"Regular" psych vs. geriatric psych?

Specialties Psychiatric

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Specializes in Trauma/ED.

Where I work we have both. Personally I think the geri pt's are a lot more mentally draining. We get a lot of geri's that have been kicked out of all the nursing homes in town for being too violent or eloping too many times, so they end up being placement nightmares (we are acute care). I think it just comes down to what you like to do. Of course there is more bedside care with them but they are awfully rewarding when they aren't sundowning or pinching and biting :)

Good Luck!

Murse Larry

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Whomever said "diaper patrol", shame on you. If you are comfortable working with psych patients of any age, you will do fine working with geriatric psych. Maybe you can float or shadow someone a few times before making a choice. Please make sure you try out a morning and a night shift because Larry has a point about sundowning. Working with the elderly is VERY draining. It is pretty tough to work with so many folks who are nearing the end of their lives. Most have multiple chronic conditions and very limited mobility, which means more for you to do. Add psych conditions to all of this and there you go. I wish you much luck. If you decide to go for it, please know that you will be doing somthing so very worthwhile, so very far away from "diaper patrol".
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The degrading term "diaper patrol" is definitely a part of working with elderly "psych" patients. Most of these patients from my experience suffer from some form of dementia. I rarely saw the psych illnesses associated with younger people such as schizophrenia, schizoaffective disorder, bipolar, etc., etc.

Back to diaper patrol, not only are these patients manifesting symptoms associated with cognitive changes but also those associated with aging, such as limited mobility and decreased control and awareness of eimination needs. So yes, there is "diaper patrol" involved but also a whole new world of kowledge and an entirely different skill set required to be an effective, professional RN giving care to these PEOPLE.

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Working with older people with mental health problems is not just diaper patrol. Shame on those who think of it as such. I have worked in this field for 20 yrs and have loved it. My professional knowledge and skill base has benefitted tremendously. In how many other fields of psychiatry do you need to have as much knowledge on caring for physical illnesses as you do mental illnesses. My role includes IV therapy, catheterisation, wound care, Dysphagia, stroke management etc etc etc. I am also involved in ethical problems such as resuscitation in Dementia and the with holding and with drawing of medical treatments. Do not think of older age psychiatry as burden and toil, think more in terms of dedication, skill and love.

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you will meet some very endearing people in geropsych.

I will never forget the woman who had had a labotomy because she was "promiscious'' in the 1950's, or the survivors of the death camps in Europe.

Or thr guy that ate the live parakeet before we could stop him, feathers feet and all!

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I have to say working in acute psychiatry that sometimes my colleagues are not that flattering about the work in geri, however as I spent some time in the field I have to say I take my hat of to all who work there. Its a challenging field and the work can be physically demanding, so all who work in geri I sallute you :nurse:

regards StuPer

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Thank you to both Sanakrz and StuPer

In my 20 years or so in older age psychiatry, I have come across many sad and many funny situations. All these go to enrich the work involved in looking after this client group. Before regulation and controls, many people were put in institutions for inappropriate reasons. When I was training, I came across one old dear who was put in hospital for getting pregnant out of wedlock, she had been in in hospital for 60+ years. There are many such stories as this.

Not that long ago, I looked after a gentleman suffering from Lewy Body / Parkinsons Disease. His mobility was shocking and he fell umpteen times a day despite all efforts. One day, after a series of falls, he fell, went to get up and then shrugged his shoulders and just crawled to a wall, sat there. He then asked me to get him a plate and a sign to say "wife and kids to support".

:kiss

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I work on psy and we have ages 18 on--. You do not always have to change diapers on elderly, but also on young adults who are delusional and hallucinating. Nurses are needed in all ages, basic needs must be met also.

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I've been a psych nurse (CNS) for a long time. In my current job, I travel around to psychiatric units all over my state (working for the state). If you particularly like working with the elderly, you may well enjoy a job on a geriatric unit. If what you really enjoy are the more conventional/traditional aspects of psych nursing, you may find a gero unit v. frustrating.

What I observe on gero units all over my state is that the majority of the patients are transfers from nursing homes. Often, either the patient created some sort of large (or small) disturbance at the nursing home and they quickly shipped them to an acute unit, or the psychiatrist consults with the nursing homes (makes monthly visits, or whatever) and identifies patients who may (barely) meet criteria for an inpatient psych admission and arranges for admits because Medicare will pay for same without asking a lot of questions. One psychiatrist in our state actually talked a small hospital into converting their general psych unit into a gero unit by telling the board that there was a lot of money to be made (from Medicare) in gero psych and the gero program would generate a lot more income for the hospital (and himself) than treating younger adults.

A large proportion (not all!) of patients on any gero psych unit will be pretty demented. I see lots of situations where I can't figure out what the acute inpatient unit is supposed to be doing for the patient that couldn't be done in the nursing home. Typically, the admission is about tweaking medications in the hope of producing some (minor) improvement in the demented patient's level of function. The same treatment could be provided by the psychiatrist in the nursing home, but it would mean going to the nursing home more often than once a month (!) and the doc wouldn't get paid as much ...

I don't mean to sound like I'm flaming psychiatrists -- I know many great ones. But I'm v. troubled by a lot of what I see on the gero psych units I inspect for my state.

Working on a gero unit will involve quite a bit more personal care than a general psych unit, and a lot less of a conventional psych milieu. I have a lot of respect for the people who enjoy working gero psych, and wish you well if you decide to try it!

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Originally posted by Jewelrmn

Thank you to both Sanakrz and StuPer

In my 20 years or so in older age psychiatry, I have come across many sad and many funny situations. All these go to enrich the work involved in looking after this client group. Before regulation and controls, many people were put in institutions for inappropriate reasons. When I was training, I came across one old dear who was put in hospital for getting pregnant out of wedlock, she had been in in hospital for 60+ years. There are many such stories as this.

Not that long ago, I looked after a gentleman suffering from Lewy Body / Parkinsons Disease. His mobility was shocking and he fell umpteen times a day despite all efforts. One day, after a series of falls, he fell, went to get up and then shrugged his shoulders and just crawled to a wall, sat there. He then asked me to get him a plate and a sign to say "wife and kids to support".

:kiss

I always get a thrill when someone can keep their sense of humor when the odds are against them! ;)

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