Today I had my ‘key induction’ on placement (for the non-regular readers my placement is in a department attached to the medium secure wing of a hospital). It was really interesting, but quite scary!
Although it is called ‘key induction’ the training also now covers safety and awareness of prohibited and restricted items. In case you are wondering what the difference is: prohibited items do not come onto the ward under any circumstances, restricted items are only allowed on in carefully controlled conditions. It was an enlightening experience!
How often have you misplaced a pen, or left that last bit of blue tack stuck to the wall, or left a plastic bag lying around? These are all restricted items that could be put to dangerous use on the ward. Blue tack could be used to jam locks, enabling someone to lock themselves in and harm themselves or someone else, or hold a hostage. A plastic bag could be used as a ligature, a weapon, or for ‘fishing’ – hanging out of windows off the ground floor to collect ‘deliveries’ of all sorts. We were told that in one hospital a patient had got a hammer onto the ward in this manner and violently and seriously assaulted staff and trashed areas of the ward. This could have been prevented if careless individuals hadn’t inadvertently supplied the patient with the tools to obtain a weapon.
At the start of the induction we were given a list of prohibited and restricted items and asked to pick five and list the risks associated with that item. Some are obvious, some less so. I felt a little bit like I was channeling the lovechild of Jason Bourne and McCauly Kulkin as I sat devising ways to turn innocent items into weapons and tools of escape!
I invite you to give it a go; pick some items from the list below and think why/how they could be a risk on a secure forensic ward.
Aftershaves and perfumes
Needles and pen devices for insulin
Pens and pencils
Pornographic material other than that cleared by clinical team
How did you do?
Do you have a lot of words like ‘assault’, ‘harm’, ‘injure’, ‘attack’? As our instructor pointed out, these are sugar-coated. On a medium secure forensic ward there are patients who have killed, who may not show any remorse. The words that need to be in your mind when you are trying to remember to keep unsafe objects out are words like ‘death’, ‘murder’, ‘kill’. Luckily it doesn’t happen often, but in these settings were sternly reminded: People. Can. Die.
And that could be the result of that one little item you forgot to check in at the lockers outside the secure perimeter.
It isn’t just intentional harm that is the risk. We were told of an instance in one hospital where someone had dropped a lighter on the ward and a patient pulled it apart and over months fashioned a sharp point out of one piece. They also got hold of a pen and used this to tattoo themselves. They then did tattoos for others on the ward. But they got more than they bargained for and 74% of the ward patients screened positive for hepatitis-B!
It may come as a surprise that mobile phones are one of the biggest risks. Not so much in terms of direct harm but…
With access to a mobile phone a patient has unsupervised contact with the outside world. They can make deals, arrangements, plans, all out of the awareness of the staff. They could call in a bomb threat to the ward, meaning all patients would have to be evacuated from the building – a very high risk situation! If a patient got hold of your phone they then have a list of your friends and family. I’m sure you can imagine the risks of that! Most phones these days have cameras, so they could take photos of staff, of keys, doors, and so on.most phones have timers – so now the patient can accurately time how long it takes a secure door to close after someone has rushed through and not closed it properly. Your phone is likely to have pictures of your family, even your children; there are pedophiles in these wards.Modern phones have internet access, which means the patient now has access to pornography, instructions on fashioning bombs and weapons, and just as worryingly: access to Facebook. Why is this worrying? If a patient takes a dislike to you, they could have access to all sorts of information about you! Where you are from, where you studied, maybe even where you live, what family you have, a whole range of personal information. “But my profile is set to full security, I don’t need to worry” it may be, but are all your friends as security conscious as you? Remember that although the patients may be suffering from illness or other things, that does not mean they are stupid. In fact some are exceptionally intelligent in certain areas! And they have a lot of time and patience.
In the end today has taught me one key thing (excuse the pun): there is no such thing as being too careful.