Please don't judge me and my daughter - page 4

The night my daughter told me she wanted to kill herself was not an easy night. I drove her to the Emergency room that I used to work in, thinking they would care for her best. What I found was not... Read More

  1. by   dianah
    Note:
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  2. by   Serhilda
    So many new nurses wanting to work in the ED would never in a million years consider psych nursing, yet psychiatric needs are constantly needing to be addressed there. It seems so incredibly foolish and ignorant to believe psychiatric patients are simply segregated off somewhere, conveniently out of your way so you never need to consider their needs and care. You all went to nursing school and were taught how to properly handle psychiatric disorders, so if you need a refresher, feel free to do so on your own time. Everyone should know better, choosing ED nursing is no excuse. Responding in an empathetic way to psychiatric patients doesn't require an education though, it requires giving a damn about the mentally ill.
    Last edit by Serhilda on Sep 24 : Reason: Clarification
  3. by   wondern
    Quote from TriciaJ
    Patients can spot a fake smile and it usually doesn't go over well. Smiling and laughing when someone is suicidal is completely inappropriate to the point of being insulting. Maybe the customer service crowd endorses this, but I'm not buying.
    Again, TriciaJ, I'm not talking about a snarky smart aleck nor insulting smile or laughing at inappropriate times as you are insinuating. I think most readers understood what I meant but if not thanks for allowing me the opportunity to clarify.

    Yes I am in the customer service business as a nurse it's called patient care and it is an art like Cat says. It's healing. I think it's okay for a suicidal patient to smile or possibly even laugh with their caregiver if they feel like it. May not be real likely but who knows it sounds like a most excellent outcome to me.

    Actually the only time I see a smile or laughter could hurt is if its done out of meanness or ignorance like a bully or plain inconsiderate person would do. That's not what I was talking about in my post.
  4. by   wondern
    Quote from smartnurse1982
    What does a smile have to do with excellent nursing care?

    I am not following.

    I think some people do need to realize that a neutral face is not a sad or angry face.
    Sorry you weren't following, smartnurse1982, RN. The previous poster said they felt a 'fake smile' would have been "totally inappropriate." No one said anything about a neutral face I don't think.
    While cursing a person usually has an angry face and it can be very stressful to others who don't like to hear it, just saying. Would you call it a hostile or loving environment when your child's caregiver is cursing in her ill presence?

    Actually come to think of it and since you asked, I do think an appropriate loving, caring smile is an integral part of excellent nursing care! It's healing. It's compassionate.

    Nothing is wrong with an 'appropriate' smile in my humble opinion. We can certainly agree to disagree.

    I was merely trying to point out that it can be easier than one thinks to change their mood and also help those around them by just trying to put on a happy face and for goodness sakes not curse in front of our pediatric patients! How absolutely rude is that?!

    I'm sorry that happened to Cat and her daughter! It's a sad state of affairs. I'm glad she spoke out both as a parent and a fellow nurse.
  5. by   5150rn2
    It's amazing to me that you set aside a suicidal pt crisis as being different than any other health crisis. They need your help just as much as the man having the heart attack, when that man looks at you with fear in eyes, what do you do? Do you look him in the eye and try to ease his fear or just keep on "saving" him. Or do you acknowledge his fear?
    With a suicidal pt it's not the lab draw or the it start or the vitals that help them, it's looking them AND their family and acknowledging them and their crisis. It doesn't take a long time with a suicidal pt esp with family at bedside. They either have a sitter with them or are where you can see them and likely someone from psych is coming to do that assessment.. so outside of your tasks that's all you have to do.. but a compassionate look or touch or even sometimes a smile or some appropriate humor makes all the difference in the world. It's the moment when a pt in any crisis knows you see them.
    I have worked in the ER..it takes no extra time when doing tasks to acknowledge that there is a person on that gurney, not an MI or a suicide attempt.
    And please this Mom knows all about aching backs and being swamped .
    I have a quote from maya Angelou as part of my email signature.. the one about people don't remember you for the things you do or say, they remember how you made them feel... ( paraphrased)
    Seriously, its only about a moment of empathy.
  6. by   5150rn2
    Neutral maybe, but your eyes can convey volumes..
  7. by   5150rn2
    No one chooses to go to an ER anytime, unless of course you have had a sore throats for 4 days (I have seen it)
    No one says you have to get involved in the why and how or other parts of the issue. But portraying yourself as warm and empathetic is something everyone can do. With everyone..no matter their reason for being there.

