Psyched Out

"It's primarily patient safety, and other employee safety," she said. "That's why we have a Violent Behavior Prevention Policy. We are talking about patients with certain medical, surgical [and] psychiatric conditions…that really affect the patients' episodes of violence. And this is not something we take lightly."

Terry Jemison, a spokesperson for the U.S. Department of Veterans Affairs in Washington, D.C., was unable to say whether the procedure was implemented systemwide or was unique to DeBakey. He stated in an e-mail: "After a quick scan of the Houston policy, some of our national mental health managers were laudatory and said such policies typically are in place at all VA sites (or should be)…The teams often are trained as a group in safely subduing patients by force as a last [resort]. This is only done when the patient is in imminent danger of harming themself or others and no other intervention is effective."

Simon was the only nurse interviewed for this story who is going to leave before she had planned to. She hoped to work three more years, but instead will retire in February.

For Simon, it's not the premature retirement so much as the reasoning behind it. She says she's acted on Code Greens before, but the tactics taught in the class were not applicable to those situations. There's just no way a 50- or 60-year-old nurse can subdue a young, well-trained veteran.

"The way they teach you in the classroom, you don't do that," she says. "These veterans can kill you, because they've been trained how to kill."