dilemma regarding antipsychotics - page 3
Hi everyone, I'm a new grad (LVN) who would like to go into psych nursing. I'm really struggling, however, with the idea of antipsychotic med. maintenance after reading research that indicates... Read More
0Jun 2, '12 by greenbeanioQuote from kidsI don't necessarily agree. Before I even considered nursing as a career, I had an experience as a patient that has really stayed with me. I had spent years using nothing but alternative healing and then suddenly I was a patient on a L&D unit in a life-and-death situation. I felt very helpless and scared in a system whose values and practices were alien and antithetical to mine, until I was assigned to a nurse who "got" where I was coming from and talked with me in terms of herbs and natural therapies. It was such a relief to be cared for by someone who spoke my language!To put it simply, if you don't agree with the standard treatment modalities utilized by a specialty, it's NOT a "good fit" no matter how much you want it to be.
Going to work in psych nursing when you're not comfortable administering anti-psychotics makes as much sense as going to work in an abortion clinic when you oppose abortion.
Now, as a psych nurse on a medical-model oriented inpatient psych unit, I do still struggle with the ethics of handing out some of the meds I hand out, knowing what I know about them. On the other hand, I am convinced there is a place for me there since I am the one who takes every opportunity to talk with my patients about what they can do for themselves - aka non-medication alternatives - in addition to the meds. I take my cues from the patients, and when I sense discomfort around or resistance to taking psych meds, I do not badmouth the psych meds but simply focus their attention on what they can do of their own initiative.
As part of this discussion we talk about regulating the sleep-wake cycle, exercise, diet, hydration, stress-reduction techniques, CBT techniques, etc. We talk, but I also use handouts and what is the most effective of all is demonstration. It's not easy to fit into a busy schedule, but I see that as my ethical responsibility.
I think it is empowering to the patients to know that it's not ALL about meds, and that meds can be a helpful "crutch" to get them on their feet enough to be able to do all the things they need to do to regain balance and health.
0Jun 2, '12 by greenbeanioQuote from algebra_demystifiedI once asked a doctor why a particular patient was on an antipsychotic when he had no sxs of psychosis, just severe depression. He said it was because the insurance companies wanted them out so fast that there wasn't enough time for the antidepressants to really kick in and the antipsychotics can reduce anxiety enough to let the antidepressants be more effective. He also said this was a short-term use of antipsychotics with the assumption that the outpatient prescriber will taper and discontinue them.In my opinion, antipsychotics are useful for managing psychosis. At the same time, they are used to treat many other conditions that could be better managed by talk therapy and community integration techniques rather than using antipsychotics as sedatives.
Anyone else ever hear this?
2Jun 2, '12 by tothepointeLVNYeah I've personally experienced this. Inpatient they'll often go up on the doseage on everything you are taking till either it gets you through the hump or you stop complaining then your outpatient dr tapers it all down. It can sometimes take years to taper everything off. I find a small prn dose of an anti psych can be more effective for anxiety than a benzo without the dependence and tolerance issues. I really think they need to rename the drug classification as antipsychotic doesn't seem to cover all the possible benefits. There's not a lot of talk therapy going on inpatient. Honestly its more of a keep you safe hotel.
Overall I've taken a wide range of psych meds. Not all are bad and for most the side effects are tolerable when you get the right fit. Could I have survived without meds? Sure but my quality of life would have been pathetic. I certainly would never have been stable enough to become a nurse.