To be clear, I in no way implied the Dr's or Nurses or any regular staff should be put in harms way, however, nor do I accept that this is the only solution short of denial of care. This in no way seems binary to me, the behave or get out thing is not reasonable when these institutions collect a great deal of public and tax based funds if they accept Medicare etc.
In my first post ( at the very bottom) I offered what is, to me, the simple solution of facilities hiring many more staff whose sole purpose is mental health care and evaluation and management if restraint of some kind is necessary. This may or may not be a solution but it would seem these facilities are both the best well placed and have the highest contact rate with the at risk populations, not to mention they have the countries ear more often than not.
As a society we really do need to decide what we are doing, it seems a pivot to something else is necessary. When a person is acting out, as we've even seen here on the boards, literally THE VERY FIRST THING people say is, "Please go get help and talk to your Dr." and this is also true in real life. So if that institution is not going to pick it up the line, who then? We are seeing a massive uptick in violence and stories like what happened with Adam Lanza's mom being unable to get help, which are heartbreaking to me. None of this is going to do anything but grow unless we all take the bull by the horns. There has got to be something to be done.
Not putting this on Dr's or Nurses, they are physical caregivers, this is a non physical manifestation of maybe physical things and it requires a whole different set of skills on deck.
It would be nice, but there aren’t any simple solutions. There never are, in a hospital. Everything is extremely regulated and policied to the nth degree, and those have to be followed if people want to keep their jobs, licenses and accreditations, etc.
What they are talking about is the general patient population becoming more abusive. It’s not just from psychiatric patients. And psychiatric patients don’t exist in a bubble. In a hospital, there may be psychiatric units perse, but they are also mixed among the regular population because they have medical issues, too - sometimes in double rooms or wards; certainly in waiting rooms and common areas, etc. If it’s strictly psychiatric issues, they might be discharged to a psychiatric facility after initial evaluation. But someone who’s got acute medical issues who happens to be mentally ill may have a much longer admission on a unit appropriate to their medical situation.
As I said, it’s very hard to find staff right now to deal with these types of things at relatively low pay when they can do a much easier job for the same amount and not risk their lives where someone tries to strangle or whack them (not to mention dealing with lots of yucky stuff, lol).
Having a patient in restraints isn’t ideal, and it takes a huge amount of oversight. Patients have to be viewed every 15 mins and that has to be documented, as well, with a goal to get them out of restraints asap. (If not documented correctly the hospital could be cited during an audit.) They may also require medication administration for their agitation. Someone can’t really stay in restraints constantly. (I mean, they can if necessary, but there’s a lot to it.)
I think there is a long way between “staff shouldn’t be put in harm’s way” and “this is the only solution short of denial of care”. I highly doubt there will be much denial of care. Certainly not routine, IMO. They said they would investigate issues to see what the circumstances were, and why it happened, and take it from there. People will likely have a chance to apologize and change their behavior if they are able. In certain organic circumstances where they don’t have control, that will be looked at (and IMO, understood). There will be a few outliers who are just being jerky - that’s who I think this will impact the most.
