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Does an RN on a psych unit have any recourse if management ignores her concerns about being the only staff member on the unit?

Monday September 1, 2014
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Question:

Dear Nancy,

I work in a psychiatric hospital on a small unit where the patients are, for the most part, emotionally stable. Often am the only staff on this unit. When I voice concern about potentially aggressive patients, I am told I should be able to handle it even if I am the only staff person on the far end of the hospital. If something happens to me, is there anything I can do or am I out of luck? When I accepted the position, I was not aware I would be expected to put myself at more of a risk than when working on a regular inpatient psych unit.


Beverly



Dear Nancy replies:

Beverly,

Having only one staff member staff on a psychiatric unit is not a wise idea for many reasons, one of which is the potential for unpredictable behavior, not only aggressive behavior, but also suicidal or self-mutilating behavior. Moreover, those patients who may need more observation or even need to be placed on a 1:1 watch will not receive the care they require, and that lack of required care can result in injury to the specific patient as well as other patients on the unit.

You should bring your concerns to the CNO, the COO and the risk manager of the psychiatric hospital. Not only are they placing you and the patients at risk, the facility is at risk for any injury that might occur due to understaffing. If you are injured, the facility faces a claim under workers' compensation. If patients are injured, it runs the risk of being sued for negligent staffing, among other allegations.

If your concerns continue to go unheeded, you may want to consult with a nurse attorney or other attorney in your state who can advise you of required staffing numbers and other requirements necessary for the facility to continue its accreditation. The attorney may also discuss with you the need to share the unmet staffing requirements with the state agency that licenses psychiatric facilities. The attorney you consult with can help guide you with reporting or whistleblowing the conditions under which you work, and under which the patients are cared for, with your protection in mind.

Sincerely,
Nancy




Nancy J. Brent, RN, MS, JD, is an attorney in private practice in Wilmette, Ill. This information is for educational purposes only and is not intended as legal or any other advice. The reader is encouraged to seek the advice of an attorney or other professional when an opinion is needed.