Confessions of a Psych NP

[Oldmahubbard]

I'm the one you may have heard about. There are a lot of rumors about me circulating at our LTC facility :

The Psych NP took a patient off clozaril for no good reason. It's true that we didn't know about the blood work, we thought it was optional, and when it fell on Thanksgiving or something, it just didn't get done. It didn't seem like a priority, and we only have one nurse on the floor for 40 residents.

A few days later, when the labs were finally drawn, we simply started the patient back on her medicine, the same dose.

Then we heard this Psych NP stopped the clozaril, for no good reason. The patient was doing well on it. Meanwhile the patient was sent to Enriched housing.

The patient was started on a different antipsychotic. She was seen by the Psych NP, who didn't seem to understand the staff's point of view. The patient was annoying and unpleasant!

The NP then went on vacation for a week, and the patient continued to be a major PIA. We resented the NP for d/c the clozaril and starting a new medication, which we saw was clearly less effective.

The NP came back from vacation. She saw the patient her first day, and ordered some labs.

A few days later, the NP looked into the situation and discovered the patient's antipsychotic dose was refused by the insurance company.

The patient had not been getting any antipsychotic medication whatsoever in Enriched Housing for 10 days or more, but nobody ever checked and we didn't know enough to report it.

However, the NP is still at fault in this scenario.