I work in a 18 bed psychiatric facility. I was a case manager there, but now that I'm in my 2nd semester of nursing school I've switched posistions to a QMA. Recently a new RN was hired to work the 2 days the regular evening nurse is off. While she is a nice person and seems to know her basic nurising stuff, she has NO psych experience. Normally this wouldn't be a problem, but she is also very resistant to learning how to deal with psych patients from the staff with experience.
While I must admit it is hard form me to be working "under" someone with so little psych knowledge when I have my BA in psychology, I really have been trying hard to help her cope with her surroundings, (because I know how disorienting working the the severly psychotic can be at first) but she doesn't want to hear it. I'm not sure if it is an ego thing or if she is afriad of looking insecure but she won't take any advice that is offered. She is very overeager to medicate pts. whose perodic outbursts can be controlled with talking and quiet time. I honestly feel that she is afraid of the pts. and would rather overmedicate them till they drool, rather than take the time to redirect their behaviors.
The final straw for me has been the admission of a paranoid schizophrenic patient that we often treat. When he comes in he is always very psychotic and believes he is being held in a prisoner of war camp. Because he is commited to our facility so we have the right to force him to take medicaitions. For the last few admissions we have been mixing his Haldol, Ativan, and Clozaril in with his food because he is VERY resistant to taking medicaiontions when he is on this level. Once he clears he is a completley different person and is usually med compliant. The new RN refuses to "hide" his medications in his food. She thinks that it is unethical, despite the fact that it is perfectly legal. This means that every two or three times a shift we have to forcibly restrain him and she injects his medications. This poor man truly believes that we are killing him chemical injections and he cries and shakes after every episode. And of course this destroys all therapeutic rapport that has been developed with him. I don't think I can do that to him again. The past two shifts have been terrible and I want to cry everytime we have to hurt him that way when there is a much less invasive and traumatic way to get meds in to him.
I've spoken with our unit manager about it and she has recommended that the regular evening nurse and I talk with her about her about this since our DON is on a three week vacation. My question to you guys is what is the best way to approach this discussion? I don't want to hurt her feelings or put her on the offensive. How can we help her see that sometime psych patients have to be treated with a little bit more understanding and compassion than other types of patients. Thanks for any words of advice.