You also have to worry about aspiration pneumonia and all the other joys that can come with working in facilities like this. I have been in mental health for a while now and work in an out patient medical facility that serves under served populations so I don't have as many issues as you describe, but when I was doing my undergrad studies, I can remember working at a very well reputed nursing home for d.d. populations. Many times as an intern I was the only one there because they didn't have to pay me (ahh the joys of being young and foolish). We had a patient revolt at about 12:30 pm one night and there was always the risk of patients getting outside and freezing (many facilities have doors that lock behind you) and problems with people just plain not knowing where they were or needed to go if they get out of the place. A lot of places will have staff there for the overnight who are "sleeping staff", meaning they are mostly there for the emergency needs if the patients at the facility are fairly "high functioning". The facility I interned at was near a state college and a lot of the staff (including myself) were hired from the school. I can't tell you how many times I can remember people I was working with being under the influence on over night shifts. Often this was tolerated to some extent as the pay was low, the skills needed minimal most of the time, and the number of emergencies fairly low. In other words they were often just paying for a warm body to cover them legally should something happen or to take blame if something went wrong. After I left I know of at least 2 deaths due to issues with staffing. A lot of it is because with deinstitutionalization many of these facilities no longer have the medical facilities on site and the communities hospitals have had to pick up the slack (often farther away and not having doctors that have the experience with the patients.)
You also have to worry about aspiration pneumonia and all the other joys that can come with working in facilities like this. I have been in mental health for a while now and work in an out patient medical facility that serves under served populations so I don't have as many issues as you describe, but when I was doing my undergrad studies, I can remember working at a very well reputed nursing home for d.d. populations. Many times as an intern I was the only one there because they didn't have to pay me (ahh the joys of being young and foolish). We had a patient revolt at about 12:30 pm one night and there was always the risk of patients getting outside and freezing (many facilities have doors that lock behind you) and problems with people just plain not knowing where they were or needed to go if they get out of the place. A lot of places will have staff there for the overnight who are "sleeping staff", meaning they are mostly there for the emergency needs if the patients at the facility are fairly "high functioning". The facility I interned at was near a state college and a lot of the staff (including myself) were hired from the school. I can't tell you how many times I can remember people I was working with being under the influence on over night shifts. Often this was tolerated to some extent as the pay was low, the skills needed minimal most of the time, and the number of emergencies fairly low. In other words they were often just paying for a warm body to cover them legally should something happen or to take blame if something went wrong. After I left I know of at least 2 deaths due to issues with staffing. A lot of it is because with deinstitutionalization many of these facilities no longer have the medical facilities on site and the communities hospitals have had to pick up the slack (often farther away and not having doctors that have the experience with the patients.)