Dementia Unit - should I accept it?

ClearBlueOctoberSky · Mar 9, 2012

It might be helpful for you to sit down and list the pros and cons of each position.

I personally love the dementia patients. They are a hoot to be around. Is there a lot of work? You betcha. The main question you need to ask yourself is if this is the type of population you want to work with. Are you considering the position chnage because you want to be in the lockdown unit, or are you considering the position change because you think you would be involved in less work than you are now?

If you have never worked with the dementia population before, I would suggest that you ask to shadow for a day or two.

lammcc · Mar 11, 2012

Dear fellow nurses,
I was offered to work in our dementia unit? Should I accept it?
I currently work 2nd shift in a different unit in the same nursing home/rehab. Our residents includes short & long term care, so we always have new admits and discharges. There are days that I almost give up because of so much paperwork: doctor's order/lab works to process, new admission, fall/skin events, etc. I have 27 residents, 11 of them are diabetic that need 2x accucheck during my shift. Almost all of them has 1600 & 2000 meds. We chart for everything ex: resident who moved to different room; from multivitamins to multivitamins & minerals, etc will be in 72h charting.
I'm sure our Dementia unit will have similar procedures and it has less number of residents, but will it be wise to accept it or am I giving myself more work?
I worked in a dementia unit for three years and absolutely loved it. Most of the patients were in the middle stages of Alzheimer's and were DNR. I tried to make each day the happiest day of their lives, which involved a lot of imagination and patience. We received a lot of training on when to orient to reality and when NOT to. For example, if they thought they were in danger, ORIENT; if they thought they were on the way to a job that they left in 1942, or to visit with their mother who died 30 years ago, maybe just re-direct to another activity to distract them to avoid a catastrophic reaction.
A few nurses would fill in and they didn't agree with this philosophy, and they didn't last long. I had to weed out some CNAs who were impatient and insensitive but finally found some great ones, and I pitched in any time I could with baths and anything else that needed to be done; we worked as a team. If you have compassion and patience, and really want to make these patients happy for whatever time they have left, you will do fine.
BTW, I agree that the paperwork is a pain in the neck; it's about the same everywhere!
Great idea to shadow someone.
Best of luck in your decision.

NamasteNurse, BSN, RN · Mar 11, 2012

I agree with the other posters. I work in the dementia unit and most days I love it. It's not easier or harder than other floors, it's just different. Less visitors, less involvement with other disciplines, although now that I say that, you do see a lot of speech therapy for swallow evals and diet changes as they progress in the disease. Also some rehab for maintaining walking, but not a lot.

Laughs a minute and crazy a$$ conversations, you NEED a sense of humor and a LOT of patience. After telling the lady that her room is down THIS hall and is the third door on the left, and that dinner is in four hours and yes you DID JUST eat, all this several times in just five minutes...multiply that by 40 residents.....PATIENCE!

And doing your meds, getting them to appointments, talking to families, doctors, all the usual. It's HARD. Because all the time you are trying to get your work done, you're answering the incessant questions about where's my room and when can I go home, and watching the one who keeps standing and falling, and running for bells.

Of course you're not alone. Hopefully your aides and other nurse are awesome and are doing all that too.

Rewarding? Yes, if you are mature enough to totally take care of another human and accept them exactly where they are today. You will be called names, everything from whore and worse to I love you so much you are my baby. You'll hug kiss and dry a lot of tears. You have to think of them as adults who are very childlike. Their long term memory is there so a lot of them cry for their mama, in the next breath they are yelling at you now.

On a good day, Hopefully no one falls, it's not doctor day, you are fully staffed, and no one dies. Please don't go to the dementia unit thinking it's easier. NO WAY! :) You will either love it or hate it, there's no in-between. Good luck .

daleguthery · Mar 11, 2012

I work in a dementia unit also. Don't forget the residents that are constantly exit seeking

lammcc · Mar 11, 2012

Ha, ha. You're right, daleguthery, there is a lot of "exit-seeking" on a dementia unit. We used to ask the patient if they could wait to leave for about 15 minutes while the outside floors dried. It worked every single time because by the time 15 minutes were up they would have forgotten about the escape plan!

daleguthery · Mar 11, 2012

We always told them that the door led to the kitchen, and if they went out that the cooks would make them do dishes

lammcc · Mar 11, 2012

That's a good one, daleguthery!

Ariesanne, I hope that you're seeing that a sense of humor mixed with compassion and imagination is the key to working in dementia! Some nurses like a more clear-cut workload, but if you have a creative side, dementia is a great field.

dudette10, MSN, RN · Mar 12, 2012

The main question you need to ask yourself is if this is the type of population you want to work with.

That is the most important question for a nurse to ask herself prior to accepting a job on a dementia unit, IMO.

I would rather be unemployed than work on a dementia unit. I have too much personal baggage with the disease in a family member to do any good for patients.

If you have never worked with the dementia population before, I would suggest that you ask to shadow for a day or two.

For those who think they might try it, this would be an great way to make a final decision.

Great post.