A typical day in a psych unit

allnurses Guide · Dec 23, 2015

I work geri-psych.

Listen to report.

Pull my meds.

Check my labs, orders and vitals (MHA's do VS)

Try to skim the chart as I f/u on wonky labs and VS.

Get interrupted constantly.

Do my med pass and assess my patients as I go.

Get interrupted constantly.

Try to verbally redirect, then distract my agitated geros.

Play whack-a-mole as all my high fall risk geros try to get up and "walk" at the same time.

Redirect my geros who are banging on the exit doors, because they "have to go home and feed the baby".

Break down and prepare the Haldol, as quickly as possible, because staff are trying not to get kicked in the face or nads.

Get interrupted constantly because my noncompliant diabetic is in my face, demanding chips now, and doesn't care I'm bookin' it with a syringe in my hand, while staff is trying to hold down an 88 year-old man who thinks he's Bruce Lee.

Check my orders and find the psychiatrist wants my patient to have ECT tomorrow... no labs, EKG or x-rays done. Crap.

Try to get all of it done in half a shift while constantly being interrupted.

Take my patient to the toilet because all of the MHA's have disappeared somewhere.

Stop everything because a patient has chest pain and crummy VS.

Deal with a medical emergency.

Get an admit.

Deal with constipation... though not my own.

Try to be therapeutic in my interactions with my walkie-talkies, while my butt-hole is in a pucker because I'm one noodle away from drowning.

Med pass again and visiting time.

Deal with the visitor that is absolutely crazy. She is demanding Mom be put on this antibiotic that she read about on WebMD, instead of the one Mom is on. I come close to asking her is she has a lab at home and has run the culture on the urine herself, but I contain myself.

Try, again, to get dementia patients to take their meds. I promise them it's not poison.

Find poop on my WOW.

Play with the phone as I finish up coordinating the ECT, check on my chest pain patient in ER and watch my Haldol patient wind back up again.

Get interrupted for a warm blanket by a patient who has decided to walk past the MHA in the hallway and ask the nurse allllllllll the way over here at the nurse's station with a phone in her ear.

It's bedtime, but the patients do not sleep. They are milling around in the dark. It looks like Night of the Living Dead.

Make an old lady put her clothes back on.

Give report and run like hell.

ATX77 · Dec 23, 2015

Well done Hygiene Queen :)

A&Ox6, MSN, RN · Dec 23, 2015

Is there such thing as a typical day?

Just kidding...or am I?

motor_mouth, MSN, RN · Dec 23, 2015

Hygiene Queen nailed it. For me, since I only work with dementia patients, things can get a little interesting with med passes, toileting/changing, etc. Never a dull day!

mago8388 · Dec 23, 2015

Well, I got the job at the intensive psych unit. I'm so so exited and a little scared. Hygiene Queen, that sounds like a very busy day! If anyone can give me any tips on how to organize my day and most commonly used meds that I must know etc. I'm not brand new to psych but my prior experience was adolescent long term psych like I mentioned. I hope my background helps me somehow :)

jtkforever · Dec 24, 2015

Well, I got the job at the intensive psych unit.

Congratulations!

mago8388 · Dec 28, 2015

Congratulations!

Thank you

DRZmaui · Dec 28, 2015

A bit of advice.

Listen to report; be aware of any changes in an individual's base line behavior. Such as an aggressive, and intrusive individual becoming withdrawn, and subdue. Usually this is indication something is brewing.

After report, do walking rounds; touch base with all the patients. Get a feel of how things are going.

Never ignore a difficult situation, utilizes physical presence (most effect tool we have at preventing a crisis) as an descalation intervention.

Listen to your coworkers. (aids, house keepers, clerks etc.); seek their input, and feeling how the milieu is running.

Stay out of the nursing station, interact, and work with the patients. Patients are watching, and sizing you up.

And always, always, trust your gut instincts

Elladora · Dec 29, 2015

Is there such thing as a typical day?
Just kidding...or am I?

That was my first thought!

Elladora · Dec 29, 2015

Patients are watching, and sizing you up.

This is particularly true when you are new. They will try to pull every trick in the book because you are new. They WILL test you. Related to this, LISTEN TO YOUR CO-WORKERS! I have seen many staff members come and go, and new employees almost always think they will be the one to save the world. They are flabbergasted or offended when we tell them that the clients can't be trusted, that they will lie to your face, that they will try to gain your trust then stab you in the back. If a co-worker warns you about a client...LISTEN!

(I might be a little jaded....)

nickfitz1969 · Jan 12, 2016

Elladora,

Mental health care in the USA must be completely different to other places in the world. I have worked in the UK, Australia and currently New Zealand. In my experience, most patients aren't in the slightest bit interested in me or sizing me up, rather the opposite! Some patients might be challenging, but most won't be. To have an attitude that patients can't be trusted or will lie to your face is an exaggeration to say the least. Yes, again some patients may be challenging but for the most part, they won't! Colleagues who warn you about client's may also be ill-informed, but sometimes they are correct. As an effective mental health nurse, one would have the necessary skills to assess a variety of clinical situations. Elladora, I would encourage you to look after yourself as your suggestions are indicative of being burned out. I don't believe that some of the advice that you have provided benefits the mental health nursing profession, especially for inexperienced colleagues. Good luck!