Wednesday, June 12, 2013

Assaultive Behavior Management Training 2013

          8 months ago, I was assaulted by a patient ( Last Saturday, I had to attend a refresher course on how to deal with violent patients. Did I learn anything new?
          Professional Assault Response Training (PART), Proc-ACT, Management of Assaultive Behavior (MAB), and now ABM. Well at least it’s not LBM! What used to be a mandatory 8 hour class  for work every year has been compacted to a 4 hour class every 2 years. Is it for the better? Well, that very debatable. But first things first. A good breakfast to start with on a Saturday morning. I’m not a breakfast eater but knowing that the class would last from 9 a.m. to 1 p.m., I thought it was best that I had something in my belly. So I went to the hospital cafeteria and ordered a breakfast burrito consisting of hash browns, scrambled eggs, and sausage, wrapped in a toasted tortilla. It was probably the most cholesterol laden food I’ve had in weeks. Having filled myself with all the fat I can handle, it was time to go to class.
          There were 17 students who signed up, ate some doughnuts the instructor brought in so we could give him positive reviews, and were given handouts about the course. Most of us were there for recertification so we were fairly familiar with the subject matter. So what can you do in fitting an 8 hour class to half the time, which was similar to when I took it 2 years ago? Well, there were a lot of shortcuts to be made. Mostly, the theoretical parts of assaultive behavior was discussed – how to identify and respond to it. Well and good in a perfect world. First of all, this is not a criticism of the class or instructor  because they are limited to what they can do with the time they are given. This is just an observation. There is now lesser information and training and mostly theoretical, and even that felt incomplete due to lack of real life situation examples. Even with the best intention of the class, which is to avoid seclusion and restraints by verbal interventions and alternative techniques like medications, when push comes to shove so to speak, the students will not necessarily know what to do because the physical part of the training has been lacking. Heck, even how to do verbal interventions was just skimmed over. I don't know if it's only to save time, but also to save money, but reducing the class to a barest minimum could be dangerous for someone who has not been exposed to real life situations in a psychiatric unit. Gone is the role playing we used to do in responding to agitated patients. For people who have taken the longer and more detailed classes, it would have been sufficient as a refresher. For the newbies and those who haven’t worked in a psych unit for a while, I don’t think they would be well equipped to handle explosive situations that would arise at work.
          In my opinion, the class would have been more efficient if we stuck to the syllabus or handout and were given realistic scenarios of what could or usually happens in a psych unit. It seems that the aim of the class was just to satisfy a requirement rather than to give adequate training. That being said, I’m glad it was only a 4 hour class. After all, who would like to go to such class on their day off anyway?!

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