Whats your record??

1. I was volunteering today and in the ED we had 10 mental health pts when I arrived, they all went to the psych unit and then another came in full restraints, shackles and the dr loaded him up with diazepam first after a few hours he loaded him up with midaz. Said pt caused 3 code blacks ( personal threats) and a fight broke out between two girls.
   
   What's your record?

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2. 26 Comments

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3. 
   Nov 27, '12

   I find counting the number of psych patients you had in one shift offensive.
4. 
   Nov 27, '12

   I don't find it offensive at all, that's cool if you do though....
   
   
   3 out of 6 psych pts, of course with medical issues bringing them to me but def full blown psych patients... Little do we all know there's a very good chance that all of our patients are psych pts..
5. 
   Nov 27, '12

   Quote from somedaypeds

   I find counting the number of psych patients you had in one shift offensive.

   I don't find it any different than counting how many critical care, or cardiac patients you have in a shift. Psych is a specialty like any other.
   
   OP, that sounds like a busy shift!
6. 
   Nov 27, '12

   I work psych-geriatrics.
   These events happened within two hours.
   So far?
   - Resident 'a' (a kindly-looking older gent in his 60's with a cane + delusions of granduer, schizoaffective and BP, I think) was railing off and on about wanting to leave.
   - Resident 'b' (a WC bound portly lady of 56 + 'borderline' personality disorder and BP 2) went to his room to compare notes.
   Ruh, Roh.
   LOL
   - Resident 'c' (a WC bound little 70 yr old with cognitive handicaps and a host of mental problems) is wheeling about in his wheelchair in a 'mood'. 'I AINT TAKING NO GODD*MN PILLS!" He was wheeling up and down the hall with his eyes bugging out of his head screaming, "I AIN'T TAKING NO GODD*MN PILLS!"
   The irony?
   No one was offering, but he thought he'd put us on notice. Earlier it was, "Mama, there's a snake in my room! There's a snake in my room". He doesn't cut loose often. HOWEVER, he has threatened me with a 'whooping'. His nurse sent him to his room for a breather. He started slamming doors. I went to settle him down, asked him to sit down and he yells, "NO!"
   I said, "______, please sit down. You're gonna fall!"
   "I'M GONNA TAKE OFF MY BELT!"
   So, he was going on about pills and how he 'ain't taking em'. I said, "Mr _______, did you brush your teeth?"
   He said, "No!" I said, "Go brush your teeth, papa."
   He paused. I said, "Go brush you teeth..."
   He went, too. Crisis averted.
   
   - Resident 'd' (a little old woman with schizoaffective + BP) was ranting about Jesus off and on. I said, " ______, mama - what's going on? " She settled when I started talking to her. She'd already been in a cripple wheel-chair fight with another resident whom she accused of stealing her money. Don't ask me. I don't know.
   
   - Resident 'a' comes out of room screaming about missing laundry and wanting to leave. Earlier that day, he'd threatend to 'f' one of the nurses up. I settled him down and led him away.
   - Resident 'b' follows behind him screaming and ranting. Full-on Rage Attack. She and my coworker (the only one that can handle her) go at it. She went back to her room in a little huff.
   - Resident 'a' is in his room as well. Next thing you know, the police and FD show up. Guess who called them?
   
   He's on the stretcher, I'm scrambling to get the paperwork ready. Next thing I know the other nurse calls me. She's doing vitals on another of my residents (a mid 60's dialysis pt) who was looking like a blowpop at the moment. JVD + periorbital edema.
   Great. I got on the phone to call the ambulance + doc + family. When the ambulance got there, she went to the bathroom and refused to come out. sigh. Called her sister and the resident wouldn't even listen to the sister. The ambulance left and, eventually, the sister came with her husband to take the resident to the ER.
   
   That was a 2 hour fiasco.
   With the exception of the anti-pill guy, these were ALL my residents. For some, I have 'the drama hall'. The 'sundowning' is not to be believed. I swear, the weekend of the super eclipse? Half the elders went bonkers!
   I love my geri's, but sometimes...? LOL When they cut loose? They cut loose.
   We're a no-restraint facility, also. So, it's not like we're going to 'take anyone down' or slap anyone in 4-points.
   Therapeutic communication skills...not optional.
   We just talk them down, send those who understand + can self-correct to their rooms for timeouts and give ativan or xanax if they get too out of hand. (not that it helps. it's usually just a single mg.)
7. 
   Nov 28, '12

   I have had numerous nights where I bat 100% for admissions. The floors hate me when I work trauma/high acuity ha ha.
8. 
   Nov 29, '12

   My record has nothing to do with psych.
   
   I've done more CPR on non-patients than I have on patients! In the past 2.5 years, I've had three "person down" events with hospital visitors, one of which required CPR. In that same timeframe, I also performed bystander CPR in the community.
9. 
   Nov 29, '12

   Quote from somedaypeds

   I find counting the number of psych patients you had in one shift offensive.

   I agree.
10. 
    Nov 29, '12

    Quote from somedaypeds

    I find counting the number of psych patients you had in one shift offensive.

    I find that silly.
11. 
    Nov 29, '12

    I work in psych. Instead of counting those patients, I count insulin-dependent diabetics. Or asthmatics.
12. 
    Dec 1, '12

    Quote from somedaypeds

    I find counting the number of psych patients you had in one shift offensive.

    Wow, what?! This just makes me shake my head. People are so quick to get butt hurt and take offense at EVERYTHING nowadays. Why is psychiatry offensive? It is a medical area, just like cardiology, nephro, etc. Would you find it offensive if the OP had counted the amount of Code Blues for a shift?
13. 
    Dec 1, '12

    It may be because psych is singled out.
    
    Why aren't we counting the number of type two diabetics in HHNKS crisis, or CHF patients drowning in their own secretions?
    
    Psych is "weird" and hard to handle, it's not really accepted as being normal like, well, like diabetes and CHF...but diabetics and people with heart failure don't usually punch you in the face because they think you're Satan.
14. 
    Dec 1, '12

    Quote from Anoetos

    It may be because psych is singled out.
    
    Why aren't we counting the number of type two diabetics in HHNKS crisis, or CHF patients drowning in their own secretions?
    
    Psych is "weird" and hard to handle, it's not really accepted as being normal like, well, like diabetes and CHF...but diabetics and people with heart failure don't usually punch you in the face because they think you're Satan.

    But that's the thing. It is singled out because of the stigma that we as a society give it. If we just see it like any other medical diagnosis requiring treatment, then the whole reason to take offense goes away.
    Also, my teachers in nursing school told us that EVERYONE has some kind of personality disorder, we just have them in different degrees. So I guess that makes psych more normal than CHF or diabetes really.

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