I was orienting a brand new nurse. …today we were assigned to the “psych” rooms. In the Emergency Department, there are six designated rooms that have an ability to lock for patient safety and the patients that are seen in these rooms often require a psychiatric evaluation. Shelby was aware of the new challenge that this assignment could bring, but she seemed up for the task. I remember Shelby starting to get overwhelmed as the day went on. I instructed her to focus on the patients that she was already assigned…. We kept getting ambulance after ambulance and eventually got to the point that our “psych” rooms were full but we had to triage appropriately to place patients who were a risk to themselves and to others into the rooms that had the capability of locking. The fact is that we were busy and, even to the experienced nurse, this could be very overwhelming and difficult to perform our duties properly.
Ralph, he is a middle-aged man, known schizophrenic, and can often be verbally abusive to staff. Shelby had her first encounter with this gentleman and, although he was not abusive in any way, she felt that he was a ticking time bomb.