Mary Price WednesdaySep 1 at 1:33pmManage Discussion Entry Hi everyone! I recently made a decision this past Monday at work which was debated by a number of colleagues. I work in an inpatient...

Mary Price

Hi everyone!

I recently made a decision this past Monday at work which was debated by a number of colleagues. I work in an inpatient substance use stabilization program, and many of the patients that we have also have a co-occurring mental health disorder. I have a young female patient who is currently experiencing significant paranoia and hypervigilance which is a direct result of past trauma and a recent assault by her ex significant other. Our patients are roomed with one other individual and we have a program rule that while in their bedrooms, only the people residing in that room can be in there, no other patients are allowed to be in the rooms hanging out. This is a rule that was implemented to ensure safety amongst all of our patients. My patient had informed me that on several occasions her roommate had up to 5 additional people in her room to just “hang out” and that because of this she was feeling very unsafe. She stated that she had tried to talk to her roommate about it but it continued to happen. Her roommate’s counselor also talked to her about this and reinforced the program rules. Due to the behavior not changing, I made the decision to move my patient into a different room to help keep her physically and psychologically safe. This decision caused controversy amongst staff members as they were upset that this created more work for them and they believed that I was favoring her over other patients. I attempted to explain that she was being moved as her current living situation was causing her psychological discomfort and was exacerbating her mental health symptoms. Some of my colleagues were understanding of this, and some were not. As my patient is one who has been deemed as “needy” much of the controversy was opinion based rather than fact based. The group norms were different amongst different staff members due to their job duties as some were agreeable to hearing and understanding why the change was made, and others were not and simply did not agree with the decision. Overall, there was not a full consensus amongst group members. The decision-making process did not involve an equal vote, as I made the decision based on the needs of the patient in the moment. I believe that the consensus of the group may have been different if my colleagues were involved in the decision-making process and could have had their opinions on the matter voiced prior to the final decision being made. This is an example of something that I often face in my current position as decisions are frequently made in the moment to meet the needs of our patients rather than discussing it with the entire team.

Thanks!

Mary

Janice Spangenburg

Katie and class,

Thank you for the amazing information here: "I can’t claim that every member of our group felt equally as strong about skipping the concert. It’s possible that there may have been one or two people who would have taken the risk if no one else had voiced concerns. But because someone spoke up first saying they’d prefer not to attend, when the rest of us followed suit it was less clear if anyone may have had mixed feelings. Our group norms are generally fairly kind and understanding, and if some members of the group had decided to still go, I ultimately think it wouldn’t have impacted the friendship. We didn’t discuss the process of how we’d make a decision; it just happened organically via text messages. It’s also possible the outcome may have been different in person since people communicate differently via text and have more time to think through responses." What are some aspects here that you can use going forward? Janice

References

Centers for Disease Control & Prevention (2021). Your Guide to Masks. Prevent Getting Sick. Retrieved fromhttps://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/about-face-coverings.html