what to expect on 7p-7a geriatric psych floor

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I got a job on 7p-7a on a geriatric psych floor!! I was wondering if anyone has experience working this shift and on this floor. What is this shift and floor like? I'm excited, I've been wanting to work psych but did my med/surg rotation for a little over a year. Thanks!

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Specializes in PCCN.

a lot of sundowners:lol2:

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Yes! Sundowner's for sure! :D

Thanks for your input!

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Specializes in PCCN.

I actually did some of my clinicals on a geri/psych floor- was interesting to say the least- lots of seroquel going around- that stuff is great for the elderly, cant believe what a difference the proper dosing makes. I just had to be careful of one of the pts who would swing at people for no reason.

I imagine there are some times during the night shift things are interesting, as some of the demnted elderly seem to lose the abilty to sleep well too.

Good luck in your new job

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a lot of sundowners:lol2:

That was the first thing that came to my minde when I read the title. :crying2:

Expect a good bit might want to go to bed right after dinner. Some will go and sleep and a good bit will sleep for a few hours and then be up all night.

Sometimes those getting up at night might not need a prn but instead the behaviors could be caused by pain, hunger, cold or heat or the need to use the bathroom/ incontinence. A prn for pain, a snack and an extra blanket can be all they needed....then again...... I always assess during the pm med pass and offer/ give prns for pain or anxiety or sleep aids then. Sounds simple, but you won't believe how many don't get meds on the pm pass.

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Specializes in Med/Surge, Psych, LTC, Home Health.

Congrats! I really enjoy working with this population. I'm currently working in a nursing home; a job in geri-psych is hard to come by around these parts.

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Specializes in LTC.
That was the first thing that came to my minde when I read the title. :crying2:

Expect a good bit might want to go to bed right after dinner. Some will go and sleep and a good bit will sleep for a few hours and then be up all night.

Sometimes those getting up at night might not need a prn but instead the behaviors could be caused by pain, hunger, cold or heat or the need to use the bathroom/ incontinence. A prn for pain, a snack and an extra blanket can be all they needed....then again...... I always assess during the pm med pass and offer/ give prns for pain or anxiety or sleep aids then. Sounds simple, but you won't believe how many don't get meds on the pm pass.

And then there are some who do not sleep at all.

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Specializes in Psych.
I got a job on 7p-7a on a geriatric psych floor!! I was wondering if anyone has experience working this shift and on this floor. What is this shift and floor like? I'm excited, I've been wanting to work psych but did my med/surg rotation for a little over a year. Thanks!

On our unit from 7-11, we do snacks, PM Care ( typically aides, but rns help as needed), group ( usually a discussion about the tv show they are watching). We tend to have more behavior problems, sometimes d/t sundowners, other times because of differnce in staff. Night shift consists of rounds, meds, red lining, keeping track of sleep times. Sometimes everyone sleeps, other times no one sleeps.

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

Good luck. I start on the 22nd as a float pool for behavioral health. I'll be floating between 3 units, and the psych ER. One of the units in geri psych.

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Thanks everyone for your replies! I cannot wait to start working with this population. I imagine it will most times be a very lively and busy shift!

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Specializes in Hospice / Psych / RNAC.

Previous comments and your title lend me to believe that that it is a wing in a LTC facility reserved for psych and dementia and not a psych unit. Having said that my post is from a psych unit prospective.

I know from doing clinical in nursing school that some psych units in some states will admit Alzheimer's patients onto the floor but that is met with great resistance since elderly demented people are not psych patients. Anyway......this is from a psych unit experience.

On the shift you will work expect many admissions. Many of the admits are voluntary but I would say 1/3 were involuntary (this is where the fun starts). You also have your people who, for whatever reason, have decided to stop taking their meds and acted out in an extremely flamboyant manner as to attract the attention of the authorities. You have your suicides, there are your regulars; good and bad and an occasional faker (a person pretending to hear voices for whatever reason; usually for three hots and a cot IMO), a host of DSMIV classics, and your withdrawals.

Your charting needs to reflect the patients Dx in order for your facility to get paid and to get days extended when necessary. I have literally took verbatim lines from the DSM IV for some of the health insurance companies that were famous for denying payment due to inadequate charting. You will find out which ones are good etc... Also with the admit process since there's no ward clerk on the eve/night shift (bummer) many places will expect the charge to do part of the admit process that is usually left for the ward clerk. Where I worked they had us do the initial admit on the computer which included what type of insurance they have.

I have had the pleasure of meeting George Washington, Benjamin Franklin twice, the Mother Mary, various Angles and one time I actually met a patient who claimed to be the true God. Psych is a special place; not for the faint of heart. It will teach you things about life that will absolutely amaze you one day and the next you will be questioning your own existence.

It takes a certain type of individual to be an advocate for these people. You can't be shy and certainly must have confidence in yourself because many of these patients do not. Psych patients will pick up on the slightest details so be on your toes. This is where I was glad that I took courses in body language in college. Remember talking is not the only way people communicate.

I would like to add that if you're working in a LTC facility much of what I wrote will not apply. As I was posting I forgot you said geriatric and went on my experience from psych units. You will have your psych Dx but in all reality it will be mostly older advanced Alzheimer's people. Also they will be permanent residents and not the typical psych unit stay of a few days. Good luck to you.

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Tyvin, thanks for your reply! Your post was confirmation to what I experienced in my psych rotation and what I expect when I start working. The unit I'm going to work is in the hospital in the psychiatric department and the geriatric unit is one of five in that department. My experience right now on the job is working a small hospital on second shift general floor (we're the only floor besides ER) so when we get admissions (and the majority happen on our shift), we, too do all the paperwork etc. as we don't have a unit clerk. We also do not have a pharmacy after 3:00pm so we're reconciling the meds and pulling them for the new patients as well.

I cannot wait to start working and I agree with the communication! It's the nonverbals that trip most people up! I work very hard when I'm stressed to be cognizant of what I'm saying through body posture and gestures. I'm very good at reading people...and as far as people stepping all over me...well, I try to be understanding and give you the benefit of the doubt but if someone takes that as weakness and a chance to bulldoze me, it won't happen!

I'll keep you all posted how it goes! Thanks again for your input!

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