Most entertaining job posting

[TexasPhysician]

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I saw this and found it both funny and sad. No one is ever taking this job:

Psych Duty Requirements:
Manage Joint Commission standards
Teach psych residents
Supervise NPP’s
Manage inpatients and consults and any “emergency” events
On call coverage with the potential to come in-person while on call

Non-Psych Duty Details:
Job is considered to be in a “hazardous area”
Must be able to “jog 1/4th mile and lift >30lbs”
Assist injured patients by “dragging or wheeling” them despite weighing “significantly more” than self.
“Stressful” environment
Must be able to get a security clearance

Pay:
Maximum of $130/hour. Minimum 30 hours/week.

This is a non-military job posting.

 

[Sushirolls]

Could be a military base contracting out to civilian sector.
Or a middle of nowhere community mental health clinic.

Or locums firm gets hired to fill it... they pay the doc $160/hr, and the firm gets $40/hr.
Because its better to bleed locums then improve the job.

 

[comp1]

I think it's an interesting job. Most inpatient jobs attached to a hospital with some admin responsibilities have these same requirements (minus the security clearance and possibly the needing to come in during call); they just don't spell them out so aggressively and they tend to pay a good deal better. Concur with this likely being a military contractor, but would love for the OP to post the actual listing firm if locums or site if not. I mean this is basically my job, again minus the security clearance and approaching 50% more pay when factoring in W2 stuff. It ultimately comes down to how many patients you actually see a day. I mean you could have all of this and still be at four patients a day (with residents and NPs), particularly at a military site.

 

[calvnandhobbs68]

I think it's an interesting job. Most inpatient jobs attached to a hospital with some admin responsibilities have these same requirements (minus the security clearance and possibly the needing to come in during call); they just don't spell them out so aggressively and they tend to pay a good deal better. Concur with this likely being a military contractor, but would love for the OP to post the actual listing firm if locums or site if not. I mean this is basically my job, again minus the security clearance and approaching 50% more pay when factoring in W2 stuff. It ultimately comes down to how many patients you actually see a day. I mean you could have all of this and still be at four patients a day (with residents and NPs), particularly at a military site.

lol no inpatient job I've ever seen has required you to:

“jog 1/4th mile and lift >30lbs”
Assist injured patients by “dragging or wheeling” them despite weighing “significantly more” than self.

It's like they mixed up the roles of a inpatient unit tech and a psychiatrist.

 

[Stagg737]

lol no inpatient job I've ever seen has required you to:

“jog 1/4th mile and lift >30lbs”
Assist injured patients by “dragging or wheeling” them despite weighing “significantly more” than self.

It's like they mixed up the roles of a inpatient unit tech and a psychiatrist.

Why hire a tech when you can just have the psychiatrist do their job at the same time!

 

[comp1]

All psychiatrists and any other staff who work on an inpatient unit should be trained and ready to assist with therapeutic containment in an emergency. It is certainly a formal requirement at all VAs (and I assume military hospitals where this post originated). You never know when you are going to need to pitch in. We're not somehow above this. The phrasing is certainly odd, but it is hard to assume they mean anything other than therapeutic containment.

 

[TexasPhysician]

All psychiatrists and any other staff who work on an inpatient unit should be trained and ready to assist with therapeutic containment in an emergency. It is certainly a formal requirement at all VAs (and I assume military hospitals where this post originated). You never know when you are going to need to pitch in. We're not somehow above this. The phrasing is certainly odd, but it is hard to assume they mean anything other than therapeutic containment.

Further digging - It appears to be an organization with many ex-military members bidding on a contract to run an immigration detention facility. The job doesn’t actually exist yet with them. They are trying to get enough low bidding professionals to provide the lowest bid and get the contract(s). There isn’t a psych residency there, so I’m assuming they are trying to get multiple contracts simultaneously. If this is how they are attracting talent, it is probably for the best that they don’t get the contracts.

 

[sloop]

I know you said it was a non-military listing but, as I was reading it, I was imagining some psychiatrist asking about everyone’s feelings while assisting with some sort of hot extract of a SEAL team. Like, dragging some dude by a plate carrier and yelling “I think this might be a great time to exercise our coping skills!”

 

[ObsequiousAplomb]

My residency job description (and the attending description there as well) definitely included being able to walk a certain distance in a certain speed (I wouldn't call it a jogging pace), that I could lift 50 pounds over my head, and that I could assist with physical holds (even though we were also barred from performing them by policy). I agree with others that frequently job descriptions have these things, though the expectation that a psychiatrist will actually do any of these things seems dubious. I always thought it was in there to give an excuse to fire someone for getting too old and frail.

