help. Many are so
manipulative, they can't be trusted. I doubt many of them even want to get
well. Jim does. That is the impetus driving my 'involvement' in this
case." Donna was enraged and felt attacked.
Monique
was quiet for a moment and then spoke. Her voice was repentant and
reassuring. She'd accepted Donna's rebuke with grace. She shook her head and
said, "I'm sorry, I apologize. I know how you feel, Donna. I have a
special place for Jim myself. But, we have to keep it all in perspective. I
am sorry if you think I suggested that your involvement is anything other than
professional," Dr. Desmonde's voice was pensive and apologetic. She
hugged Donna around the shoulders and added, "Nice job in there,
gal."
Donna
hugged her back. "Thanks Monique. But, you and I both know we've gotta
do something about this place and the staffing. That situation could have gotten
completely out of hand -- the one last night did! My nurses are scared.
Several are terrified and are planning to leave the Pavilion." Donna
stopped for a minute and then admitted, "I'm scared too, and that's not
even factoring in what happened to Angie. The patients are getting sicker and
sicker and more and more violent, especially since we started taking the ones
from the state hospital that Lester Whitset contracted for. We're not staffed
for those types of admissions."
Dr.
Desmonde sighed. "Yes, yes. I know, Donna. I'm trying to get more
positions allocated, even if they are only muscle positions. I'd be thankful
to have strong bodies to help us in emergencies like this one today. Since
we've been under this contract management, it's next to impossible. We need
more behavioral health techs to help us out when we have these outbursts of
violence."
Alex
nodded in agreement with Monique and said to Donna, "I'm concerned about
your staffing, too. You don't have enough staff to handle such severely ill
patients and control these kinds of situations. What's your typical
census?"
Donna
responded quickly. "We've got 22 general psychiatry beds and average
about 18 or 19 patients. Usually, 8 or so of them are overtly psychotic and
have histories of violence or acting out behavior. The rest are acutely
depressed or have organic brain syndrome and/or Alzheimer's disease."
Alex
nodded in understanding. "How long have we been mixing the elderly and
the adolescents with the others? I thought they used to be separated."
Alex asked, looking questioningly at Monique and Donna.
Donna
shook her head and answered, "We started mixing them at the time the
contract manager started. Whitset cut our staff 20%, making it impossible to
run an age differentiated behavioral health unit. He maintains that a
therapeutic milieu can occur with all ages together, so everyone can ‘learn
from each other'! Isn't that some crap? We've even had to eliminate
geriatric and adolescent tract therapies. We couldn't staff them!"
Donna's voice reflected her dismay.
"How's
it working?" Alex asked.
"Not
well, not well at all I'm afraid," Donna said. "The patients just
don't identify with each other because of their ages. Mrs. Smithson, the
elderly patient with the apple cheeks, is appalled when the adolescent female
patients talk about their sex lives and how they have to have "it"
every day. The way they talk about sex is disgusting to Mrs. Smithson and I
know it horrifies her. In fact, her son told Angie last night that he thought
she was worse. He said he was gonna transfer her to Ochsner's private
geriatric program. I don't blame him. She could get better care there, at
least more care directed towards her age group. I'd move my mother over
there, as opposed to here, so she could get better care. No question about
it." Donna shrugged her shoulders.
"Is
Mrs. Smithson the little lady who looks like Mrs. Santa Claus?"
Monique
and Donna nodded.
"Why's
she here?"
"She's
in for a
manipulative, they can't be trusted. I doubt many of them even want to get
well. Jim does. That is the impetus driving my 'involvement' in this
case." Donna was enraged and felt attacked.
Monique
was quiet for a moment and then spoke. Her voice was repentant and
reassuring. She'd accepted Donna's rebuke with grace. She shook her head and
said, "I'm sorry, I apologize. I know how you feel, Donna. I have a
special place for Jim myself. But, we have to keep it all in perspective. I
am sorry if you think I suggested that your involvement is anything other than
professional," Dr. Desmonde's voice was pensive and apologetic. She
hugged Donna around the shoulders and added, "Nice job in there,
gal."
Donna
hugged her back. "Thanks Monique. But, you and I both know we've gotta
do something about this place and the staffing. That situation could have gotten
completely out of hand -- the one last night did! My nurses are scared.
Several are terrified and are planning to leave the Pavilion." Donna
stopped for a minute and then admitted, "I'm scared too, and that's not
even factoring in what happened to Angie. The patients are getting sicker and
sicker and more and more violent, especially since we started taking the ones
from the state hospital that Lester Whitset contracted for. We're not staffed
for those types of admissions."
Dr.
Desmonde sighed. "Yes, yes. I know, Donna. I'm trying to get more
positions allocated, even if they are only muscle positions. I'd be thankful
to have strong bodies to help us in emergencies like this one today. Since
we've been under this contract management, it's next to impossible. We need
more behavioral health techs to help us out when we have these outbursts of
violence."
Alex
nodded in agreement with Monique and said to Donna, "I'm concerned about
your staffing, too. You don't have enough staff to handle such severely ill
patients and control these kinds of situations. What's your typical
census?"
Donna
responded quickly. "We've got 22 general psychiatry beds and average
about 18 or 19 patients. Usually, 8 or so of them are overtly psychotic and
have histories of violence or acting out behavior. The rest are acutely
depressed or have organic brain syndrome and/or Alzheimer's disease."
Alex
nodded in understanding. "How long have we been mixing the elderly and
the adolescents with the others? I thought they used to be separated."
Alex asked, looking questioningly at Monique and Donna.
Donna
shook her head and answered, "We started mixing them at the time the
contract manager started. Whitset cut our staff 20%, making it impossible to
run an age differentiated behavioral health unit. He maintains that a
therapeutic milieu can occur with all ages together, so everyone can ‘learn
from each other'! Isn't that some crap? We've even had to eliminate
geriatric and adolescent tract therapies. We couldn't staff them!"
Donna's voice reflected her dismay.
"How's
it working?" Alex asked.
"Not
well, not well at all I'm afraid," Donna said. "The patients just
don't identify with each other because of their ages. Mrs. Smithson, the
elderly patient with the apple cheeks, is appalled when the adolescent female
patients talk about their sex lives and how they have to have "it"
every day. The way they talk about sex is disgusting to Mrs. Smithson and I
know it horrifies her. In fact, her son told Angie last night that he thought
she was worse. He said he was gonna transfer her to Ochsner's private
geriatric program. I don't blame him. She could get better care there, at
least more care directed towards her age group. I'd move my mother over
there, as opposed to here, so she could get better care. No question about
it." Donna shrugged her shoulders.
"Is
Mrs. Smithson the little lady who looks like Mrs. Santa Claus?"
Monique
and Donna nodded.
"Why's
she here?"
"She's
in for a
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