is your neuro floor also a pysch floor?

[Lola77]

Wow - i swear sometimes my neuro floor is like a straight up psych floor. My hospital doesn't have a pysch floor so we end up with all of the drug OD, schizophrenics, people going thru DT's, suicide attempts, AMS in restraints, etc. . .

Is this true on all neuro floors?

[StepbyStep]

hmmm thats even more stressful. no we dont have people who are suicide attempts if that is the only reason for admission. we have a lock down psych unit however they do not take patients who have other complications going on. so if a patient comes in has a stroke or an overflow med surg type patient has schizophrenia then yup we get them, etc. the majority of our patients have psych issues going on. we have a lot of patients in restraints some due to brain injury related reasonings others due to just being crazy lol. keeps it interesting. lol

[sistasoul]

I work on a neuro/ortho floor. Yup. Get all of the detoxers, suicides, strokes, changes in mental status. Some nights it is pretty much a psych floor. Some days we have 2 or 3 little old peeps out at the nursing station with us. I love my cute little old dementia patients most days but sometimes it is overwhelming trying to keep them safe. These types of patients are very time consuming and undortunately take time away from our alert and oriented patients. The detoxers are usually my nightmare patients. They are on the call bell constantly for their CIWA or COWS protocol or their pain meds. A lot of the time they come up with everything under the sun wrong with them to stay another day. I feel for the MDs in these situations as the tests that are run on these folks for these so called "maladies" suck up the Docs time and our healthcare dollars. But the MD must order the tests just in case that this time there really is something wrong.

[Hands&Feet]

Yep, sounds like our neuro floor too. Our hospital does have an inpatient psych unit - but they won't take anyone who isn't "medically stable." (and apparently even MRSA means they're unstable.)

[jmqphd]

I think there is a real problem with neuro being the "dump" unit for all the patients that don't "fit" elsewhere. (i.e., patients no one else wants.) Face it, the Central Nervous System is something that everyone has... it's going to be affected in almost any metabolic alteration... if you let Admissions get away with it, Med-Neph will only get Med-Neph patients, and Ortho will only get patients with fractures, and GSU will only take patients after belly surgery, and Oncology will only get cancer patients on chemo, and so on. But NEURO gets anyone who's altered... PLUS everyone else's overflow.

You need a nurse manager who is a strong advocate. (And it doesn't hurt to have neurologists and neurosurgeons in your corner making the argument for you either.)

I'll tell you how that nonsense got stopped (mostly) in our hospital. The admissions supervisor at our place would fill our beds with patients no one else wanted (uninsured bariatric patients with boils in their butt-cracks, homeless people who have a clean CT scan but want a warm bed on a cold night, suicide gestures, little old ladies from nursing homes with catheter associated UTI's, etc, etc.) And once our unit was full... an acute stroke patient would roll in. Or a patient on another unit would have a seizure. Or a SDH-post craniotomy patient would need a bed. Or that cancer patient would suddenly be unable to move their legs or empty their bladders... in other words, there would be patients who needed to be cared for by neuro nurses.

Then... golly gosh! THe nurses on Med-Neph, or ortho, or GSU or Onc suddenly didn't want those admissions. And would you believe it? Neurosurgeons didn't want to send their fresh back surgery patients to non-neuro units.

So, what goes around comes around. If administration lets the Neuro unit be used as a dumping ground, then there might as well not be a neuro unit.