I'm pretty heart broken right now seeing the type of care given at my facility. I work at an acute psych facility.. and i feel for the patients who has a hold, reised status, conserved.. a lot of times, these patient's basic rights are taken away. The other day i had a patient who was reised.. and complained that her med was giving her severe constipation- that is affecting her entire GI system, making her nauseated, extreme pressure. naturally, she refused the med and said "this med is giving me such a strong SE". I wasn't sure how to handle this situation since she is reised. She pleaded to me and said, "i know you nurses will shoot me with an injection if i dont take my oral pills.. please don't.. please, you're killing me".
When i contacted my charge nurse, she said just GIVE IT! these patients are psychotic, dont care about what they say! they are doing everything to manipulate you into thinking they don't have to take the meds. just give her the IM backup and get it over with!
So i decided to call the MD to see if we can change to another med (since the pt agreed to take another similar one). the MD disregarded the case. . the nurses yelled at me for picking up the phone =/ and said "i'm too new to know how manipulative these ppl are.. If you going to bother the Dr. about constipation, just wait to get your head chewed out. I know you're a new grad and you like to follow the book, but its NOT like that here. just freaking give the IM already!".
i was so heart broken.. i feel for the poor patients. this is not how i imagined being a nurse.. I struggle between the fine line of listening to someone's real concerns vs disregarding them because they are just manipulative and psychotic and "reised".
sometimes i hate my job. evil is another word to describe it.. nurse ratched anyone ?
Wow.....Lazy or crazy??? I'd hate to see what you would say about LTC nurses.
If they need to take the med for psych reasons and there are side effects to the meds...call the doc to get something for the constipation or GI issues until they get on track with them.
The patients who are in LTC has the right to have Dementia and or AMS. They are older lived their lives. Where I work most of the elderly are admitted to the psych unit, why? They have right to have some changes in behavior. I am not talking about the elderly generation.
Lkwashington, you are going to find poor patient care in all aspects of nursing. It is usually a reflection on the individual, NOT on the career field as a whole. To make a general statement saying all psych nurses are either lazy or crazy is condescending and disrespectful, regardless of how you try to justify it. A bad experience is a bad experience. We've received absolute trainwrecks from OSHs, including huge Level I trauma centers and hospitals that are noted for their outstanding patient care. We chalk it up to a bad day on the other end or carelessness of an individual. We don't crap all over their specialty as a whole. You need to be more careful in choosing your words in the future.
The patients who are in LTC has the right to have Dementia and or AMS. They are older lived their lives. Where I work most of the elderly are admitted to the psych unit, why? They have right to have some changes in behavior. I am not talking about the elderly generation.
So elderly patients have the right to illness, but psych patients do not? As if patients who are mentally ill have some kind of control over the illness if they're not elderly? That is basically what you're saying. I think you should leave this subject alone. You clearly need a little more life experience. Your rationales are based around one major incident. That in itself is not enough to call a huge profession of harding working nurses "lazy" or "crazy."
To the OP - regarding the question of why the patient couldn't be given an alternative psych med: keep in mind that many psych meds require up to several weeks of regular dosing to reach theraputic levels and become effective. Many of these meds are also not compatible with each other so would require the patient to be off the first med for some period of time before initiating the new drug. This would likely result in a worsening of the patient's psych condition for some time.
Your most effective move would have been, as others have said, to evaluate the patient for physical signs of constipation and assure her that you will consult with the physician for treatment of any side effects. By doing this you are showing respect for her concerns while still insuring that she is receiving the proper treatment for her primary psych dianosis which she is currently considered legally unable to make an informed decision about.
So elderly patients have the right to illness, but psych patients do not? As if patients who are mentally ill have some kind of control over the illness if they're not elderly? That is basically what you're saying. I think you should leave this subject alone. You clearly need a little more life experience. Your rationales are based around one major incident. That in itself is not enough to call a huge profession of harding working nurses "lazy" or "crazy."
I did not say about patient dont have control over their illnesses. I dont know where you got that from. Basically, I was not saying that. What I was stating about the patients I deal with on a daily patients. Mentally ill patients needs special attention. It dont matter what it is. You have a right to your opinion. No I am not a psych nurse. I may need a more experience about working on a Psych Unit, but I dont need more life experience. It was three incidents I noted in my post. You are correct about me negative speaking on a huge profession of Psychiatry nurses. Thanks.
Lol, I embrace my laziness and craziness. I also embrace my open-minded, caring, curious, individualistic nature. Anyway, to OP...wow that would really wear on the spirit. In psych it is crucial for pts to feel they have an alliance with their treatment team. If pts attempt to refuse meds based on SE in the future, maybe consider insisting that they take the meds and assure them you will alert the MD and request something for the SE. Once you get that golden year experience, consider moving to another psych facility, at mine we do not have "reised" pts. Best of luck..and never stop advocating! It is better to have the charge nurse or doc upset with you, than for you to go home with a heavy heart upset with yourself. :redpinkhe
lkwashington
557 Posts
The patients who are in LTC has the right to have Dementia and or AMS. They are older lived their lives. Where I work most of the elderly are admitted to the psych unit, why? They have right to have some changes in behavior. I am not talking about the elderly generation.