How to prepare for first hospital job in inpatient psych unit?

Kay28 · Jul 5, 2015

Make sure you are familiar with the medications used in an emergency situation on an inpatient psych unit. We use a lot of haldol, Benadryl, Ativan, and Thorazine (either IM or PO) in emergencies. Also review some of your routine psych meds given such as depakote, lithium, zyprexa or latuda. Be aware of your environment at all times, keeping a clear exit to the nearest door. Best of luck!

excited1 · Jul 5, 2015

All of the above, plus be sure you know the hospital/states laws regarding vol/involuntary admission.

Davey Do · Jul 5, 2015

any tips you guys and give me.

Use the Search option near the bottom of the Forum Page!

We'll be here for any specific questions you may have, too!

And, good luck to you, Puertoiiquena!

Jules A, MSN · Jul 6, 2015

Google some YouTube videos of EPS learn to recognize it and treat quickly.

southshore2014, APRN · Jul 6, 2015

Stock up on wine.

Davey Do · Jul 6, 2015

Stock up on wine.

Abstemiously, yes.

But use other methods to deal with stress by pursuing a generally healthy life style, such as exercise, humor, meditation, personal interests, camaraderie, etc.

Red Kryptonite · Jul 6, 2015

Abstemiously, yes.

Ooooh, you win the vocabulary award today! However, I don't know if it's possible to "stock up" abstemiously.

PS love your new avatar photo. I'm old enough to remember Dr. Johnny Fever from WKRP.

JustKeepDriving · Jul 6, 2015

Abstemiously, yes.
But use other methods to deal with stress by pursuing a generally healthy life style, such as exercise, humor, meditation, personal interests, camaraderie, etc.

Just substitute Abstemiously for Copiously, and Wine for Craft Beer then you've mastered my coping skill! I mean if the "Check Liver" light hasn't come on yet.. you're good right?

Davey Do · Jul 6, 2015

Ooooh, you win the vocabulary award today! However, I don't know if it's possible to "stock up" abstemiously.
PS love your new avatar photo. I'm old enough to remember Dr. Johnny Fever from WKRP.

Thank you, Red K. Yeah- I thought about that afterwards. Perhaps I should have said something like, "Stock up for abstemious use..."

In keeping on topic, a method to help decrease stress in a stressful environment, is as mentioned, the pursuit of personal interests.

For example, I am lexiphanic. Can't spell or type worth a darn, but love to learn and use big ol' words.

Word trivia is also part of that lexiphanic pursuit. For example, abstemious is one of the two words in the English language that have all the vowels, in order: a-e-i-o-u. Make it an adverb and you got y.

I could, however, be abstemiously facetious.

Ya know?

Davey Do · Jul 6, 2015

if the "Check Liver" light hasn't come on yet.. you're good right?

Yes, JKD, as long as one's imbibing in the fruit of the vine, or the brew, or some such, does not affect their health, personal relationships, work performance, or general contribution as a member of society, you're good to go!

TCASII, ADN · Jul 9, 2015

Not much you can read in a textbook to prepare for psych. Aside from learning about the medications, psych patients will present in maybe three ways - 1. nice/pleasant, 2. entitled/demanding 3. psychotic. Manics will be extremely intrusive, argumentative, nasty, manipulative, and require constant redirection. Some manics are surprisingly pleasant, but they are busybodies and basically all over the place. Don't expect manics to really sleep much, if at all. Snowing them doesn't work, so don't try.

Psychotics are varying degrees of bizarre. From talking to themselves and isolating from the group (e.g., pacing) to acting out and causing problems. In my experience, from working crisis and voluntary, the problem children with psychosis are meth-induced or on spice (drugs in general). Non-exogenous induced psychotics aren't usually that bad. They hear voices and are troubled, but unless pushed will not cause problems. They might be easily agitated, but left alone, they are okay.

Then the majority of the patients are personality d/o IMO. They might say they are bipolar, however, I find that a large number of these "bipolar" patients are simply anger-management types. No history of staying up all day and night, no true manic Sx. Look at Mayo Clinics differential video on bipolar versus borderline and it explains things pretty well. Personality disorders aren't billable codes, therefore, the Dx of a primary psych problem is required. You aren't really treating disorders anyhow, rather symptoms.

Last but not least, and unfortunately, psych patients are not very honest. They will tell different stories to suit their needs. They think we don't communicate with each other as staff. They will often lie about when they received a narcotic thinking we don't keep record. They will staff split, meaning try to tell one staff that another said it was okay when it wasn't. A lot of them openly admit to their peers that they are just at the facility for pills (e.g., Ativan, pain pills).

As far as being on guard, I never felt very unsafe. Be mindful of your patients problems and history. A history of assault/arrests/DTO will often mean that they might hurt someone. The more limits you set with your patients, the more resistance you will get. They don't like rules or structure. If someone is aggressive and possibly a problem, I let them have their way unless it's a true problem/violation.

I always try and treat my patients with respect. Regardless of their problems, intentional or not, they are human beings and just want to be treated with fairness and honesty. A lot of RNs and techs will test them and even lie. They will know and act upon that. Even the most manic and psychotic patients know what's going on. If you are nasty or disrespectful to a manic or psychotic patient, they will remember it and know you for a long time. They will often apologize for bad behavior after they clear from an episode.