    Also re psych pts in the ER, everyone has to be cleared physically in the ER before they can be admitted to a psych facility/unit. And currently the trend is to have dedicated mental health staff in ER's these days
  8. by   5150rn2
    Beautifully said!
    And oh yes indeed a smile and even some humor ( appropriate of course) can do wonders. It doesn't mean you are making light of what they are going through,but sometimes it helps someone realize it's not so bleak..
    I have worked in psych for a long time. And many aren't cut out for it. But I worked as a nurse in the hospital setting for many years before that, different dept's, different hospitals. Both as "regular" staff and as a traveler. Never once did I find that kindness,being genuine and frequently a smile let me down.
  9. by   nsue
    I agree with you about nurses. My daughter is chronically ill and has gone to the emergency room many times. We have run into the same thing with nurses who don't care and are down right rude! I want you to know though there are still many good compassionate nurses out there that consider nursing a calling. I
    am one of those. I am finding that people everywhere are becoming more rude, entitled and heartless. It is a sad situation! I hope your daughter is better.
  10. by   Cmburns
    I am sad to say, you are correct

    My heart breaks for you and your daughter. Though, unfortunately I know your story is true. I worked in the ER of a large, very busy hospital. Many of the nurses were hateful to patients, particularly Behavioral Health, homeless and anyone who asked for pain medication. I hope that we are able to change this culture of judgmental, uncompassionate nurses. I am really glad you have spoken out about this. I hope your daughter is well.
  11. by   ConnieDiamondWhite
    Working in a nursing home, we are taught that complaints are a gift our residents, families and other customers provide us with, to assist us to make our care the best it can be. Any profession (or any other system) that only receives positive feedback will implode. It's time we as a profession start taking in these complaints and fixing what we can about ourselves. Attacking the very people we work for is hardly professional, when a mother is with a child, yes, her judgment may be clouded. However when handled correctly, can leave both mother and child feeling cared for. I am really hoping I never run into a nurse with your attitude when I or my family need care, by reading your post, I can see making widgets on an assembly line is more your passion, not caring. It's not a "romanticized sappy calling", it's one human caring for another, seeing pain and fear and dealing with it to provide the patient with the tools to deal with their current situation. It's not up to you to decide, it's the most important part of your profession, LEARN IT!!!!
  12. by   carolmcclure
    i also work in a small ER, and know that the ER is not equipped to handle psych pts...to the outside world, that seems absurd. to those of us who work in an ER, we know it to be true. ER's are designed to save lives in acute emergencies. they were never designed to house disturbed, psychotic, homicidal or suicidal pts..at the best of times, we have very little to offer. at the worst of times, i'm sure we are perceived as cold, uncaring, etc..we cannot make a suicidal pt's many needs a priority over medical emergencies. we can only do our best to ensure safety. we are constantly met with pts/family attempting to bully us, persuade us, or threaten us into circumventing policies put in place by the hospital. i am not willing to risk a pt's life or my job by refusing to follow policy. i learned this the hard way by seeing the aftermath of a new nurse giving a psych pt a can of soda. she worked at that can for an hour, twisting it back and forth til it broke in two, then slashed her wrists with it. nor am i going to take a pt outside to smoke, even though other rn's do it, which leaves those of us who won't as a target for being hateful and uncaring. again, i am not risking my pt's well-being or my job. what happens when that pt runs off? i am now open to lawsuits and firing. as a health care professional, i am a little taken aback that you thought things were going to be different when you took your daughter there..did you believe you should be able to flout the rules because you work there? quite possibly, you put the nurse in a bad position by attempting to go around what you knew to be policy. that was not fair of you. again, i agree that the ER is probably one of the worst places to take a psych pt. our system of psych care is horrible. with that said, safety is about all we can offer. there is no way an ER nurse can spend hours with a psych pt. not when there are mi's and strokes and surgicals coming in the door...that isn't pretty, but it is the truth.
  13. by   kbrn2002
    I am sorry you and your daughter went through this. I am glad she reached out for help and hopeful that she is getting the treatment she needs. I do think though that you should look at your ER experience from the other side a little bit. One paragraph in particular made me think that your impression might be a little off:

    "And to you the nurse who said it looked like we were camping out. Did you consider not everyone lives the same lifestyle and some of us may need food because of our way of life? Did you notice I kept everything neat and then cleaned up before we left? Did you consider that I needed that food and water to keep me from falling apart? How do you know that it wasn't for my daughter who has food allergies? As far as my daughter's belongings we had hoped she was coming home with me and she did. But you made us put them in my car and she walked out in the lovely paper scrubs provided for her."

    My impression was the ER is not the place to bring multiple meals and your own water. Taking the time to bring carefully packed supplies to an ER does not exactly scream "this is an emergency!" to me. As for the staff requesting that you take her personal belongings away and keep them in the car I 100% believe this is the correct thing to do when dealing with a suicidal patient. Isn't removing anything from the environment that could be used to carry out a suicide a standard procedure? How is the ER staff to know what type of weapons or things that could be improvised to make a weapon might be packed in those carefully prepared belongings? If you took the time to pack food, how would the ER staff know that your daughter didn't take the time to pack something she could use to kill herself with?

    Just food for thought that maybe all the staff weren't really as uncaring as you perceived.

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