Unlocked Unit

[hibbo]

Anyone here have experience working in an UNLOCKED inpatient unit? I have an interview with a VA in my hometown that has one. The pay is great and they'll have two NPs working under me for a 15 bed unit.

Anyone know much about these units? Ultimately, I'm scared about the liability of housing people who can just get up and leave.

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[SmallBird]

Anyone here have experience working in an UNLOCKED inpatient unit? I have an interview with a VA in my hometown that has one. The pay is great and they'll have two NPs working under me for a 15 bed unit.

Anyone know much about these units? Ultimately, I'm scared about the liability of housing people who can just get up and leave.

We have an unlocked unit at our CMHC - it seems to work well conceptually, although sometimes its anxiety provoking on call because if people leave late at night its not always clear whether to be alarmed or not... I've also worked on unlocked 'treatment units' which were mainly for severely depressed or anxious patients. I found it a great place to work because you may do a lot more therapy (of various kinds) than on a locked unit. 15 beds with two NP's and sounds fantastic. What I would be interested in ensuring is that its not purely substance abuse (which may or may not be your thing).

 

[hibbo]

Thanks SmallBird. I like the idea that the people there are going to be less severe so I can do short burst therapy with them and send them back to the outpt doc soon after.

Any other things I should consider that would be unique to this environment? I have the interview in a couple of weeks....

 

[Therapist4Chnge]

15 beds with two NP's and sounds fantastic. What I would be interested in ensuring is that its not purely substance abuse (which may or may not be your thing).

My thoughts exactly. A 100% substance abuse treatment unit isn't all bad, but you have to want to be there or it can be a grind.

I did a rotation through a VA-based residential substance abuse program and most of the Veterans were thankful to be in the program (as there was a long wait), so significant issues were rare. There were still a lot of challenges, though having good staff coverage really helped. The unit's psychiatrist genuinely enjoyed working with substance abuse, so he was more "present" on the unit…not just tucked away in an office doing 5-10min med checks.

 

[Baller MD]

My thoughts exactly. A 100% substance abuse treatment unit isn't all bad, but you have to want to be there or it can be a grind.

I did a rotation through a VA-based residential substance abuse program and most of the Veterans were thankful to be in the program (as there was a long wait), so significant issues were rare. There were still a lot of challenges, though having good staff coverage really helped. The unit's psychiatrist genuinely enjoyed working with substance abuse, so he was more "present" on the unit…not just tucked away in an office doing 5-10min med checks.

How many hours do the physicians of the latter quality actually "work" per day then?

 

[milesed]

We have an unlocked crisis unit where they are admitted if not quite meeting inpt criteria and an unlocked substance abuse tx facility. We do occasionally need to xfer patients to a regular unit from the crisis unit in very rare cases. They just complete the paperwork and police take them elsewhere. They key is having good staff who can assess relative risk before accepting an admission.

 

[hibbo]

That's a good point milesed. I'll def have to check into the ER staff and how well they screen patients. I'll also have to figure out when patients are officially transferred to me from whoever is covering overnight call. Thanks everyone for the replies.

 

[Salpingo]

Are these units literally unlocked? My sense is that everyone was there voluntarily, but that a safety assessment had to be done prior to discharge, so that patient can't just get up and leave in the middle of the night without telling anyone. Presumably, that would make it the same level of liability as a psych ER job, or an inpatient medicine for that matter.

 

[OldPsychDoc]

Are these units literally unlocked? My sense is that everyone was there voluntarily, but that a safety assessment had to be done prior to discharge, so that patient can't just get up and leave in the middle of the night without telling anyone. Presumably, that would make it the same level of liability as a psych ER job, or an inpatient medicine for that matter.

I did moonlighting for a small community hospital that had half of its psych beds on an open unit.
Essentially it was just the same as any med-surg hospital corridor--so yes, literally unlocked.