Nurses with Psych/Mental Health Issues

Nurses General Nursing

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Specializes in Education, IV Therapy, Travel Medicine.

Okay you guys, I know nurses are human and can have issues just like everyone else but, this is the issue: how do you address this with the individual? Even though the BON standards of practice say you must report. I feel a bit inadequate in the borderline cases. Not obvious over the top stuff, of course report just like other impairments. But, if an individual is emotionally distraught on multiple occasions that you speak, blames others but, makes no effort to see what part they play in their problems, refuses recommendations for counseling. What do you do?

I see why employers have so much screening now. I have recently, started phone and in person interviews of nurses for our refresher program before clinicals due to this issue. Not going to allow everyone to go. I hate this as I always felt there is a place somewhere for all nurses to return to.

I have to ask myself, would an employer want this person in this state? Will I be putting our companies and my reputation at stake by sending this person to clinicals. Is this state temporary due to excess stress/strain of broken family relationships (recent death, divorce,etc) or is this a chronic issue.

So, do you work with individuals like this? How have you handled it? Especially, looking for other managers and faculty feedback.

Specializes in ICU, Telemetry.

In my old life as a computer engineer, we'd occasionally get people who were just nuts. I mean, what I recognized now as clinically bipolar, major depressive disorder, personality disorder, full range of behaviors but some were truly crazy and some were scarily so. What we were told is that unless the employee's behavior directly affects their work -- they are not getting the work done, etc., or a a clear and present threat to themselves or others that you'd be willing to testify in court to -- we couldn't approach someone and say, "hey, we think you're crazy, can you get some help or we're going to have to let you go." If you handle it instead of letting HR deal with it, you're the one that could be in trouble -- job and otherwise.

If you can document specific behaviors that directly have a negative impact on patient care (If the person is presenting a clear and present danger to themselves or others, call 911) otherwise call HR and get their take on it. I'd never, ever approach someone who I thought wasn't stable and essentially shake their tree; I've seen someone have a 911 level meltdown at work (prior to nursing), and it's frightening, upsetting to staff, and causes a LOT of "he drove her over the edge" and problems in the working group. A manager approached an employee in our datacenter about poor work behavior (late, slow, distracted, weepy) and told him he needed to see him behind closed doors. The guy (we found out later his wife had served him with divorce papers, one of his kids had leukemia and the doc had said it was time for hospice, and the bills were driving him into bankruptcy on top of it all) just snapped, whipped out a knife and slit his own wrists at his desk -- only a really fast reaction from EMS and some onsite care by a guy who was also an EMT kept the guy alive. The manager, who decided on his own to approach the employee and put them on a corrective action plan without HR's knowledge, ended up getting fired.

Call HR. That's their job. Please, please don't end up on the news....

Specializes in ER, Trauma.

I'd bring the persons condition to the attention of his/her supervisor. Many employerrs have an employee assistance program for ust this type of situation.

Anything you report to the board of nursing (and I don't think this person qualifies for that) becomes part of the public record. Report a medical condition to them and your HIPPA protection goes up in smoke! Kinda scary when you think of it.

Specializes in Emergency, medical-surgical,.

I have studied with a young women having a borderline personality disorder,

partially autoaggressive, she had immense problems to cope with stressful, complicated patient-nurse relationships.

She was reported to treat patients with disrespect and using violence during patient care.

Within the first year she tried to play everybody off against everybody - this led to a tensed atmosphere in our class, culminating in a desaster during our

communication workshop where all lies were disclosed.

Afterwards she had to leave the class and quit nursing school because of beeing accused of battery and verbal abuse.

Although she had sufficient cognitive abilities to successfully complete the nursing program, her personality disorder made it impossible for her.

We care for vulnerable patients and we can't allow nurses to misuse their power.

I am aware that not every mental disorder will peak in misconduct and of course I don't want to ruin someone's dreams to become a nurse but nurses with personality disorders should be supervised in an extended manner to enhence coping strategies and to guarantee safe and ethical patient care.

Changes in behaviour and acting should then be reprted immediately to protect the patient and the nurse.

The decision should be determined to the level the nurses' behaviour is affected by his/her disorder.

But I think that each HR department should have "experts" to evaluate a persons suitability.

Specializes in PACU, OR.

It sounds like a sticky situation-as the previous poster mentioned, it sounds as is this student may have a personality disorder; but then again, it may be only a personality type. You don't mention her age, and of course we can't assess her background, but she might just have come from a very sheltered, protected environment and be unable to cope.

If she won't voluntarily go for psychological evaluation, is there any chance of interviewing her in the presence of a qualified therapist?

Sorry, I'm not an educator myself, but I've had quite a bit of contact with personality disorders in both colleagues and family, and I know what problems they can cause! :rolleyes:

I think half the students in my class have issues some of which are pretty extensive.

Specializes in Emergency, medical-surgical,.

The student I wrote about was nearly 30 years old and was in therapy during her first year in nursing, unfortunately the therapy wasn't successful.

She changed the therapist and career and is now working in a medical lab.

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