What type of security do you have in your psych facility???

[ecipsoh]

I am a new grad nurse. I found a RN position working with in a psychiatric facility for troubled adolescents. I am curious as to how other facilities are operated. This one has residential counselors who ideally work 5 children to one counselor, but it ends up being considerably more than that since the facility has a large turn over of workers. When there is a crisis on one of the units it is the residential counselor, usually female and a nurse who are responsible for maintaining the crisis. This means restraining if need be. The kids run in age from 7 to 21 and some are quite large and violent. Last week three codes were called on three separate units simultaneously, so there was no backup counselors to help restrain the fighting adolescents. The older adolescents broke free from their unit and it was up to three nurses all female and one residential counselor to get them back on their unit. This of course did not work and the police were called. They did not want to come in and said they were not security for that building, but eventually did help when they found out the residents had taken the keys and soon it would become their problem. I have only been there two weeks and I have resigned, but I am left with questions of what a facility uses for security, and what or whom should I contact, because this was the mildest of the crisis I witnessed in two weeks. Is this "the norm"????? Thank You

[pinkiepie_RN]

In the facility at which I'm a tech (free-standing psychiatric hospital), at least 1 if not 2 security guards show up to each code. Every unit has a pager and when a code is called, the pager goes off and usually 1 tech from each unit is responsible for attending to a code if called during the shift. The shift coordinator also responds, in case the code results in a patient getting LDS or restraints (and that unit needs extra staffing). I've never been in the hospital when multiple codes were called, though I have heard of when multiple codes were called on the same patient during one shift. What happened to you doesn't sound safe at all. No offense, but gee I wonder why the staffing turnover is so high? Good call on getting out of there!

[rachelgeorgina]

In the private, stand alone clinic I have experience with there are four 'wards' and an ICU. Every nurse and staff member wears a duress and if security is needed, the nurse hits their duress and a nurse from each of the units and ICU will come running. One nurse on each unit per shift wears the "red tag" which indicates they are the runner for the duress. That's five nurses on the scene straight away.

In the locked, acute adolescent facility I have experience with, again, the nurses wear their duress alarms but when they hit their duress, hospital security comes running (i.e. big burly guys in uniforms!) They get the patient into seclusion and hold the patient down for an injection if it's needed.

[elkpark]

In the free-standing inpt. facility in which I work, we page overhead for "codes" and additional staff from the other units respond. If that is not sufficient, we could call for security personnel from our sister-facility general hospital across the street, but that would take a while.

[ecipsoh]

Thank you for your responses. I left out a few incidents on purpose, so not to sound so dramatic, but after reading your posts, I know this place needs security. This was my first experience in a psychiatric facility, so I just didn't know what to expect.

[aloevera]

our security people have all been let go.........on our codes, techs from other units and the supervisor shows.........usually enough to handle things...but I certainly miss our security guards !!!!

[ecipsoh]

Your description sounds similar to the facility where I was working. On evening duty the supervisors usually were gone leaving the "residential counselors" and the nurses. On this one night it took ten police men coming in to get safety back to the unit and facility. They were not to happy about being the "security" for this place either. This place can not keep it's workers and it is simply from cutting out the security.

[TIMBO9205]

I work as a psych tech on a 32 bed acute care unit attached to a small hospital. We generally have 2 nurses and 4 techs on the night shift. I have worked nights when a code was called and nobody from outside the unit responded. The police will no respond either because they are not allowed to bring firearms onto the unit. We usually do ok, but some nights the patients and the staff do not feel safe.

[lapswimmer]

At our facility we overhead page a "code gray". Throughout the hospital there are individuals who are trained in CPI and they usually respond. Security must also respond.

We have a 21 geriatric unit and 19 bed adult unit. That will soon change as we get another 30 beds. Psych beds will make up about 30% of all the beds in the hospital.

When I was in nursing school back in the day, I worked as a CNA/Mental Health worker at a psych only hospital on a geri unit but was often called to codes on the adolescent unit. Police were often calle don weekends when staffing was minimal.

Joe, RN

[tempest]

I work on the acute psych unit of a major university hospital. We have awesome techs and security here. No problems that I have seen.

[Nurse Turbo]

I thought I had it bad!!! I'm a nursing supervisor for a state psych hospital in NJ. We call a 'code gray' and people come out of the woodwork! Psychiatrists, nurses, social workers, techs, even other patients try to help! Usually everything is situated within 5 minutes but there are those times when no one is there and all hell breaks loose! We recently got new administrators and they do the strangest thing.....listen to us, provide change, AND ask for feedback! I never thought life at 'the plantation' could have such a positive change!

[wonderbee, BSN, RN]

Inpatient free standing psych facility here. If not for our awesome security officers, it would be like being thrown in a cage with wild tigers. They respond to an emergency page pronto, at least two but usually three of them. Elevators are dedicated while there is a code going on. If they are not enough to handle a situation, we call a general overhead code that brings a specially trained team from all parts of the hospital.

With the closing of state hospitals, acute care facilities are becoming the new catchment for forensic patients. A specially trained and dedicated security team is vital.