 

[TexasPhysician]

My residency job description (and the attending description there as well) definitely included being able to walk a certain distance in a certain speed (I wouldn't call it a jogging pace), that I could life 50 pounds over my head, and that I could assist with physical holds (even though we were also barred from performing them by policy). I agree with others that frequently job descriptions have these things, though the expectation that a psychiatrist will actually do any of these things seems dubious. I always thought it was in there to give an excuse to fire someone for getting too old and frail.

Normally I’d agree that it is just copy/paste from their other generic jobs. This time it appeared to be one of the more reasonable qualifications. I’d prefer to jog 1/4th mile while holding 30lbs over dragging someone significantly heavier than myself. I’ve also never seen an employer admit to providing a stressful work environment.

 

[FatherPsychiatry]

ChatGPT can write Adderall and Zyprexa scripts better than anyone here, but its gonna be a while before it can jog 1/4th mile and lift >30lbs

 

[calvnandhobbs68]

All psychiatrists and any other staff who work on an inpatient unit should be trained and ready to assist with therapeutic containment in an emergency. It is certainly a formal requirement at all VAs (and I assume military hospitals where this post originated). You never know when you are going to need to pitch in. We're not somehow above this. The phrasing is certainly odd, but it is hard to assume they mean anything other than therapeutic containment.

The post above doesn't exactly seem to be referencing physical containment (sounds more like they want you dragging around injured patients or something?) but since this topic came up again....

Most psychiatrists and medical (non-nursing) staff members are in fact specifically NOT allowed to be part of physical hands on with any patients in any inpatient units I've been at unless they've received and practiced formal training around holds, restraints and coordination with team members on this.

I guess maybe less of a problem at the VA since they can't sue you but otherwise have fun getting the crap sued out of you when you inadvertently injure a patient by trying to hop yourself into a restraint/physical hold situation. Also, never heard of this when I rotated at the VA, it was literally never the protocol for any member of the medical team to go joining in on any attempts at physical containment.

 

[Merovinge]

The post above doesn't exactly seem to be referencing physical containment (sounds more like they want you dragging around injured patients or something?) but since this topic came up again....

Most psychiatrists and medical (non-nursing) staff members are in fact specifically NOT allowed to be part of physical hands on with any patients in any inpatient units I've been at unless they've received and practiced formal training around holds, restraints and coordination with team members on this.

I guess maybe less of a problem at the VA since they can't sue you but otherwise have fun getting the crap sued out of you when you inadvertently injure a patient by trying to hop yourself into a restraint/physical hold situation. Also, never heard of this when I rotated at the VA, it was literally never the protocol for any member of the medical team to go joining in on any attempts at physical containment.

Totally agree, spent a lot of time at the VA for both medical school and residency and know several VA staff psychiatrists none of whom took place with physical hold situations. The psychiatrist would walk the opposite direction of whoever was coming towards the patient. We go extremely far out of way to make sure to never be the person to touch the patient as the attending physician.

 

[ObsequiousAplomb]

ChatGPT can write Adderall and Zyprexa scripts better than anyone here, but its gonna be a while before it can jog 1/4th mile and lift >30lbs

nah, we all know it will hallucinate some aspect of the prescription. Or leave out a necessary prescription.

Admittedly, I went to the doximity chatgpt thing and it did a passable prescription, only it left out the indication and the route.

 

[comp1]

It's currently called "Prevention and Management of Disruptive Behavior" throughout the VA nationally and indeed rotating trainees (residents/medical students) are not trained in it due to its (very) extensive nature and as such they should not participate in containment. However, all VA attending, nursing and other staff who are employed in an inpatient psychiatric or ED setting are required to complete it to the highest level (currently called 3) so that they can participate in therapeutic containments where needed. I can't argue against some MDs in these settings existing who would walk (or run) away and I'm not even saying that attending MDs are always the best person to do it if there are multiple immediately available options, but they still should be ready and able to help. I get it's not a pleasant thing for anybody and will strain any sort of therapeutic alliance, but the attending gets to walk away afterwards. The nurses are stuck still being around the patient. It's a heck of a lot worse for them. And yes, the Federal Tort Claims Act is indeed a major benefit of working at the VA. The military has even less liability, although it can get murky for locums/contractors at either.

 

[michaelrack]

although I think psychiatrists should try and avoid getting involved in random holds/containment; a psychiatrist needs to know how to handle being attacked by a patient, which is usually part of this training (for example, "lean into a bite", rather than trying to pull away from a patient biting you.
Also, as part of this training is learning how to block a punch, and then maneuver the patient into a hold (while other staff comes to assist/take over).

 

[comp1]

Yes the above is currently called part 2 of the VA PMDB national training.

 

[docloufan]

although I think psychiatrists should try and avoid getting involved in random holds/containment; a psychiatrist needs to know how to handle being attacked by a patient, which is usually part of this training (for example, "lean into a bite", rather than trying to pull away from a patient biting you.
Also, as part of this training is learning how to block a punch, and then maneuver the patient into a hold (while other staff comes to assist/take over).

