how do you guys do it?

[june2009]

I don't know if this should be posted here or on the pediatric forum but here goes.

We have an eight week psychiatric rotation. The 1st place we were was a geropsych unit, Seriousely, it was just like being in long term care on a lockdown alzheimers unit. I hated it. Then, I had some time in the ED with a social worker who was doing an admission interview on an intoxicated manic young man. Thet was...ummmm....interesting. Then that afternoon, from 12-4pm, myself and another student went over to the pediatric psych unit. I almost lost my composure reading over some of the charts. I was expecting teenagers who had run away, or had anorexia, or were acting out in school.

That's not what I saw. A 5 year old, a 7 year old, and a few teenagers. They had absolutely had HORRIBLE lives and when I saw the terrible things that had happened to them, it was almost too difficule to do my paperwork. When I left that unit, I felt broken. I went home and cried my eyes out. My twin boys are 4. That 5 year old boy played and acted just like any other child that age. just like my children. I saw his admission picture and I had a hard time getting over it. I've talked about my experience with instructors and the staff from that floor and feel o.k. now. Just God bless those of you who pediatric psychiatric nurses, and even adult and geriatric psych nurses. I can tell that area of nursing Isn't for me but I am so glad you guys are out there for others. Thanks!

[traumaRUs, MSN, APRN]

All I can say is bless the pedi psych nurses.

[rph3664]

We once got a med order for a 5-year-old, and in the progress notes, they said that he didn't want to leave the unit - it was probably the first time in his life that he had three meals a day, rules, school lessons, any kind of positive attention.......

You just know that most of those kids are never going to have productive, fulfilling lives no matter what anyone does. They're already destroyed.

[aloevera]

We once got a med order for a 5-year-old, and in the progress notes, they said that he didn't want to leave the unit - it was probably the first time in his life that he had three meals a day, rules, school lessons, any kind of positive attention.......

You just know that most of those kids are never going to have productive, fulfilling lives no matter what anyone does. They're already destroyed.

We need classes and tests mandatory before anyone can become a parent....It will break your heart to see what adults have done to their children...I used to work on an adolescent psych unit...after reading the charts in the am to become aware of what is going on, it was all I could do not to break down....I lasted 6 mo. then asked to be transferred to the adult unit...I applaud all those working on these units...:yeah:But I imagine that it is these kids that end up on the adult unit later on.....

[rph3664]

We need classes and tests mandatory before anyone can become a parent....It will break your heart to see what adults have done to their children...I used to work on an adolescent psych unit...after reading the charts in the am to become aware of what is going on, it was all I could do not to break down....I lasted 6 mo. then asked to be transferred to the adult unit...I applaud all those working on these units...:yeah:But I imagine that it is these kids that end up on the adult unit later on.....

The first time I worked in a hospital that had a child psych unit and saw a 6-year-old admitted, I said to another pharmacist, "What kind of nightmare life has this kid had?" and she read me some cock and bull story about "If you have a child with attention deficit disorder, you can't give up on them......" etc. etc. I replied that I thought ADD was about having difficulty paying attention in class, not things like spreading gasoline around the house to burn it down, or deliberately killing the family dog, or whatever, and she was kind of like, "Wait until you have kids and try to tell them no" which was one of her favorite lines. Edit: I hadn't worked there very long.

This woman had a child on the autistic spectrum, and she was very peculiar because she never looked at people (not didn't make eye contact, DID NOT LOOK AT PEOPLE - big difference) and while it was really obvious that her son wasn't normal, the fact that he and his brother didn't have any rules didn't help matters any.

And to top it all off, her husband was a minister! Did I maybe hit too close to home or something?!?!?!?

Thing is, who would administer those tests, and what would be the criteria for passing? Some of the best parents I've known were dirt-poor and intellectually challenged, and some of the worst were wealthy and had high IQs.

Edit: I, too thought child psych was mostly going to be stuff like a teenager who swallowed a bottle of Tylenol because their boyfriend or girlfriend dumped them, and some of that does occur. When I was growing up in the 1970s, there was a residential treatment facility in my neighborhood for the "emotionally disturbed" and some of the kids went to school with me. Most of them had spent their lives in and out of foster care; they probably had what we now call Reactive Attachment Disorder but I distinctly remember two who were probably on the autistic spectrum.

Edit: Those kids wouldn't be so much a candidate for adult psych as the criminal justice system.

[aloevera]

Intellect or money wouldn't be a requirement to be parents...

Just plain common sense and being drug free would be a good start....

[rph3664]

Intellect or money wouldn't be a requirement to be parents...

Just plain common sense and being drug free would be a good start....

ESPECIALLY drug free, meth in particular.

[aloevera]

Many of the pts. in the adult psych unit are there INSTEAD of being incarcerated....probably should be in jail but manage to get into therapy....

[rph3664]

Many of the pts. in the adult psych unit are there INSTEAD of being incarcerated....probably should be in jail but manage to get into therapy....

And we get a lot of people FROM the jail who attempted suicide.

[Thunderwolf, MSN, RN]

We once got a med order for a 5-year-old, and in the progress notes, they said that he didn't want to leave the unit - it was probably the first time in his life that he had three meals a day, rules, school lessons, any kind of positive attention.......

You just know that most of those kids are never going to have productive, fulfilling lives no matter what anyone does. They're already destroyed.

Well said

....and the truth of it is very sad.

[medsurgrnco, BSN, RN]

We need classes and tests mandatory before anyone can become a parent.

I wish our government would set it up so that no parent could get a tax break for their children without attending parenting classes, and no parent who has been convicted of a drug offense within a certain time frame could get a tax break until they have attended substance abuse classes. Unfortunately, that might hurt children from lower income families. But this setup would be cheaper than the current sad outcome for many children.

[june2009]

one pt. was in for trying to perform oral sex on a family member who had custody of the pt., since the pt. been removed from their parents. Well, needless to say the child was going to go to foster care after the time on inpt. was up. That broke my heart even more because I knew from then on that child was not going to get the intense therapy needed, and because of the behaviors displayed by that child, was not going to stay in one foster home for very long. Then Friday I spoke to the behavioral health coordinator and she told me that this child was not going to foster care, but to an intense psychotherapy facility. I guess that made me feel better, however I still know that child will never lead a "normal" life and will likely have major issues in adulthood. Thanks for the responses everyone.