ICUs being used as babysitters for Behav Health units

allnurses Guide · Jun 1, 2008

We have a poisons unit that takes all of the OD's, addicts and drunks. There would be no way that our ICU would be used like this, we struggle to get our critically ill patients in there let alone looking after pateints that need to be else where.

AntFlip7395 · Jun 2, 2008

I work in a small 6 bed ICU. Every weekend with out fail we get either a drug overdose/ETOH or an attempted suicide. They are put into our unit until they are medically stable to either go up to BH or home. We get them because our ratios are so low and if they are an attempted suicide they need 15min checks, our unit is set up in half circle with the nurses station in the middle. I work weekends so it seems my most common drug anymore is ativan!! I know the wasp protocol like the back of my hand.
It does agrivate me because a drunk can take alot of your time until they fall asleep...so I am trying to take care of the critically sick as well as the drunk. One night we had 2 attempted suicides( a self burn/an attempted hanging who also consumed 30 xannax po--didnt have the strength to tie the knot on the rope, was found asleep-under the tree with rope around neck) a drunk who got into a fight with the local police and a critical post op. Guess who got the most of my time??
Are you all finding this as well?? They are not going out to the Med Surg floors as the MS nurses have 6-8pts to take care of and their unit is a long hallway, so they can not keep of close of an eye on them as we can. But if we have a critical pt, we cant keep that close of an eye on them either!!

I know all too well what you mean. My MSICU is the 1st pick to get all ODs/suicide attempts/ETOH W/D patients. The other ICUs will not take them unless we are full. With the weather turning warmer, it's only going to get worse. And in addition, the inpatient psych unit is closing and moving to another location, so it will be even more difficult to move them once they are "medically stable". These patients, in my opinion and I am sorry if this offends anyone, are a colossal waste of my time. Why? Because they are usually manipulative, demanding, whiny, and at times, dangerous. I've been working at this place since late November last year and I feel that these patients, at least to some degree, are a part of the reason why this unit won't get more critical patients and therefore necessary experience. I didn't sign on to be a babysitter and I though I realize psych nursing goes beyond the behavioral health unit, I also didn't sign on to be a psych nurse.

**canoehead, BSN, RN** · Jun 7, 2008

We use the medsurg unit and a 1:1 sitter.

akemi27 · Jun 7, 2008

My medical ICU is usually the first unit of choice for these as well...however, suicides do get sitters and most of the etoh's usually end up being a GIB anyway...I think micu's are usually dumping grounds anyway

NeosynephRN · Jun 7, 2008

We get them all! I got called in last weekend for a cocaine OD...she did end up sleeping all night, I could not believe that they wanted to pay me overtime, plus night and weekend diff for that. We get them in droves on the weekends. It gets really really old. I did not go into psych nursing for a reason...mainly I suck at it. We do not get sitters either. Either they sleep...they behave...or they get restrained.

PMHNP10 · Jun 7, 2008

I work in a small 6 bed ICU. Every weekend with out fail we get either a drug overdose/ETOH or an attempted suicide. They are put into our unit until they are medically stable to either go up to BH or home. We get them because our ratios are so low and if they are an attempted suicide they need 15min checks, our unit is set up in half circle with the nurses station in the middle. I work weekends so it seems my most common drug anymore is ativan!! I know the wasp protocol like the back of my hand.
It does agrivate me because a drunk can take alot of your time until they fall asleep...so I am trying to take care of the critically sick as well as the drunk. One night we had 2 attempted suicides( a self burn/an attempted hanging who also consumed 30 xannax po--didnt have the strength to tie the knot on the rope, was found asleep-under the tree with rope around neck) a drunk who got into a fight with the local police and a critical post op. Guess who got the most of my time??
Are you all finding this as well?? They are not going out to the Med Surg floors as the MS nurses have 6-8pts to take care of and their unit is a long hallway, so they can not keep of close of an eye on them as we can. But if we have a critical pt, we cant keep that close of an eye on them either!!

I had to thank you for not saying the behavioral health unit should take these patients (even though you might be thinking it and maybe wish they would). Unless you have a unit specific for this type of pt., they really do need a place where they can be safely monitored until stable; and a BH unit isn't that place. it's a bummer, but whatcha gonna do?

racing-mom4, BSN, RN · Jun 9, 2008

I had to thank you for not saying the behavioral health unit should take these patients (even though you might be thinking it and maybe wish they would). Unless you have a unit specific for this type of pt., they really do need a place where they can be safely monitored until stable; and a BH unit isn't that place. it's a bummer, but whatcha gonna do?

Your welcome. I was told by my Mental Health instructor once that we are all behav health nurses and that really sunk in to me. I dont think there was ever a statement more true. We see people at their best and worst times, we deal with not just their illness and disease we deal with their emotions. Sometimes I think in the rush of a day sometimes we forget this. But I know once I had a patient that was dying, she was in multi system failure and there was just not much hope. I bet I spent 4 of my 12 hours that shift consoling her son--she finally passed peacefully at 5am and he wouldnt leave her side until I left for the day at 0730.

Yep that night I was a BH nurse.

NeosynephRN · Jun 10, 2008

Oh I totally agree that we are all behav. health nurses...man I sure have a deficit. I am trying though. It is SOOO hard to be theraputic and compassionate to a repeat cocaine OD...when my pt next door is critically ill, not because of something that they intentionally did. I need to be next door with my sick patient and their family, instead all my time is used making sure that some crack head does not tear my room up, smash my monitors, or try to beat the crap out of my tech. That is unacceptable. We have no where else to send them. I treat all my patients with respect, even these, whom somedays it takes all I have in me to do so.

dopaminequeenRN · Nov 17, 2008

We have a poisons unit that takes all of the OD's, addicts and drunks. There would be no way that our ICU would be used like this, we struggle to get our critically ill patients in there let alone looking after pateints that need to be else where.

That must be nice! I wish we had a unit like that! Do those nurses get hazard pay? LOL!!!

dopaminequeenRN · Nov 17, 2008

I work weekends so it seems my most common drug anymore is ativan!! I know the wasp protocol like the back of my hand.
"wasp protocol," That's hilarious! I'll have to use that one at work. We get those all the time!