I have the pleasure this year of being the
GBMC Senior Team member who is assigned to Unit 36. Each of us on the Senior Team
works with two units to narrow the gap between what the “front office” knows
and what the “front line” knows.
Unit 36 is our Medicine/Psychiatric Unit. The
Unit cares for people with mental illness who also have acute medical needs.
The leadership dyad of Nancy Amann-Santos,
RN, the unit manager, and Darin
Lerner, MD, the medical director, are two of the most dedicated people I
have ever met. Everyone who knows anything about healthcare knows how
challenged our mental health system is. Nancy and Darin deal with this
dysfunction everyday and they never lose sight of the reason why they and their
Team are there…to deliver the care to their patients and families that they
would want for their own loved ones. But
boy is it hard!
This morning I went to the Team huddle at
change of shift at 7:15 AM. Nancy showed me the Team metric board that showed,
among other things, recent hand hygiene audits that were at 100% compliance and
many days of no patient falls with injury. I then listened while the staff debriefed
on an incident where family members who were not associated with the same
patient but who evidently knew each other, got into a verbal altercation on the
Unit.
Trina
Griffin, RN
explained to the group how she had acted to deescalate the situation, avoid
getting the patients upset, and get the visitors to act appropriately. The Team
quickly brainstormed on other things that they could change to avoid this type
of problem in the future. They then discussed two other patients: one who was
admitted with a significant medical problem but who also had obsessive
compulsive behaviors and the other who could not understand why it wasn’t safe
for him to get out of bed by himself.
Working on an inpatient unit where the
patients understand the care and are generally grateful is hard enough –
dealing with the same issues in a population who does not always understand and
who may take actions to harm themselves or others takes it to a whole new
level. The Unit 36 Team comes to work every day to get to better health, and better
care with less waste for their
patients. You can feel their joy in
knowing that what they do means so much to their patients and families, even if
the patients….and sometimes the families…don’t always understand. I am very
proud of them and very grateful for all that they do.
I went to the Schwartz Center Rounds when the staff of Unit 36 presented and I thought, "wow, our staff should hear this - it would give them a whole new perspective on what they consider to be "difficult" patients." I give a heartfelt salute to the men and women who work with this very difficult population. You are truly doing God's work.
ReplyDeleteDr Chessare, we do not have to go to unit 36 to deal with the challenges that the staff face in that unit. Take an elderly patient in a new environment, medicate them for their pain with a little dose of narcotics and here we get a challenging patient. In unit 36, nurses get 4 patients, the security officer is right in the unit, in the other units we deal with the same challenging situations and we get up to 6 patients. Thanks to all the staff who try to keep patients safe no matter how challenging they are.
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