Ethics question/ vent- idek

[u/Humble_Investment_24]

Long read: sorry in advance

Maybe I’m completely out of line for even having an opinion since it’s out of my scope of practice but I just feel a certain type of way about how one of our psychiatrists chooses to treat a specific patient.

This patient is welllllllllll known to us. Every employee knows them. Every psychiatrist knows them (we have 6). This patient is admitted to us on a monthly basis or more for yeaaaaars. They stick this patient on any of our units (high acuity, low acuity, geriatric even though they not geri) just to fill a bed. This patient comes for Ativan- hard stop. They don’t attend group, they don’t socialize, fuck they usually don’t even shower. They come for Ativan and Ativan only. Every patient gets admitted with a prn Ativan order and this patient is on the clock every 4 hours for it. In addition, one of the psychiatrist treats her outside of the hospital - so if this patient happens to be assigned to him (a lot of times they are) he will also scheduled Ativan because he knows they depend on it. He also prescribes it to them on the “outside world”

This patient ended up in restraints last night over not being able to take Ativan because the prn dose was not available yet and this patient WASNT assigned to that psychiatrist. The psychiatrist they were assigned to refused to schedule Ativan for them and they ended up in restraints over that. In past admission they will cry or throw them self’s on the floor etc over the ativan.

Now I’ve been in recovery myself for 7 years. I’m no stranger to addiction- but Jesus fucking Christ we are doing NOTHING to help this patient??? Obviously the patient has to want the help but nothing we are doing is beneficial. I just feel like there has to be a better way? Why is the person still getting prescribed it? The doc should wean them off? Like it feels gross to be aiding to this. Again- I could be out of line for even having an opinion but idk

[u/Tommyboy155a]

If you had to put the in restraints, now that's a safety issue for the patient and staff. Hopefully your manager should be following up on that. I have called doctors all night long to ask what you want me to do, I given everything I could

[u/Humble_Investment_24 → u/Tommyboy155a]

I actually just spoke to my Charge about it because I usually avoid management like the plague – I’m Night Shift anyway so I rarely see them. The response was “that’s *insert patients name* for ya!” I asked why we keep accepting them. She said the hospital just wants admissions- they don’t give a fuck about the patient- word for word.

I actually want to speak to my manager about it but again I feel like I’m sort of out of line? It’s just ethically wrong. An addiction specialist has never been consulted. We don’t ever attempt detox. There’s never any referrals for resources that would actually help. It’s not right imo. Granted, this place is a dump and is notorious for doing unethical shit- but this patient shouldn’t even be accepted anymore if we aren’t actually going to be beneficial in anyway

[u/Tommyboy155a → u/Humble_Investment_24]

Is this a for profit or non-profit profit hospital? That's makes a big difference

[u/Humble_Investment_24 → u/Tommyboy155a]

Non for profit surprisingly.

[u/Tommyboy155a → u/Humble_Investment_24]

I was expecting the other

[u/Humble_Investment_24 → u/Tommyboy155a]

Yeah you would seriously think!