Well said. I find the mention of EmPath units interesting in the comments. When I retired two years ago, our administration had closed the Behavioral Assessment Unit in the ED; it had functioned quite well for many years, but then when our state psychiatric hospitals had beds shut down by the federal government, transferring patients in need of care at those facilities became a nightmare. A friend of mine who has only worked psych her entire career worked in that unit for several years and said that the problem now is that patients are much more prone to violence. The havoc drugs has wrought on their brains has literally rewired them and they are extremely resistant to many medications (as I am sure you have noticed.) Add to this the lack of inpatient treatment for alcohol/drug dependence (there are literally NO programs in our area for that, everything is outpatient here.) An "intermediate care unit" was created that was supposed to house medically complicated behavioral health patients; however, due to beds at capacity everywhere, it was a constant battle to place other patients in there.
Shauna, thank you for the comment. I agree. Our psych patients are often exactly the same as our substance abuse patients and they are aggressive and manipulative. And more so than in the past. I believe that the enormous amounts of THC folks use have caused them to be more confused and agitated; even more so when mixed with meth. There is no place for these folks to go. None. The ED is it and we can't manage them. Meanwhile hospitals build beautiful new cath labs or birthing centers but leave the chaos in the ED.
I think had I not worked in Bed Placement for 12 years I would not have realized the extent of the problem. It especially ballooned in our city after one of our local psychiatrists who took on more of the difficult patients like these was murdered by one of his clients at his clinic. Situations like this just make it more difficult as other practices refuse to take in these clients because of their manipulative and oftentimes destructive and dangerous behaviors--which leaves the ER staff very vulnerable.
And yet, nobody is supposed to protect themselves and the hospitals generally won't pay for quality security. A deputy once told me that the ED was the most dangerous place in the county...
Well said. I find the mention of EmPath units interesting in the comments. When I retired two years ago, our administration had closed the Behavioral Assessment Unit in the ED; it had functioned quite well for many years, but then when our state psychiatric hospitals had beds shut down by the federal government, transferring patients in need of care at those facilities became a nightmare. A friend of mine who has only worked psych her entire career worked in that unit for several years and said that the problem now is that patients are much more prone to violence. The havoc drugs has wrought on their brains has literally rewired them and they are extremely resistant to many medications (as I am sure you have noticed.) Add to this the lack of inpatient treatment for alcohol/drug dependence (there are literally NO programs in our area for that, everything is outpatient here.) An "intermediate care unit" was created that was supposed to house medically complicated behavioral health patients; however, due to beds at capacity everywhere, it was a constant battle to place other patients in there.
Shauna, thank you for the comment. I agree. Our psych patients are often exactly the same as our substance abuse patients and they are aggressive and manipulative. And more so than in the past. I believe that the enormous amounts of THC folks use have caused them to be more confused and agitated; even more so when mixed with meth. There is no place for these folks to go. None. The ED is it and we can't manage them. Meanwhile hospitals build beautiful new cath labs or birthing centers but leave the chaos in the ED.
I think had I not worked in Bed Placement for 12 years I would not have realized the extent of the problem. It especially ballooned in our city after one of our local psychiatrists who took on more of the difficult patients like these was murdered by one of his clients at his clinic. Situations like this just make it more difficult as other practices refuse to take in these clients because of their manipulative and oftentimes destructive and dangerous behaviors--which leaves the ER staff very vulnerable.
And yet, nobody is supposed to protect themselves and the hospitals generally won't pay for quality security. A deputy once told me that the ED was the most dangerous place in the county...
I don't doubt it!