Full Moon or Bad Planning Case Study Analysis

The Full Moon or Bad Planning case study illustrates the crisis involved in the buildup created at Greenville Community Hospital (GCH) due to the increase found in Emergency Department (ED) admissions in relation to substance abuse patients requiring further psychiatric care. (Buchbinder & Shanks, 2015). These patients needing psychiatric assistance could not be admitted to the adjacent mental institution that cordially relates with GCH given their shortage of beds for long haul rehab. The situation is also exasperated by the drug rehabilitation establishments in the region being too expensive when individually owned or full to capacity if backed by Medicaid.

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The influx of patients with health concerns secondary to drug utilization has resulted in mixing of the sick with other medical-surgical patients in a non-secure unit. The lack of safety in the unit is demonstrated by Rosemary, a floor nurse, who went to take vital signs of a patient admitted for substance abuse and found the patient having sex with her boyfriend (Buchbinder & Shanks, 2015). The boyfriend chased Rosemary out of the room and there was no way she could call for help nor did she have a place to hide from the aggressive patient. Given the implications of this case, the management team of the facility should develop mechanisms to protect its employees, meet the legal and ethical obligations of its staff members and develop an emergency readiness plan to protect the best interest of its work force.

Management Implications and Actions

From this case, it is evident that the GCH management is overwhelmed by the number of cases related to drug abuse needing additional psychiatric aid. The hospital management has failed in developing mechanisms of referral, particularly to these patients admitted in ED for substance abuse who require additional help from the psychiatric establishment (Cherry & Jacob, 2016). Further, the administration has also failed to upgrade its security to suit the impossible situation of the substance abuse patients. It is evident in the case that an intruder can enter the institution unnoticed and leave. Further, the hospital administration is viewed as lapsed due to its failure to identify the dangers of admitting and mixing patients needing psychiatric help with other medical-surgical cases (Cherry& Jacob, 2016). The dangers are not only to the latter patients but also other hospital employees such as nurses who are untrained to handle psychiatric cases. In this manner, for GCH to protect its employees, it needs to adjust to the influx of substance abuse cases that require psychiatric assistance.

The adjustment will incorporate improving the security of the institution to ensure that intruders cannot find their way into the hospital premises undetected. The hospital will also need to separate the patients of substance abuse with other medical-surgical cases. The placement of drug abuse cases in a separate unit will facilitate the hospital’s staff to tread cautiously in the unit due to the unpredictability of the patients. Additionally, the hospital will need to come up with places where employees can hide from aggressive patients and activate an alert security system.


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