Optimum Care For Psychiatric Patients. I worked at a hospital as the Charge Nurse on a psychiatric Crisis Unit, which was attached to the Emergency Department. The purpose of the Crisis unit was the treat patients who were experiencing either acute or chronic psychiatric issues. However, a large number of addicts would arrive at the facility with suicidal ideation or asking for help to get off drugs. I have never witnessed a poorer level of care than that exhibited by the Psychiatrist and other Nurses towards the Addicts.
The psychiatrist would not admit drug addicts, typically stating the reason “I am not going to take up a Psychiatric Bed for an Addict.” Instead the drug addicted patient would be held on the crisis unit until the psychiatrist was certain that they were a safe discharge the next day. Many of the Nurses would state how they hate drug addicts. The Emergency Department Physicians would intentionally not do comprehensive workups on the Drug Addicts.
Optimum Care For Psychiatric Patients. I started my own Excel Spreadsheet cataloging all the variances in care. The Emergency Physicians were supposed to medically clear the Emergency Patients that were going to sent over to the crisis unit. I was working there to get some experience in psychiatric nursing. I had a very strong emergency/trauma background prior to working there. I would assess these crisis patients admitted to my unit only to find that Emergency Department had missed fractured wrists, arms, cardiac issues, upper & lower gastrointestinal bleeds, actually overdosing on my unit, and one guy who had ingested floor stripper and was coughing up blood, but the ER doctor did not believe him.
I finally went to Emergency Nurse Manager and she blew it off. So then I saw the Director of Nursing and she blew it off. Then I went to Chief Emergency Physician and he blew it off.
It was then that I realized that nobody cared! I didn’t sign up to be a Professional Nurse to stand idly while healthcare professionals treated the psychiatric patients like crap. What Did I Do? I reported the whole thing to Joint Commissions and sent them the data I collected. I told the Director of Nursing that I reported them to Joint Commissions. Than I resigned.
Optimum Care For Psychiatric Patients. In about one week the Chief Emergency Physician calls me up on home phone to ask me Why did I report the facility to Joint Commissions? I said because you, the Emergency Department Physicians , Psychiatrists and some of the Professional Nurses are failing to deliver an acceptable standard of care to patients. I said that I had made you aware about it and you did not act so it is what it is! Than I said, in medical school you must have missed the class on medical ethics. Your not a judge or jury deciding who gets a standard acceptable care and who doesn’t.
Optimum Care For Psychiatric Patients. Then, about a day or two later I get another telephone call from the Vice President stating because I left employment without the customary two weeks notice, they could not pay me my accrued vacation. I said SO WHAT! Than the VP says well we can pay you your vacation and the bonus you earned if you sign a document to agree to help them should legal matters arise. I SAID NO THANK YOU, I WON’T ACCEPT THAT MONEY. MY ETHICAL VALUES ARE NOT FOR SALE.
The bottom line is that Healthcare Professionals should control their biases and treat everyone including the Psychiatric patient population with the same good standard of care. A lot the Drug Addicted population were reporting Suicidal Ideation and the Psychiatrist, Crisis Staff and Nurses were vehemently opposed to take a psychiatric bed for an Addicted Patients. Instead the addicted patient was given a bus pass and the address of the Division of Substance Abuse to ask them for help.
CE: Suicide in the Hospitalized Patient: Improving Identification, Safety Care and Prevention: