DavidLCPCCSADC replied to MADHAT6's topic in Psychiatric
Why is it neccessary to make something up? Since they are not a direct threat to self/others, at this point, that's "good" news. Ultimately if they keep drinking and/or drugging there will likely come a day where they will need the inpatient psychia...
DavidLCPCCSADC replied to wonderbee's topic in Psychiatric
"This is unacceptable. People MUST be held accountable for abusing healthcare workers, and management MUST back up their employees in situations such as you have experienced. You have every right to file assault and battery charges against that patie...
DavidLCPCCSADC replied to KristieRae71's topic in Psychiatric
You realize that you're likely looking at a huge pay reduction if you make the switch as a BA level counselor. Many substance abuce facilities use RNs and get a chance to do some counseling while still getting the nurse pay. Suggest that you start he...
DavidLCPCCSADC replied to MADHAT6's topic in Psychiatric
Sounds like it's time to get a support network in place. This is a good issue for individual and group supervision. Many of us are blessed with a supportive fellowship that is available 24/7......it's also a good idea to have a personal network of p...
DavidLCPCCSADC replied to IamRN08's topic in Psychiatric
I went through this early last year with our patients. My review of the research suggested that the patients generally take to it easier than the staff does. Indeed, our staff anticipated issues but they were minimal. Giving patients access to the "p...
DavidLCPCCSADC replied to stellina615's topic in Psychiatric
As a general rule, guded imagery relies on the patients internal state to influence the content and "feel" of their imagery experience. For a patient that is in acute distress, this is generally an unpleasant "place" to go. Using some abreviated imag...
DavidLCPCCSADC replied to stellina615's topic in Psychiatric
Guided imagery is much more appropriate for the nonCMI population. For the patients in need of short-term stabilization it's generally noneffective and can actually elevate the symptoms and stress. A focus on symptom management, self-monitoring, CBT ...
DavidLCPCCSADC replied to cherilee's topic in Psychiatric
BTW, just to clarify, when I refer to a "addictionologist" I am referring to an MD who is ASAM Certified. If you have such an MD who is also good at group, 1:1, and in coaching coping skills it sounds like a terrific resource :-)
DavidLCPCCSADC replied to cherilee's topic in Psychiatric
"I just find it sad that so few of these pts ever become free of any of their addictions!" Often working in the field you mostly just see the revolving door patients and frequent relapsers. It's rare that a patient will return to visit with you, just...
DavidLCPCCSADC replied to cherilee's topic in Psychiatric
Withdrawals are typically divided into two stages: AAS (acute abstienence syndrome) and PAWS (post acute withdrawal syndrome, AKA: protracted withdrawal). AAS can take a couple of weeks with benzos while PAWS takes months. Also, it's not uncommon to...
DavidLCPCCSADC replied to Jules A's topic in Psychiatric
My fear is that we may be guilty of "trivializing" real CMI while at the same time discounting the genuine pain & sufferring of many of our patients. Granted there are some valid points here about the med-reps, over-use of Rx meds, etc.... Howeve...
DavidLCPCCSADC replied to thegreenmile's topic in Psychiatric
My prayers and best wishes go out to you and the staff. Although it's of little help now, the time to have the safety net (support network) in place is before people need it. Many of us are blessed with a supportive fellowship that is available 24/7...
DavidLCPCCSADC replied to sleepybunny005's topic in Psychiatric
My first suggestion is to speak with the nurses on the floor and to your clinical instructor. Second, your job is not to "orient her to reality" but assist in her general functioning on the unit. Rather than focusing on the delusions, you might want ...