I am getting so fed up with the medical portion of our hospital. We are NOT a medical psych floor. Patients we have are SUPPOSED to be medically stable. When we send a patient to the medical side for something it would be AWESOME if all the testing was completed before trying to send back to us, in less then 24 hours. Oh the patient medically stable, what did the CT say, oh you havent even done the CT yet. Call back when its read and we will be up.
Call the admitting doctor- are you aware so and so has a PICC line for daily infusions. Yeah, I didnt think they told you ( from our own ER, not a transfer, those we pick threw with a fine tooth comb to find out if the people are telling the truth). Getting report... an IV line- no? really what about the PICC, oh thats just for blood draws. Gotta love being lied to over the phone in report.
Yes, I understand that I went through the same training as other nurses. Yes I can start an IV if needed ( but we do so few of them, is it fair to the patient to be pretty much a practice arm), we dont have monitors to keep tabs on them. Hell our patients dont even have standard call bells or electric beds.
I understand that they are busy with their 5-6 patient assignment, but I may be passing meds to 24 patients. We have higher ratios because our patients are MEDICALLY STABLE. Any time there is a psych patient on a medical floor, its usually within 12 hours that the nurses and doctors are chomping at the bit to get them off their floor and over to us. But if one of our patients decide to get sick while there it is like pulling teeth to get someone transferred medically. Or if they are being aggressive in the ED, they want to send them over before they are medically cleared. Nope, sorry I need the results and the precert information. BTW you have the man power over there and a doctor right there to give orders, I dont.
Jun 27, '13
by Davey Do, ASN, RN
May I say that I enjoyed reading your Post? You are quite the Spokesperson, stating your Areas of Concern in a Universal Tone that made your Perspective easy to identfy with.
Your Post set me to thinking: It didn't use to be like this. I began my Psychiatric Nursing Career in 1984, and aside from some very minor Medical Areas of Concern, I did nothing intensely Medical my first 2 1/2 years of Nursing on the Psych Unit.
Fast Forward to nearly 30 years to a Medical Center where I've worked for 10 years. A vast majority of the Patients I work with have a need for Medical Assessment/Treatment. We do Foley's, IV's, Tube Feedings, dressing changes, scans, flushes, along with various other forms of Medication Administration. Granted, I work primarily with the Older Adult Population who are more proned to illness than the General Population. Still yet and all, had I not had Surgery, Med/Surg, ER, and Home Health in my Repertoire by the time I came back into the Hospital Psych Setting, I fear I would be lost.
I wonder if the Areas between Psych and Medical have blurred to the point that Those With Power have difficulty discerning the Difference. Whatever Diagnosis Those With Power choose to be the Primary Diagnosis tells them which Unit to send the Patient. And, we as Nurses on the Frontlines must Fight the Good Fight.
There have been instances where Recidivistic Psych Patients with Valid Medical Conditions in need of Treatment have been Rubber Stamped and sent to the Behavioral Health Unit without so much as a Basic Workup. It's so sad when Profesionals put Opinions before Principles.
I can identify with, commiserate, and applaud your Well Worded Post, Mandychelle.
Last edit by Davey Do on Jun 27, '13