Any "geri-psych" nurses on board?

Crazy Mama · Nov 20, 2004

I'm about to start a new position on the geri-psych, locked unit of a city hospital. Have mostly worked with adult population, but have NO experience with the elderly. What do I have to look forward to?:)

I have worked Geropsych for 5 years. i love what i do. the patients have more medical problems and a whole lot of medications. Don't let the elderly fool you, they are strong and can go off before you realize whats happening. At the facillity where i work, we take patients that others will not accept. usually half of our patients are total care. you have to get the pt up each morning (physically). They all eat in the dining area so, someone has to stay with them to make sure no one chokes (has happened). You have incontinent patients, ones that need to be fed, bathed. There are times that we have to hang blood or iv flds. at those times, we have to have the patient on a 1 to 1. Then there are times when you can sit down with a patient and talk about the past. its wonderful. I found out from a pt that in WWII the soldiers were sent to the Phillipines for a rest on the way back to the states. It made me understand my own fathers route at that time. Did you know during the depression that rubber was not available to the civilians and people would put burlap sacks in their tires when the tires went bad? If you've worked with the adult patient, you'll be fine. some are just lost and afraid. Some know that they are losing their memory and that's sad. They will come out of their room for the 50th time and do not know which way to go to group or to the dining area. You have to be more creative in giving meds and getting them to sign for the psych meds. It all depends on when you can catch them at a good moment. I hope this helps. I can go on and on at times.

jerelm3773 · Nov 20, 2004

Hey! I'm a psych nurse on the geriatric ward. I find you seem to get more attached to your patients because they usually stay longer at our hospital. The wards that have more younger patients usually have more restraints and fighting going on than we do. Also with the younger psych patients they are usually into harder drugs out on the street than some of our patients. Sometimes you run into patients that it seems nothing works on them to help control their behavior. A lot of times we will send our geri patients out to nursing homes and they just come right back in no time at all. You think they are doing great and here they come back. Just be careful and never turn your back on any of them, because they can hurt you fast. I enjoy working in psych and it has it's many rewards, especially when you see patients that you never thought would get better, get better! You think, man they are really out there and before you know it (sometimes it does take a while), they are talking to you like normal. One thing about it, you rarely ever have a dull night or day!

Orca, ADN, ASN, RN · Nov 20, 2004

I worked on a hospital geropsych unit per diem until recently. I worked on this unit for about four years. I got burned out because our unit became more about keeping beds filled than providing any kind of real service. Basically, if the patient had Medicare they were admitted, whether they were appropriate or not. Our intake people accepted a patient with end-stage Huntington's Chorea because he had taken a poke at someone on a nursing home, and took one patient who was mentally retarded. They took numerous patients who were in horrible medical shape. We had several deaths on the unit, which should tell you that depression wasn't their primary problem.

I also had a big problem with mixing patients with Alzheimer's Disease with patients with more traditional psychiatric problems. It seemed pointless to me to try to treat a patient's depression when her next-door neighbor thought that she was her mother and kept wandering into her room and taking her clothes. It became more about keeping people out of others' rooms than providing any kind of treatment. I was doing more herding than meaningful intervention.

Nursing homes often come up with trumped-up mental health diagnoses in order to get patients admitted, then refuse to take them back when their treatment is over. The hospital is then stuck with patients who stay for weeks (or months) after their treatment is over because they have worn out their welcomes everywhere in the area.

Maybe it was just the philosophy under which my unit was run, but I never want to work geropsych again - and I enjoy psychiatric nursing.

lovingtheunloved, ASN, RN · Nov 20, 2004

I work in an Alzheimer's and Behavioral Health nursing facility. Not formally geropsych, but that's what it boils down to. 3 different units, all lockdown. I'll tell you one thing. It's fun. It's stressful, and sometimes I think I'm going to lose my ever loving freaking mind, but I absolutely LOVE it. One piece of advice: learn to duck.

margo123 · Nov 21, 2004

Orca, you just described the Gero unit at the hospital where I work. I work the acute adult psych ward and sometimes float over to Gero when they are in a pinch. It appears that we're doing respite care for the ECF facilities. Any of the patients who have much cognition and are appropriate for group therapy beg for discharge because they can't stand the nursing home mileiu there. I just don't see the point in admitting folks with dementia to a psych ward. We aren't really providing them anything they aren't getting in the ECF. Then, our mentally cognizant patients are getting short shrift because we're so busy doing total care on the others.

I worked on a hospital geropsych unit per diem until recently. I worked on this unit for about four years. I got burned out because our unit became more about keeping beds filled than providing any kind of real service. Basically, if the patient had Medicare they were admitted, whether they were appropriate or not. Our intake people accepted a patient with end-stage Huntington's Chorea because he had taken a poke at someone on a nursing home, and took one patient who was mentally retarded. They took numerous patients who were in horrible medical shape. We had several deaths on the unit, which should tell you that depression wasn't their primary problem.
I also had a big problem with mixing patients with Alzheimer's Disease with patients with more traditional psychiatric problems. It seemed pointless to me to try to treat a patient's depression when her next-door neighbor thought that she was her mother and kept wandering into her room and taking her clothes. It became more about keeping people out of others' rooms than providing any kind of treatment. I was doing more herding than meaningful intervention.
Nursing homes often come up with trumped-up mental health diagnoses in order to get patients admitted, then refuse to take them back when their treatment is over. The hospital is then stuck with patients who stay for weeks (or months) after their treatment is over because they have worn out their welcomes everywhere in the area.
Maybe it was just the philosophy under which my unit was run, but I never want to work geropsych again - and I enjoy psychiatric nursing.