript:
"...please allow me to declare my firm belief that keeping locked doors between staff and patients for as long as 15 minute intervals decreases monitoring capabilities and greatly compromises patient safety."
Due to insufficient staffing, I worked three different psych units in two shifts. But maybe more about that later...
Saturday I was scheduled on the geriatric psych unit with two non-licensed staff members. No big deal, as there were only six patients, but it meant that I had to do all the VS, nurse assessments & charting, pass meds, plus oversee the direct patient care.
Near the beginning of the shift, there was an "all available staff" code called for a patient behavior. Unbeknownst to me, a therapist working as a tech left the unit and went to the code. A tech working in the locked community room informed me of this.
When the therapist tech returned, I informed her that she needed to allow the RN to make the decision if she should leave the unit. I said that I would not have advised that, as she was not available. We needed her to cover the hall for patients not in the locked community room.
Two points of contention reared their ugly heads: 1) The therapist tech said she took her "stuff" to the NS on her way out of the unit and the (off going) nurses should have known she was leaving, and 2) she was told two staff members were to be in the locked community room at all times.
First, I informed the therapist tech that I was the RN on the unit after shift change. Secondly, if two staff were in the community room and I was in the NS/med room, all staff would be behind locked doors and the patients in the hall could not be directly monitored.
Well, one thing led to another and, basically the therapist tech refused to follow my assignment, walked off of the unit and said she was going to talk with the house sup. I ended up propping the community room door open with a chair and asked the tech to station himself in the community room and make the 15 minute rounds on the other patients, which he did.
I immediately informed Mandy, the house sup of the situation, and although she was dealing with staff injures due to the patient behavior, got me another tech in a short amount of time. Mandy suggested that I email my supervisor, RoofElmo, and inform her of the situation.
I sent an objective report of the situation, noting that two of the patients not in the day room were bed-bound, incontinent, non-med compliant and psychotic. I added this as a postscript:
"...please allow me to declare my firm belief that keeping locked doors between staff and patients for as long as 15 minute intervals decreases monitoring capabilities and greatly compromises patient safety."
Hence, the above cartoon.