Are there any Psych/Medical Units?

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I have seen high numbers psychiatric patients with medical diagnosis's over the years-- many years. Some may not have been diagnosed yet, but were suspected of having mental health issues. Many times, the behaviors are much harder to deal with than the medical dx when caring for these patients. I have heard of Geriatric Psych Units, but never have actually seen a unit like this- other than in a SNF. Has anyone worked for a specialty Psych/Medical Unit or Geriatric Psych Unit in a hospital setting? It would be great to have MD's- Medical Docs and/or Psychiatrists deal with the psychiatric part of the patient's issues, not merely use it as admission criteria. I have never seen such a unit in my career. I think there is a need for it, but maybe it isn't beneficial for the hospitals? Maybe some of you have some insight on this.

Just to be clear, I am not talking about just Dementia here, but all problems including drug/medication addiction.

Specializes in ICU, LTACH, Internal Medicine.

One thing, it is place-dependent. My local (quite small) medical center has medical ICU filled with pretty much 90% of results of drug abuse of all kinds and sorts, from "salts" to meth and to DT.

Other option might be high-acuity LTACH. The unit I work in normally accepts patients which, rightfully, belong to any other specialty unit but cannot be kept there because their needs cross with the said specialty units' resources. LOL who cannot go to cardio because they cannot use restrains, do not have sitters, etc. for her Alzheimer and aggression, and cannot go to mental health because they do not have tele monitors and she is on Amiodarone and heparin drips for afib/RVR. A poor soul who needs to be on Ortho but cannot be there for his obvious opioid abuse issues which they cannot manage for the reason of just not having that much Dilaudid on the whole floor. Another poor soul with ICU psychosis who cannot be in the said ICU any more because of his psychotic issues unless restrained, sedated and paralyzed.

We have several nurses with psychiatry experience, and they worth their weight in gold when dealing with these patients.

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Specializes in MICU - CCRN, IR, Vascular Surgery.

My hospital has a med/psych floor. It's not a locked unit and it's only a few months old so they're working on getting the kinks worked out, but I believe that it will be a very useful floor!

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Specializes in Registered Nurse.
My first job was on a med/tele unit with an inordinate number of patients with heavy psych co-morbidities. We were not an official med psych unit per se, but it turns out we were a dumping ground for these kind of patients because other med surg units refused to take them. Found out some of the doctors at the hospital nicknamed our unit "The Abyss" because of our reputation. It took a toll on the staff, working with these patients was tough and naturally the turnover was incredibly high.

They should have sought to find some good protocols that worked for these people and the staff. It was an opportunity they didn't take to make things better.

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Specializes in Registered Nurse.
My hospital has a med/psych floor. It's not a locked unit and it's only a few months old so they're working on getting the kinks worked out, but I believe that it will be a very useful floor!

Great! Maybe I'll come work there! I like units that work well!

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Specializes in Registered Nurse.
One thing, it is place-dependent. My local (quite small) medical center has medical ICU filled with pretty much 90% of results of drug abuse of all kinds and sorts, from "salts" to meth and to DT.

Other option might be high-acuity LTACH. The unit I work in normally accepts patients which, rightfully, belong to any other specialty unit but cannot be kept there because their needs cross with the said specialty units' resources. LOL who cannot go to cardio because they cannot use restrains, do not have sitters, etc. for her Alzheimer and aggression, and cannot go to mental health because they do not have tele monitors and she is on Amiodarone and heparin drips for afib/RVR. A poor soul who needs to be on Ortho but cannot be there for his obvious opioid abuse issues which they cannot manage for the reason of just not having that much Dilaudid on the whole floor. Another poor soul with ICU psychosis who cannot be in the said ICU any more because of his psychotic issues unless restrained, sedated and paralyzed.

We have several nurses with psychiatry experience, and they worth their weight in gold when dealing with these patients.

Yes, yes....so true. The crossovers make it difficult to place people adequately...and , hopefully, those situations are *mostly temporary. LTACH might be a place to go for some. In general, I was thinking of your basic adult to elderly medical patient that also has medication seeking and other mental health/behavioral issues. On some units, you just don't have time for those behaviors/manipulations and attention seeking. But it sounds like you have been there and done that. LOL So you know!

Adding- i.e., I had a patient who hurt himself (we could never prove it was intentional) the other night to remain in the hospital to get more meds. and added at least 90 mins of patient specific work dedicated to him for that shift. He did something similar the night before on another nurse.

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