advocacy in crisis situations

we had a teaching session this week on clinical aggression that primarily focussed on patient-clinician aggression. we have a co-ordinator for the Management of Clinical Aggression whose job it is to oversee protocols, edcuation, management and assessment for any aggression and violence in the workplace.

whenever there is the potential for aggression and/or violence involving a patient Code Grey can be called. this can be planned or unplanned (I think the rate is 60% planned 40% unplanned at the moment).

when you call a Code Grey a small team attend, made up of 4 big security guards, a senior clinician, a nurse, a medical officer (usually from the area calling the code), and an emergency co-ordinator. plus any unit staff that may be involved.

what got me thinking was that there’s no one role that is assigned for someone to be a patient advocate. of course in the majority of cases/situations any health professional can be, and probably should be, an advocate for the patient and this applies to those clinicians involved in code greys. but i think there’s a potential for a specific trained person to attend code grey events and act only as the patient advocate. this could allow situations to descalate quicker than usual, as often the code grey becomes a very oppositional event and ends with what can appear to be punitive measures of restraint (chemical or physical or both).

but if there was one person who could enter the fray and tell the patient, “I’m here for you and want to help you resolve this. I’m not a doctor or nurse. I will advocate for you.” I think there is the potential to shift the oppositional status quite quicky and perhaps have less restrictive outcomes for the patient.