Tackling the issue of dangerous patients

Riddle wants to expand restraint, isolation authority at FSH

Rep. Jeanie Riddle, R-Mokane, presented a bill Wednesday to a House Health Care Policy committee that she says is one small step in helping Fulton State Hospital (FSH) become a safer place.

The hospital — located in her district — is referred to as one of the most dangerous places to work in Missouri.

Current law allows only the head of or attending physician of a mental health facility or program — like FSH — to issue restraints, isolation or seclusion on a patient when deemed necessary to protect the health and safety of the patient or others.

Riddle’s bill extends that authority to advanced-practice, registered nurses.

“Fulton State Hospital has minimal physician staff available,” she said. “It may take a long time for them to get to problem patients.”

She said the bill would reduce response time for handling dangerous situations.

While it extends authority to nurses, it would require a physician to review a nurse’s orders within a specified amount of time.

Mark Stringer, director of the Department of Mental Health’s Behavioral Health Division, said the division has problems retaining and recruiting psychiatrists at state behavioral health hospitals.

“Without enough doctors, we have problems in terms of safety and being able to draw federal reimbursement,” he said. “This (bill) is a great way to help solve the problem. This will create safer environments in our facilities and help protect both patients and staff.”

Rep. Lynn Morris, who serves on the Health Care Policy committee, thanked Riddle for bringing the legislation forward because he’s experienced firsthand what it’s like to try to get a psychiatric patient under control.

He was once a pharmacist in a hospital pharmacy that was right next door to the psychiatric unit.

“I was the closest male when that alarm (in the psychiatric unit) went off,” said Morris, R-Nixa. “I’d run there to help the nurses and staff who were about 50 feet from the pharmacy.”

He said facilities must have protocols, like one specified in Riddle’s bill.

“I’ve had glasses broken, fingers broken, a black eye,” he said. “It’s dangerous not only for employees, but also for patients.

“Your bill is spot on,” he told Riddle.

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