Bipolar nurse

[Joy in Nursing]

Hi, I'd like some advise.

I am having a hard time lately with a co worker who is an LPN and has admitted to me she is bipolar. She's been talked to by management about her moodiness and she tells me her meds are being adjusted. I wonder if her meds are wrong because she's been telling me she doesn't take them all the time, that might be part of the problem.

She is very moody with staff and unprofessional, telling a nursing assistant to check a patients blood sugar. She knows they can't do that. She makes the work environment so tense, like we are all walking around on eggshells not to upset her. She is pleasant with patients in view that I've seen. This last situation feels like it's spiraling out of control with her attitude. I feel scared of her and so do other staff members. Her behavior is very childish, like a child having a tantrum because they can't get there own way. I think management is scared of her too. I love my job, just not working with her. I feel she's putting herself on thin ice with management and may get fired soon because her unprofessional attitude keeps getting back to them. Would reporting her to the state help? Could they intervene and get her the help she needs? Or should I suggest to her she needs to seek help and get her bipolar meds stable. I'm scared of her reaction, she gets very angry quickly to the point I've thought she wanted to strike out at me. What should I do?

[VivaLasViejas, ASN, RN]

If your co-worker is practicing safely and appropriately, there are no grounds for reporting her to the state. She may not win any awards for being Miss Congeniality among the staff, but then I sense there's a lot of stereotyping and judgment going around your unit because she has a mental illness. I myself have bipolar and have been stigmatized in the workplace as well, so I can't help but feel sorry for her and wish someone would reach out to her. You sound like the right person because she has a relationship with you, even if her "moodiness" makes it hard for her to play well with others.

I think it would be a good idea for you to ask her privately how she's doing, and really listen to her response. She has already confided in you that she doesn't take her meds all the time; there are a number of reasons why people dislike psych meds. She may be experiencing side effects that may be intolerable for her, or the meds are too expensive (mine run about $800/month), or maybe she simply has a problem accepting her diagnosis and the need for them. To be blunt, taking meds sucks---many people gain weight on them, some of them may affect the kidneys and thyroid, while others have been linked to diabetes.

That being said, your co-worker needs an intervention of some kind, and the place to start is with her PCP or her psychiatrist/psych NP. Suggest that she visit him/her as soon as possible. Try not to worry about her punching you in the nose---bipolar does not equal violent behavior. It's a popular misconception that mentally ill people are more likely to be dangerous and aggressive toward others. For example, before I was medicated properly I used to throw things, smash glasses, and slam TV dinners up against the wall, but I never once hit another human being. Not even when I was flying-off-the-walls manic.

I hope you're able to reach this suffering nurse. She doesn't want to be this way, and she needs kindness, not condemnation from peers and management. Thank you for caring about her.