Ranting and new

  1. Hello, I came across the allnurses site while searching the internet for info on psych nursing (I never did find the article that is on this site!). I was thrilled to find a discussion forum just for psych nursing.

    I work nightshift in a 56 bed psychiatric hospital that is a part of a large network of medical hospitals in the US. I am an LPN and have a BS in psychology. I have worked as a counselor in the past but have been working as a nurse for 12 years (more $$$ than counseling).

    My hospital has been in absolute chaos the past few months. The main medical hospital in town shut down it's psych unit (as did 2 other hospitals in a 100 mile radius) so now we are getting a deluge of violent, homeless, sociopathic, etc. patients that we aren't used to dealing with on a regular basis.
    Our adult units stay full and we often have to shuffle people around in the middle of the night to bring in new patients. The ER doctors in the area don't accept it when they are told "Sorry, but we have no beds available." Just last night, I had to pick the "best patient", wake him at 2am, clean his filthy room, and transfer him to another unit so we could admit a homeless man that caused a ruckus at a bar downtown (isn't that what jail is for!!!!?????) Many have learned those magic words "I'm suicidal" or "I'm hearing voices" to get admitted. They are taking beds that truly sick people need.

    We are so short-staffed. I work on the acute adult and closed units (acute has 11 rooms and the closed aka lock-up has 5 rooms) We have no male staff at night (the security guard is a 56 year old woman! -- however, she is pretty damned good). Most nights, it is me and another female nurse running this unit.

    I could go on and on. Here it is my night off and I can't seem to quit thinking about it. I used to love my job. No more.

    Anyway, glad to be here.

    Kris
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  2. 5 Comments

  3. by   nightingale
    Welcome...

    It is wonderful that we have this forum. I am not a psych. nurse but know what you speak of. I am a med/surg agency nurse who gets floated to other units like psych. (I will float if there is adequate back up).


    B.
  4. by   sjoe
    Kris--all I can say is that these patients, lying about voices or not, don't simply wander up to your ward from the street. They have to be admitted by a doc, don't they? That is where the problem seems to lie. Someone needs to be setting limits and he/she isn't doing so.
    And yes, that is what jail is for.
  5. by   sanakruz
    Kris- All our clients must be screened by a crisis team to meet criterion for involuntary detention. Sounds like some triage is in order. What kind of out-patient services are available? Can't they wait? Why 24 hour admisssions? What happened to that poor guy kicked out in the middle of the night? Anyone with criminal charges here 1) Goes to jail.2) has title 19 rights to reguest mental health servicecs while incarcerated. Hey -jail is a controlled ,safe environment. Our docs dont have the power to write involuntary holds( and they hate it!) but it keeps the beds free for the really sick.
  6. by   GeorgiaGirl
    Kris, your post sounded like I wrote it myself. I work in a smaller psych unit (25) beds, but the problems we face are much the same. Mostly violent, homeless patients looking for 3 hots and a cot. The majority of which are receiving Medicaid, and is sure money for the hospital. We have 2 nurses and a psych tech on the 2nd shift, ALL female. NO SECURITY on the unit. A few nights ago, we had a homeless, schizophrenic attack several patients, attempted to attack me several times, rammed his own head into a steel door,bursting his head open and STILL continued to threaten everybody. Management refuses to address the issue of safety to the staff and patients. When I attempted to offer suggestions, they quickly informed me, "this is NOT a jail." I agree, it's not a jail, it's an institution driven by GREED and that's the bottom line. It's impossible for us who "care" to help anyone that might be helped because we have to cater to the ones who don't stand a snowball's chance in hell of getting any better.
    Like you, I could go on and on.....but I plan to submit my resignation and consider it a lesson learned.
  7. by   sanakruz
    Georgiagirl- maybe you should call medicaid and tell them what a horrible place it is. I know that in CA the medicaid (medi-cal) system takes complaints because ultimately they are stingy with our taxpayers dollars; This would be considered great media fodder also.

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