Facts of the Case
Greenville community Hospital shared the facilities with a psychiatric hospital with clearly stipulating the demarcations between them or the extent to which they can interact in the course of their operations. Such coordination and sharing of facilities are responsible to the latitude enjoyed by the patients of all kind to move freely within the two facilities. The two institutions lack proper securities measures that could guarantee not only the safety of the patients but also provide a safe working environment where the staff can confidently discharge their duties. Similarly, the management has not made any attempt at solving the persistent challenges that the two health facilities have been facing. The collaboration between the two hospitals has led Greenville community Hospital to perform roles and duties such as admitting psychiatric patients which was not part of their original mandate.
Management implications
The management general has the obligation to ensure a smooth running of the health institutions, failure to perform such roles amicably can lead to a systemic failure of the whole institution. The management of Greenville community hospital failed to address pertinent issues that involve the safety of their employees and the patients. The management also has its misdoing in regards to the failure to guarantee the safety of her staff; this is because the staffs have to work under a cloud of fear of their life. The incident in which the Rosemary was chased by a deranged patient, demonstrates the risks taken by the staff in their process of discharging their duties and responsibility. The mismanagement of the institution in which it admits the psychiatric patients against the set mandate of the institution, erroneously, the management entered into the collaboration with the psychiatric hospital with establishing terms of engagement and interaction that would otherwise allow them to effectively manage their institution.
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Role of management in employees’ protection
The management has a more pronounced role in providing a safe working environment for their staffs and ensures that their stay protected in the course of their duty. “Health care organizations should establish non-punitive environments and systems for reporting errors and accidents within their organizations” (Institute of Medicine, 2002), this will allow the institution to have the understanding of the safety situation within their facility. Similarly, the management should strive to get relevant knowledge that will help in understanding the reasons for hazardous conditions and ways to reduce the vulnerabilities of the staffs. Greenville hospital management should develop terms of engagement with the other facility in order to ensure that free movement of the patient is limited and confined to the stipulated areas.
Legal and ethical obligations of GCH
It is the responsibility of the management to take care of her employees and guarantee their safety and security whenever they are discharging their duties and responsibilities on behalf of the institution. Therefore, had Rosemary been injured in the altercation with the psychiatric patient, the management would have taken the responsibility and blame for the incidence. Being that the management is supposed to guarantee safety within their institutions, it would also be on the receiving end should a visitor attack another patient or any form of conflict arises within their institutions. The workplace safety laws stipulate that it is the responsibility for the administration and enforcement of the laws enacted to protect the safety and health of workers in America.
The healthcare institutions have both legal and ethical obligation to their staff and the patients, all set with the aim of providing a safe and working environment for the delivery of medical care. For the patients, the ethical obligation of the GCH management lies in ensuring the confidentiality and privacy of their patients at all time, however, the patients in the GCH did enjoy this ethical obligation. Their rooms were easily accessed by other patients and the staff such that their privacy was compromised. On the other hand, the management has the ethical obligation to their staff by ensuring they have favorable working environment and offer good leadership, Thomas (2009) argues notes that the management has the ethical obligation to “uphold the values of the hospital: excellence and innovation, patient-centered Care, teamwork, collaboration, respect and diversity and leadership.” Unfortunately, the GCH has failed to live to this moral obligation, the values such patient-centered care which can be enhanced through a proper working environment has not been adhered to. Similarly, by law, the management has the legal mandate to ensure safety and well-being all staff and the patients within their precinct, however, GCH management failed to guarantee this legal obligation to both the patients and the staff equally.
Optimum physical space for patients
Considering the health condition of the psychiatric patients, the physical space required is quite limited because in some cases, the patients are violent and need to be confined within their rooms to reduce cases of their destruction and disturbance to other patients and the staff.
To improve security, panic alarms need to be installed within the hospitals, nonetheless, locating the panic alarm in the patients’ rooms, at the nurse’s station or in the safe room, comes with varied costs. It would be cost-effective to put the alarms in both patients’ rooms and the nurse stations as it would help in advancing security measures for both the patient and the staff, it would also help in calling immediate response.
Failure to take action in regards to providing security and safety of the people will come with adverse costs and implication. Both patients and staff can have their safety compromised; “the hazards of nursing work can impair health both acutely and in the long term” (Trinkoff, at al, 2008). In terms of cost, the institution would have to bear the high cost of compensation and litigation fees for the staffs and patients who might have been affected by the failure of the management to address the safety issues. Therefore, the cost of doing nothing would be severe than the one which would have been incurred in the installing panic alarm.
Emergency plan
Considering the nature of the situation in the GCH, staffs need an emergency to plan in standby before the management could take a robust action to effectively solve the menace. First, the staffs should hold an all-inclusive discussion to deliberate the area’s hazards, risks, and vulnerabilities that are common within their work units that will require emergency measures and response; in this case, their safety which is normally affected by the rogue psychiatric patients and violent visitors. Having analyzed the areas of potential risks, the staff needs to determine and assign tasks and actions to be taken. In the case of a violent and aggressive patient, the action plan may include developing “Skilled communication, non-confrontation, relationship-building and negotiation represent the best way to manage situations and avoid harm” (Harwood, 2017). Similarly, the staff may desire to know about de-escalation and non-drug approaches, but also be con dent about when physical restraint and drug treatment are necessary, and how to go about using appropriate drugs, doses, monitoring and aftercare. In this case, the staff should consider adjusting their plans to fit the resources at their disposal. The staff should ensure that they develop communication strategy as well as response plan from the relevant persons.
References
Harwood, R. (2017). How to deal with violent and aggressive patients in acute medical settings. Journal of the Royal College of Physicians of Edinburgh, 47 (2), 176-182. doi:10.4997/jrcpe.2017.218
Institute of Medicine (US) Committee on Quality of Health Care in America; Kohn LT, Corrigan JM, Donaldson MS, editors. To Err is Human: Building a Safer Health System. Washington (DC): National Academies Press (US); 2000. 8, Creating Safety Systems in Health Care Organizations.
Thomas, J. (2009). Ethical and legal issues in medical practice. Indian Journal of Urology : IJU : Journal of the Urological Society of India , 25 (3), 335–336. http://doi.org/10.4103/0970-1591.56191
Trinkoff AM, Geiger-Brown JM, Caruso CC, et al. Personal Safety for Nurses. In: Hughes RG, editor. Patient Safety and Quality: An Evidence-Based Handbook for Nurses. Rockville (MD): Agency for Healthcare Research and Quality (US); 2008 Apr. Chapter 39. Available from: https://www.ncbi.nlm.nih.gov/books/NBK2661/
Workplace Safety & Health. (2016, July 15). Retrieved March 28, 2018, from https://www.dol.gov/general/topic/safety-health
