modgoth1, BSN 3,979 Views
Joined May 2, '12.
Posts: 353 (18% Liked)
The big thing with peds is there is no secondary gain for pediatric psyche cases.
I suck it up and stick it out... My mom says you gotta kiss ass before you can kick it.
You're certainly not going to see people at their best in the ED, so if they are a jerk on their best day... I try to keep in mind that they are in pain, or that they're having to watch their loved one in pain, and getting inadequate treatment. I usually will explain that the fewer things on my list that I have to do, the quicker I can get to getting them pain medication, and having to deal with a disruptive patient and husband isn't making my list any shorter.
What sticks out to me though is that the doc is only giving one time pain med orders for a patient with a known kidney stone, I've never known an ED doc to do that and is pretty much guaranteed to inadequately treat the pain. I'd tell the Doc that the patient in bay 12 wants to talk to them about their poor prescribing habits.
Right now, I am giving a Prayer of Thanks to God Almighty for my Great Co-Workers who have made the past Two Nights not Merely Bearable, but Transcendent!
Yelling, Falling, Head Banging, Hypoxic, Bleeding, Urine Soaked, Poopy, Confused, Delusional, Agitated, Verbally and Physically Aggressive Treatment Non-Compliant Psychotic Geriatric Patients could not deter these Team Members from Providing Exceptional Care!
MD, House Supervisor, Respiratory Threapist, RN, LPN, Techs, Security Guards, even though not Specifically Named, on MY All-Time Top List of People I want to Nominate (when they Die) to go to Heaven!
That they are full of tricks to get a controlled high in the beginning and you have to be on your p's and q's no matter how "nice" they are to you....just saying what I am saying
From a care standpoint the alcoholics and people dependent on benzodiazepines are the ones you need to watch as they are at risk of seizure and death. The patients with opiate dependence who are acting as if they are dying are usually not. Read up on cluster B traits both antisocial and borderline as I don't think one can sustain an addictions lifestyle without them.
Last, although it can be frustrating to continue to attempt to provide patient education keep in mind that you will never accurately be able to predict who might actually be ready to consider sobriety. Please treat them all as if they have that potential. Hopefully over the course of your career you will have helped at least one lost soul.
I work psych, and while I have never been dx with a mental illness officially... ADHD and Antisocial personality disorder traits, per our attending psychiatrist. I often say if I wasnt a bit crazy I would not be able to do my job. Seriously what sane person would voluntarily sit in a room to talk to someone who was just screaming in your face threatening to beat the crap out of you. Or sit across from a new patient who looks like they are going to explode and calmly say you look like you could use a hug ( to which he replied, that would be nice, gave him a hug and he instantly became a different person).
I do psych as contingent and love it. It is not what I want to do full-time (they keep trying to convince me) but I do like to do one or two days a week (haven't had the opportunity so much now that I am full-time on the med/surg floor). On my med surg floor, I keep hearing nurses say "I don't do psychiatric diagnoses"...and I wonder how they avoid it since almost everyone one of my patients on that floor have some sort of psychiatric history on their medical history.
I don't think most the people I meet think psych nurses are "crazy". I actually think they are more afraid of the diagnoses because they don't understand them. I get tired of nurses complaining about patients who are actually just showing symptoms of their already diagnosed psychiatric problems. I mean, if someone has panic attacks or severe anxiety...you address that and not complain that they are "acting like babies".
The brain IS an organ in our body and most psychiatric diagnoses are just over chemical imbalances in that organ....no different than diabetes is a chemical imbalance of the pancreas...or hypertension is often a fluid overload condition. It is a MEDICAL problem. And it is my experience, if I can explain it to the patients like that, they are more likely to be compliant with their medications instead of trying to go off of them to prove that they "aren't 'crazy". It is on the psychiatric floor that patients are the most vulnerable in the whole hospital...they need advocates more than any other place because it is their brain that is betraying them. They are not mentally challenged but rather have real medical issues that can be address and improved in most cases.
On the one hand, I have known psych nurses who seemed perfectly normal and mentally healthy to me.
On the other hand ... I have met a lot of nurses who have chosen their specialty because they have had personal experiences with it. For example, people who have had premature babies sometimes want to be NICU nurses ... people who have experienced Cancer want to help other people with cancer ... people who have struggled with drug/alcohol addition want to help other people who struggle with addiction ... people who have received hospice services when a loved one died want to become hospice nurses .... people who were abused as children want to help abused children ..., etc. etc. etc.
So there might be a little truth in some of those speculative beliefs. It would make for interesting research.
I've found in all 3 sectors I have worked in: disabilities, aged care and mental health, I have ALWAYS had people say "I could NEVER do what you do! You're a special kind of person!". I never really knew how to respond to this so just shrugged it off.
Mental health (psych) has another level of "Oh my! Don't you get scared? Isn't it dangerous? You can't predict what they'll do next!" and yes, the whole "You know what they say about psych nurses! Gotta be a bit mad yourself!". Funnily enough, the people who pull the mickey out of my profession the most are my nurse friends. Some work in palliative, aged care, ED, community and we have crack (mostly black humour jokes) about each other's specialty. In a weird kind of way, it makes us all feel proud and protective of our chosen specialties!
Do other people look at you weird when you tell them that or make comments that only crazy nurses want to work with crazy patients?
A little late to the party but
We get those type of admissions too. We actually have a name for them when we call the doctor regarding the admission (One hospital seems to "cherry pick" admissions and we are the dumping ground). We just say its a &&&&Special. That means, Homeless, polysubstance abuse, no insurance who suddenly became suicidal when they couldnt get admitted to a rehab, to a medical unit or where told they did not meet inpatient criteria. Im expecting a lot of those type of admissions this weekend.... Full Moon, getting colder, beginning of the month and now spent all money on their habit and a doctor who accepts anyone with a pulse. These patients do cause increased chaos on the unit, can be very difficult to redirect and typically hate that a female is the one who is attempting to redirect the behavior.
I don't post often compared to some but I do read AN extensively. I stay out of the flame wars but it gets really old seeing the same garbage over and over again, from both old and new nurses. With all the various threads flying about right now I would like to stop and acknowledge a true nursing professional.
Esme12, your posts are always insightful, kind and truthful. Your words of wisdom are delivered with class and grace without glossing over the hard facts of nursing. You epitomize the ideal of the professional registered nurse.
I wish I worked with you........but on second thought, I do. I work with nurses who have decades of experience and yet are not bitter or intolerant of others. It took me a few tries to find my niche (psychiatric nursing) but now I can look forward to every day working with the "esme12's" of my unit. Thanks.
Is it unreasonable to say that younger generations are far more proficient with computers and technology than those who are nearing retirement ?
Because ill also say that the older generations do have FAR better work ethic than my generation.
You were a secretary though, which means you had previous career experience using computers.
I really dont think the older generation as a whole is very good with computers.
I mean theres a massive amount who doesnt know how to type (without looking at the keyboard and pounding keys like throwing darts) or use resources like lexicomp etc
I wasnt being agest.
People who grew up with computers will be better than people who didnt.
Heck im relatiely young, and the internet wasnt around until I went to highschool.
Different generations have their own strengths/weaknesses.
And I think EMR is a huge weakness for older nurses
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