"Lean into the bite?" lol. Are you kidding me? Get real.

Anyone who physically attacks me is going to get really messed up. Period.

Why does it matter if they are a "mental patient" or not? There should be ZERO tolerance for this. All hospital systems have HUGE signs for this now...literally all over the place. And I've never seen one that says... 'unless you are a psychiatrist.'

 

[comp1]

The contrast here is so dramatic. One side saying they are going to wale on anybody posing a risk and the other that they are going to literally run away to "avoid liability." This is exactly why the training and associated job requirements are needed for psychiatrists and anybody else working on an inpatient unit.

 

[docloufan]

The contrast here is so dramatic. One side saying they are going to wale on anybody posing a risk and the other that they are going to literally run away to "avoid liability." This is exactly why the training and associated job requirements are needed for psychiatrists and anybody else working on an inpatient unit

No one should be doing any administration alphabet non-violence nonsense if they are physically attacked by a big and floridly psychotic mental patient or some State Hospital jailed psychopath. Why is that even controversial?

 

[Taddy Mason]

"Lean into the bite?" lol. Are you kidding me? Get real.

Ummm…it’s basic self-defense to safely get out of a bite. It forces the attacker’s jaw open, as well as throws off the attacker’s balance. Pulling/going the other direction is just going to inflict more damage to the individual being attacked. I say this as someone who has used this maneuver more than once, been both attacked and involved in restraining patients as both a tech/aid and resident, as well as trained in different self-defense protocols (some of which are admittedly BS), but this move is standard across them and does work effectively.

No one should be doing any administration alphabet non-violence nonsense if they are physically attacked by a big and floridly psychotic mental patient or some State Hospital jailed psychopath. Why is that even controversial?

As per my experience above you’re more likely to be attacked on inpatient CAP units than by adults - and I’ve worked in multiple state hospitals and correctional settings, including maximum security prisons.

 

[ObsequiousAplomb]

No one should be doing any administration alphabet non-violence nonsense if they are physically attacked by a big and floridly psychotic mental patient or some State Hospital jailed psychopath. Why is that even controversial?

Uh. Having worked in state hospitals and seeing several psychiatrists assaulted and the fallout of the assault, I sincerely hoping that's just bravado.

You should definitely do exactly what the policy is in any of those situations, because there is a policy. The facility will teach you how they want you to avoid situations but also how they want you to escape headlocks or punches. There 100% is a policy on how to respond and you will be expected to have followed it.

The altercation has an almost guaranteed 2 camera angles on it. Those videos will be reviewed ad nauseum in more committees than you thought existed. If you try to press charges on the patient and the video shows you punched a mentally ill patient who is being held involuntarily under your care ... What do you think the outcome will be for you? For your career?

 

[sloop]

Uh. Having worked in state hospitals and seeing several psychiatrists assaulted and the fallout of the assault, I sincerely hoping that's just bravado.

You should definitely do exactly what the policy is in any of those situations, because there is a policy. The facility will teach you how they want you to avoid situations but also how they want you to escape headlocks or punches. There 100% is a policy on how to respond and you will be expected to have followed it.

The altercation has an almost guaranteed 2 camera angles on it. Those videos will be reviewed ad nauseum in more committees than you thought existed. If you try to press charges on the patient and the video shows you punched a mentally ill patient who is being held involuntarily under your care ... What do you think the outcome will be for you? For your career?

I also have experience in these settings and I think my perspective lies somewhere between both of yours. You should absolutely try to avoid situations where you have to defend yourself against a patient. If it is possible, you should also try to use minimum necessary force to extricate yourself from the situation, using approved techniques if possible. What you say is true. They will review the video and use that as a basis for any possible employment or legal consequences to follow.

Having said that, everybody has a right to self-defense. That does not change because you are staff in a state hospital. While I have been at my current job, I have seen people seriously injured by patients. I know of people who were permanently disabled from assaults here. My patients have been discovered to have shanks on multiple occasions. At the end of the day, one needs to do whatever he or she thinks is necessary to defend their life, policy be damned. I am not going to be contemplating what administration is going to think as I get pummeled or stabbed. I am going to try to end the threat as quickly as possible.

 

[comp1]

Following the policy should fully align with what is necessary to defend your life. If it's not, you need to work on changing the policy (immediately) or find a new job. And indeed, you're not going to think much at all in such a high stress situation, that's why getting the training done is so important.

 

[sloop]

Following the policy should fully align with what is necessary to defend your life. If it's not, you need to work on changing the policy (immediately) or find a new job. And indeed, you're not going to think much at all in such a high stress situation, that's why getting the training done is so important.

