[NurseDixie]

I will be starting to work in a state run behavioral/nursing home type setting soon. Some of the pts have been in this facility for many years(mental retardation, Down's syndrome) and regular nursing home pts. Do any of you work in a similar setting? There will be 3 LPNs and 10 health service workers working on 4 units (total = 100 pts) I will be the only RN on nights. Any insight?

[Energizer Bunny]

Sounds a little scary to me, but I sure would like to hear from others that work in state hospitals since this is something I have considered when I graduate.

[marymary]

Originally Posted by NurseDixie

I will be starting to work in a state run behavioral/nursing home type setting soon. Some of the pts have been in this facility for many years(mental retardation, Down's syndrome) and regular nursing home pts. Do any of you work in a similar setting? There will be 3 LPNs and 10 health service workers working on 4 units (total = 100 pts) I will be the only RN on nights. Any insight?

I think that I would start off on days if possible. You have to work on your own on the overnight shift. The LPN's are your back but you are running the show, are you ready?
:hatparty:

[Gator,SN]

A friend of mine works in a state mental facility and she hates it and it looking for other employment. She complains of being short staffed, especially when a pt. becomes frustrated or combative. She has been injured when punched and kicked by these pts. and the security guards are not allowed to "manhandle" them. Which means the nurses are basically on their own all the time with patients that have refused their meds for days and are now out of control or just want to fight. Patients fight among themselves, steal from each other and refuse treatments. She has to take them out to smoke sometimes on dayshift and she is a non-smoker. Not only does she have 20+ pts a night to keep track of, but the other staff as well. Many of the patients that are there are "institutionalized" and have been their for most of their life. Its very sad. They lack family support and visitors. Weekly counseling sessions do not provide much for these patients, so I'm not sure how much of it gets through to them.
I did my clinical rotation for psych at this facility and I knew it was not for me. This locked ward was not even the worst that I saw while there. Some floors have all chairfast patients that are tube fed and can't do anything for themselves so they were put in front of a TV for hours at a time.......The only good thing I can say is that because its a state job, the benefits are very good though and the retirement plan is excellent and some of the nurses were very dedicated and tried very hard. Limited resources and lack of adequate staff make this a hard job.
Good Luck Dixie. I hope that you can make a difference with these patients because it really is a sad place that needs caring professionals.

[marymary]

Originally Posted by Gator,SN

A friend of mine works in a state mental facility and she hates it and it looking for other employment. She complains of being short staffed, especially when a pt. becomes frustrated or combative. She has been injured when punched and kicked by these pts. and the security guards are not allowed to "manhandle" them. Which means the nurses are basically on their own all the time with patients that have refused their meds for days and are now out of control or just want to fight. Patients fight among themselves, steal from each other and refuse treatments. She has to take them out to smoke sometimes on dayshift and she is a non-smoker. Not only does she have 20+ pts a night to keep track of, but the other staff as well. Many of the patients that are there are "institutionalized" and have been their for most of their life. Its very sad. They lack family support and visitors. Weekly counseling sessions do not provide much for these patients, so I'm not sure how much of it gets through to them.
I did my clinical rotation for psych at this facility and I knew it was not for me. This locked ward was not even the worst that I saw while there. Some floors have all chairfast patients that are tube fed and can't do anything for themselves so they were put in front of a TV for hours at a time.......The only good thing I can say is that because its a state job, the benefits are very good though and the retirement plan is excellent and some of the nurses were very dedicated and tried very hard. Limited resources and lack of adequate staff make this a hard job.
Good Luck Dixie. I hope that you can make a difference with these patients because it really is a sad place that needs caring professionals.

Out of curiosity, when the patients refuse their medications for "days" why did the staff not follow up and get a order to give IM from the doctor then? Why wait until it is out of control? I am going to work in a psychiatric hospital sometime this year. I will let you know what I find out from my experience in New Jersey.

[Gator,SN]

marymary,
I asked the same thing and my friend said that it wouldn't have helped because they can't give an IM injection either if the pt refuses it.......????? She did say that sometimes they take away privileges when this happens......Maybe someone else who works in psych nursing can come on here and explain.
Good luck with your upcoming job!!!!!
Gator

[lucianne]

Everyone has the right to refuse treatment, even patients on psych units. If you want to force an IM med on someone who is not actively posing a threat to self or others, you have to go to court to get an order from a judge.

[Sharon Jean]

Sound like you're setting yourself up for disaster. Best of luck to you!

[FutureRNMichael]

Originally Posted by lucianne

Everyone has the right to refuse treatment, even patients on psych units. If you want to force an IM med on someone who is not actively posing a threat to self or others, you have to go to court to get an order from a judge.

Outside Doctor Consult - two sources I believe - is needed to use IM backup's in Oregon.But, if there in the state hospital, they probably have some decision making issuses as it is.

[exhausted mom]

Originally Posted by marymary

Out of curiosity, when the patients refuse their medications for "days" why did the staff not follow up and get a order to give IM from the doctor then? Why wait until it is out of control?

We have a 20 year old son who has been REALLY REALLY needing to get back on his meds. Seroquel. We just had the police admit him to the county psych ward in Martinez, CA. You mean they can't make him take his meds either? This is real bad news to me!