Physically unsafe internship environment

[dynamicpsyd]

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Hi Everyone,

I am having a terrible time on internship. It is an APA accredited site. I have been assaulted numerous times by patients on the unit. I have been punched in the back of the head, spit on in my face, and slapped on numerous occasions by patients I was not even working with (i.e., walking in the hallway to go file my notes). My supervisors have been unresponsive to my safety concerns and so I got my DCT involved. She had to visit the site, write numerous emails, and have several phone calls and finally I am being transferred to a different unit. However, the new problem is that I perceive I'm being retaliated against. For example, now neither supervisor feels they can write me a strong letter of recommendation for post-doc. Both supervisors are now unfriendly and hostile towards me.

How would folks recommend I proceed? I'm very nervous about getting poor marks on my upcoming quarterly review.

Thanks.

 

[00851341032]

Have any of the problems been things that could fall under the category of sexual harassment/assault by patients? My understanding from a recent training I had to complete is that Title IX protects students who are being harassed by patients at training sites as part of training required to earn your degree. If so the Title IX coordinator at your school may be able to help you.

 

[erg923]

I think an important aspect here is how is violence towards staff dealt with after the fact? Are you being supplied/instructed on appropriate safety protocols and measures? Are patients who perpetrate aggressive acts toward staff put on proper supervisory protocols and/or suffer appropriate consequences?

One has to expect the risk of violence on inpatient units. Not tolerate, however. Big difference. I'm sure you knew this going in. I dont work inpatient bc I am risk adverse...

 

[CheetahGirl]

Wow. Sorry to hear about this. I was wondering the same as erg923. Are you at a forensic site or did you have aggressive patient management training beforehand?

Both supervisors are now unfriendly and hostile towards me.

It sounds like they are 'blaming the victim' here. I was struck unexpectedly by a very young patient, but I was forewarned that this patient presented with aggression issues stemming from abuse (happy to say, we worked through the issues). I was somewhat prepared on how to handle the situation because I had children the same age (as the patient) so was used to getting knocked around...accidentally by my kids, of course. But I knew how to react appropriately, which is what the aggressive patient management training helps you do. However, your post didn't state anything about how you handled the situation, only how your supervisors are reacting now.

Do you really need them for post-doc rec letters? Because if you don't, I would recommend continuing with your training without the extra support of letters, unless you feel that the site is not taking measure at all to protect your safety, which I believe are all JACHO, OSHA and APA violations.

If there is not one person at your site who could vouch for you and your current work, then go without and explain in your post-doc interviews why you excluded current site letters. If a post-doc requires a letter from a current site (IDK, I'm also currently applying to post-docs), then have your DCT write the letter explaining the current circumstances and the why there is an absence of letter from your internship site.

That is how I would proceed if I were in your shoes. Take good care!

 

[Therapist4Chnge]

Wow. I'd definitely keep my DCT involved and document document document. As a fellow I had multiple conversations w. our "Risk Management" group (in-house lawyers and compliance ppl) about pt and staff safety issues. I had my supervisors support, so it may not be an option...but maybe worth talking w your DCT about? In my cases, I wanted Risk involved bc they generally have administration support (bc they don't want to get sued) and they don't report to anyone in a clinical position, so they can "be the bad guy" when changes are enforced.

 

[Oh the Irony]

Will you have a new supervisor now that you have changed units? It's still fairly early into the internship year, perhaps building a relationship with a new supervisor that can provide a good letter of recommendation is still possible?

 

[CheetahGirl]

I can relate to urgency of this post. Relationships need to be established like yesterday, and apps are due like tomorrow. It is a good viable strategy to 'sell' your new supervisor on all that you have done up until this point and request a letter based on your 'new' relationship.

Will you have a new supervisor now that you have changed units? It's still fairly early into the internship year, perhaps building a relationship with a new supervisor that can provide a good letter of recommendation is still possible?

 

[smalltownpsych]

That sounds like an out of control unit. I have worked in some very intense inpatient settings with some of the sickest individuals and have not witnessed that level of assaultive behavior. They must be doing a lot wrong. Somebody needs to figure it out before someone gets badly injured or killed. Why are the psychologists at the site not taking an active stance in this? Let me guess, they are not in charge of anything and at best will bemoan the sad state of affairs but won't do anything to address it. Addressing these types of unhealthy work environments and the legal and ethical ramifications are precisely where our expertise as psychologists is needed. Speaking to the psychologists who are allowing this to happen and working there, at a certain point if you are working at an unhealthy system and aren't involved in improving it, then you are supporting an unhealthy system.

 

[PsyDr]

In addition to all the very valid points, I would suggest you present yourself as calmly as possible. Whether you feel calm or not. If you get excited in talking about this stuff, it will be very easy for someone to write you off. Practice.

 

[PsychologyToday1984]

I can relate to urgency of this post. Relationships need to be established like yesterday, and apps are due like tomorrow. It is a good viable strategy to 'sell' your new supervisor on all that you have done up until this point and request a letter based on your 'new' relationship.

Are you being sarcastic? Or am I missing something..."Apps are due like tomorrow."

Just checking 🙂

 

[CheetahGirl]

No sarcasm - I'm a New Yoker and that's our lingo - I live on 'New York minutes' (deadlines were yesterday and you don't really have tomorrow to think, every thing is fast paced...and I mean, everything). Post-doc applications are due in Nov, Dec, Jan of the year before you want to start. So I was being emphatic. I'm preparing now (calling supervisors, securing letters now) for Jan deadlines.


And hey PsychologyToday1984, I'm sure we'd hit it off in person and no offense to you personally, but I loathe the "publication" of your namesake. And you can loathe Cheetahs - I'm okay with that. Just forewarning if you ever read my rants...and I'm not being sarcastic.

 

[PBCocce]

Document Document Document... every email, every conversation (date/time/location/who was involved).

 

[docma]

Document Document Document... every email, every conversation (date/time/location/who was involved).

APPIC also has an informal problem solving resource you can consult through their website I think. Any APA site is also APPIC affiliated, so you or your DCT could consult them for some options as well.