Pros & Cons?

MSADN, ADN · Oct 11, 2006

I've worked ER as a tech and understand the "special" challenges spoke of in a previous post. Some of the homeless who frequent the ER are mentally ill and are not taking medications required to manage their symptoms, which can present all sorts of interesting situations for the ER team. Nope, I don't think it was meant as an insult. I just nodded and said, "Yep."

Not especially dealing with mental illness, but speaking of challenges in the ER, I've told my wife often that I fought more in my two years as an ER Tech than in the previous 35 years of my life or since. One thing I learned in the emergency room was to keep your focus because you never know what's coming through those doors.

Starphoenix · Oct 11, 2006

Thanks, but I hope to hear from ERNP for clarity. It wasn't phrased in such a way that I'd gather what you described. I do know about the challenges of treating a person with both medical and psychiatric issues. (I don't even like that there's this divide. It's all medical!) Be that as it may, if ERNP had just said "psychiatric challenges," it would have been different entirely. I want to say "she" but I don't know if ERNP is a "she," but ERNP gave quite a litany of the kinds of patients seen. I know that psychiatric patients come to the ER for things other than "medical," too, and that's what I thought was meant by "special." You know, manic episodes or psychotic breaks, suicide attempts. I don't see a distinction there. They're all problems to be treated. Someone with multiple medical problems, or systemic illnesses, wouldn't have been pointed out as "special."

Starphoenix · Oct 11, 2006

I wouldn’t be too quick to lecture the nurses or NPs on this board until you have worked in their ranks. If you ask for the “nitty gritty” and then in return scold a nurse practitioner for not being politically correct, you are going to put people off.
Yes, I want to hear it all, but while offering a litany of patients seen (ERNP was responding to the "day in the life" description for which I also asked), I didn't understand the need for calling attention to that so-called special population. Maybe hard to manage, heartbreaking....but child patients of any type can present this dynamic, as can diabetics who aren't treatment compliant and end up in a stupor.
Maybe if you suffered with mental illness, or someone close to you did, you would understand my POV.
(I see you're a nursing student.)

fidelio · Oct 11, 2006

I'm a charge nurse in a psychiatric hospital. Yes, my profile needs updating.

Starphoenix · Oct 11, 2006

That's wonderful, and quite draining, I'm sure.

I have been a mental-health counselor in an inpatient crisis intervention unit for children. I do understand the complexities! It was always interesting getting report in the morning: "We had two admissions during the night. One swallowed three pencils, a lipstick, and 40 pills....Have a good day."

Phew. It can be exhausting! :eek:

ERNP · Oct 13, 2006

Thank you for "biting."
I wondered why you called attention to not forgetting the "special patient population with psychiatric challenges." That's kind of insulting, don't you think? I happen to be one with "psychiatric challenges," but I live a full and productive life. It's little wonder there is no coverage parity with this kind of attitude, and I don't care if you were trying to be insulting or not. Nobody likes being called "special." You hear that about those who are developmentally disabled, too. "Oh, Timmy. He's SPECIAL. You know, he rides the little bus...."

Clearly this hit a personal note with you and for that I apologize. However, this IS a typical day and when I see psych patients they are generally decompensated and on way less than their best behavior. Their behavior alone when in this condition does make them a population with unique challenges. These are the situations when providing what is routine care to others can become an actual physical danger to the staff.

You asked for a look into a typical day so that is what I gave you. Nothing personal. Again, sorry you were offended.

ERNP · Oct 13, 2006

Would anyone else be interested in sharing their typical day so we can get off my use of the word special? It seems I unwittingly threw the thread off track.

Starphoenix · Oct 13, 2006

Thank you, ERNP. I do appreciate your response. I misunderstood with the particular wording.

Jo Dirt · Oct 18, 2006

I wouldn't be too quick to lecture the nurses or NPs on this board until you have worked in their ranks. If you ask for the "nitty gritty" and then in return scold a nurse practitioner for not being politically correct, you are going to put people off.
Maybe if you suffered with mental illness, or someone close to you did, you would understand my POV.
(I see you're a nursing student.)
A good number of my family is bipolar (REALLY bipolar) and schizophrenic, I have "issues" myself and I don't understand the POV. I think some people ask for advice then get insulted when someone makes a comment about something that is a touchy subject for them.
I'm not ashamed to be "special."

nursetim, NP · Oct 24, 2006

Starphoenix, here is some advice from me to you. If you are going into nursing you need to have thicker skin. ERNP did not use the terms like wack job, nut case, etc. You see ERNP is a professional and sensative. I AM NOT. Nothing in that post was derogitory in least. You seem to have a talent of making a moutain out of a mole hill. As you can tell I have issues as do we all. I may get smoked by the mods but I hope to be in ERNP's position one day. I am also not sticking up for ERNP per-say, just the principle.

mukhorty · Oct 24, 2006

I don't remember how I found it, but this is an interesting blog by a nurse practitioner, may be a help --->

http://newfnp.blogspot.com/

- Jess

ERNP · Oct 27, 2006

I don't remember how I found it, but this is an interesting blog by a nurse practitioner, may be a help --->
http://newfnp.blogspot.com/
- Jess

Found it. Related to it on so many levels.