The reality is that I have never had a psychiatric self-defense training that has taught techniques that I believe are appropriate to defend against a truly life-threatening situation, let alone what I have found out is a realistic scenario in which the patient might have a weapon.

Every one of these classes at the handful of institutions I have been part of focuses exclusively on techniques such as effectuating release from grasp/hair grab/bite. For obvious optics-related reasons, nobody has ever taught any type of strikes, but the reality is that it will very likely be necessary to strike a determined attacker in order to adequately defend oneself. If some patient has you in a corner and is pummeling you, no amount of releasing their grasp or trying to back away is going to help. You are going to need to strike that individual to have a decent chance of making it out without incurring grievous bodily harm.

I highly doubt any hospital is going to write down that they have a training policy that includes teaching strikes, but nearly every martial art recognizes that these are integral to self-defense.

 

[comp1]

Please don't start doing karate on patients. There should be training on containment in addition to escape for everyone who works on an inpatient or otherwise acute unit.

 

[sloop]

Please don't start doing karate on patients. There should be training on containment in addition to escape for everyone who works on an inpatient or otherwise acute unit.

Genuinely curious: how would you handle a situation where a patient with a shank has you cornered and is trying to stab you?

 

[Taddy Mason]

Genuinely curious: how would you handle a situation where a patient with a shank has you cornered and is trying to stab you?

 

[calvnandhobbs68]

Genuinely curious: how would you handle a situation where a patient with a shank has you cornered and is trying to stab you?

If you're following actual protocol on how to interact with patients in an inpatient setting you should never get "cornered" to begin with....so sounds like poor self awareness on your part. I'm not sure what's up with all the he-man stuff up top here.

 

[comp1]

There's a lot that being cornered (or a shank for that matter) could mean, but presumably it doesn't mean that you are tied down and gagged. So activating a portable panic alarm or otherwise alerting a need for help would be first. After this, you're going to look for evasion methods (covered in good quality trainings) while protecting your head and abdomen to the extent possible. But I do tend to agree that a combination of cornering and shank indicates several things went very wrong that should have been covered at lower levels of training and karate isn't likely to fix it.

 

[sloop]

If you're following actual protocol on how to interact with patients in an inpatient setting you should never get "cornered" to begin with....so sounds like poor self awareness on your part. I'm not sure what's up with all the he-man stuff up top here.

I’m sorry, but this is some straight up victim-blaming admin garbage. First of all, many of us work in less-than-ideal environments and this work is dangerous even with attempts to prevent assaults. Second, even assuming that being cornered is a priori evidence of negligent prevention, what are you implying? Are you saying that, because they made a mistake, such a person should just let the patient beat them to death while trying to strafe left and right like they were taught by the hospital training department?

There's a lot that being cornered (or a shank for that matter) could mean, but presumably it doesn't mean that you are tied down and gagged. So activating a portable panic alarm or otherwise alerting a need for help would be first. After this, you're going to look for evasion methods (covered in good quality trainings) while protecting your head and abdomen to the extent possible. But I do tend to agree that a combination of cornering and shank indicates several things went very wrong that should have been covered at lower levels of training and karate isn't likely to fix it.

Again, regardless of whether these situations can be prevented (and they cannot be 100% prevented, by the way . . . otherwise people wouldn’t regularly be getting murdered in prison), everyone has the moral right to defend oneself against threats of death or grievous bodily harm with proportionate force. You can be killed in seconds in a serious altercation. The personal alarm is great but you need to do whatever is necessary to get out of that situation as soon as possible. That may involve punching someone in the face or throat, kicking them in the groin, poking them in the eyes, whatever is necessary.

I am not advocating anybody go looking for a fight with patients. I am also not saying people should be striking patients in response to an assault when they can easily run away. I am just saying that nobody has an obligation to just let a patient seriously harm or kill them without striking back. You would absolutely be justified punching someone trying to jump you on the street in order to get away. That does not change just because you work at a hospital. To say otherwise is stupid physician martyrdom nonsense.

 

[calvnandhobbs68]

I’m sorry, but this is some straight up victim-blaming admin garbage. First of all, many of us work in less-than-ideal environments and this work is dangerous even with attempts to prevent assaults. Second, even assuming that being cornered is a priori evidence of negligent prevention, what are you implying? Are you saying that, because they made a mistake, such a person should just let the patient beat them to death while trying to strafe left and right like they were taught by the hospital training department?.

Idk why this has to be made crystal clear, but for all those trainees out there you should always keep your back to an exit and your front to the patient in an inpatient unit, especially if you’re in a situation where there aren’t not multiple staff members present. You should also always be greater than arms length away from the patient. What less than ideal environment doesn’t allow you to follow those rules?

It really sounds like you’re just looking for an excuse to use your kung fu skills there John Wick.