gero-psych...nothing but a nightmare!

Specialties Psychiatric

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I don't know if this will help, but I totally agree that this is VERY VERY difficult work. I believe people really underestimate how difficult it is to work with residents with advanced Alzheimers or other dementias. The key here is to have much support from your leadership. Presence of psychologists,psychiatric nurse practitioners also are a must in my opinion.

Unfortunatley I believe we are going to see much more of this population that is in distress.

Frankly here's where holistic nursing might be able to help at least a bit. Massage therapy also, Music therapy...and I don't mean just putting on a C.D. and leaving in near the patient. As you indicate, it's an insurance nightmare- I just wish that Medicare would reimburse for some of the adjunct therapies.

While no-one believes in patients being overmedicated, I have to wonder if there might be some undermedication as well.

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What is frustrating with this kind of nursing as you stated is the staff/patient ratio. Management think you can work wonders. The families think you've either over medicated "Dad" or you're not spending enough one on one with him "just sit and chat with him". Let's see one LPN, one NA, 2 Dementia patients, 1 serious wander risk (on a unit with no wander guard), 2 depressed elderly in for respite care, 2 dumped for lack of a better word and awaiting a nursing home in "hotel LTC" (and demanding full service), and one discharge for acute care whose wife doesn't want him home yet due to the new colostomy (and she's not really capable of caring for him).

It doesn't look like much on paper BUT when are the staff supposed to get their breaks? Deal with visitors, stop the wanderer leaving with the visitiors, give meds, try and teach with the colostomy, and explain to the depressed that not everybody gets visitors every day.

As for music therapy, OT, Phyio, who granted the therapists of the world a monday - friday job?

Sorry to vent but I ran from that job much as I loved it. I was becoming far to cynical and tired.

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Sorry to vent but I ran from that job much as I loved it. I was becoming far to cynical and tired.

Same feeling here with my present job, treatment centre for female substance abusers.

Getting fed up with cutbacks and gobshite bosses. Also recently found out that a new nurse got a higher wage than me, despite my higher education, experience and dare i say it competence.

Looks like ill be jacking it for a 3 day /week job translating for a medical company. Match my present full time wage meaning i can study one spare day a week and the other i can do a job i like ireegardless of the money, i psych emergency, kids psych etc.

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Specializes in LTC, home health, critical care, pulmonary nursing.

Maybe it's just not the field for you. I'm a CNA in geri-psych, and I love it. Maybe your not twisted enough. But maybe I'm liquored up after a bad day. I love my Captian Morgan!

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Specializes in Geriatric Psych, Physicians office, OB,.

It takes someone special to work in this line of nursing - and not everyone is cut out for the job. I've dealt with everything from dementia to schizophrenia to alzheimers and each diagnosis is different from the next, requiring different treatments for each. What makes it worth it? When you have that completely lost patient come in, totally bewildered and off the wall....then you see them the day they're discharged and in such better shape. When that person who would previously rather have torn off your head gives you a hug and thanks you for being there for them when they needed you, and appreciates your timeless patience and understanding. That's what makes it worth it for me.

In the geriatric/psych unit where I work, we are a locked down unit with 24 beds. I have yet to really see a problem with staffing, compared to the nursing home I previously worked at...this job is fantastic. I was beaten and abused more at the nursing home than I am here. We have a daily program we go by, and specific times for groups, etc. Everyone stays busy, so the day goes by quickly. I for one enjoy my work as a psych nurse! Each day is a challenge, and making a difference in someone's life is what I went to school for. Plus, it's very interesting!!!

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I can in a way identify with the charm in it, we get a lot of Korsakow patients which is similar and their a good laugh and easy to get on with.

My gripe is that gero psych places allways seem so understaffed and you work so hard the sweat is rolling off you.

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Specializes in LTC, assisted living, med-surg, psych.

I think ANYONE who works in any kind of psych unit must be an angel of some sort..........I know I sure as heck couldn't do it! I've worked enough LTC and acute care to know I'd rather deal with the nastiest wound, the brittlest diabetic, the sickest cancer victim than psychiatric patients of any age.

To all of you who are willing to do this kind of work, I salute you for your compassion and your bravery. And may God bless you and keep a special spot in Heaven open just for you, because you're already going through hell on earth! :eek:

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this is an area of healthcare where

we spend too many of our resources on medications

and too little on staffing

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Please tell me ANY redeeming qualities of working in gero-psych. I'll attempt to be kind. I am so sick of screaming, incontinent, hitting, kicking, biting patients. I plan to resign Monday morning pronto! How do you help this population when they don't even realize they are of this world? All I can see is it's a surefire way for the hospital to suck Medicare dry, while the nurses are overworked, underpaid and understaffed. :angryfire

The design of the unit, a good staff to patient ratio and lastly meds are the keys to prevent staff burnout and to provide good care. I work on adult unit and we take the "overflow" from gero psych. It can be very difficult. Those patients are treated by everyone. Meaning all staff takes a turn monitoring those patients during a shift. Perhaps because our unit is so well managed (and I work with great people) it isn't as frustrating. I have a hard time working with these patients not because they are difficult but because I often think about how they were before they became ill and how awful it is for them and their familes now.

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The design of the unit, a good staff to patient ratio and lastly meds are the keys to prevent staff burnout and to provide good care. I work on adult unit and we take the "overflow" from gero psych. It can be very difficult. Those patients are treated by everyone. Meaning all staff takes a turn monitoring those patients during a shift. Perhaps because our unit is so well managed (and I work with great people) it isn't as frustrating. I have a hard time working with these patients not because they are difficult but because I often think about how they were before they became ill and how awful it is for them and their familes now.

What do you consider to be a good staff to patient ratio?

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What do you consider to be a good staff to patient ratio?

The largest number of patients I have on evenings is 5, depending on the census. A mental health worker ususally takes one of my patients for individual contact and charting. When the census is high (23-28) and depending on the number of people who are 1:1 (dementia patients are 1:1) we would ususally have 9-10 staff. On gero psych, their ratio is usually 1:3. Their unit is a pod and all patients are in the milieu which makes monitoring a little easier. I do know they will use poseys. Their census runs at 14. Hope this helps.

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