BoogiePop

Recently, the administration had one of their "great ideas" , and decided to open another ward next to the teenagers ward. Problem is, this ward treats adult population, and the only thing separating both wards is a large door. For you to get a basic idea, a typical ward in my hospital is composed of two hallways, one hallway is for male patients while the other is for female patients, and in the center is the nursing station. The teenager ward is one hallway to the left of the nursing station then the right hallway is this new "ward" they recently open, where they treat adults with different diagnosis, but most of them are polysubstance dependence. What worries me is that the only thing separating this two populations is one big door (wich is in pretty bad shape thanks to an angry patient who decided to displace his anger against it), and nothing else. Patients sometime nteract with each other by talking or sometimes even yelling at each other when they are near the nursing station :argue:. Once I had this realy angry teen who just jumped the nursing station and passed to the adult area to fight with another patient . What's also a big problem is that we now have female and male patient, very close to each other! and reports of sexual aproaches have been increasing.:redbeathe:up: Now my question is, Do any of you know of any federal law or Joint Comission standar that prohibits this two populations from interacting with each other? that would be of great help, since I pretty much want to refuse keep working there, until some measures are taken that will limit the interactions that are now taking place. Thanks in advance!!:wink2:

Found it! apparently Wren 54 was right, its because of the Histamine receptor. you can find the link here; http://www.medscape.com/viewarticle/484929_8 or try http://en.wikipedia.org/wiki/Seroquel and look on reference 15 at the end of the page pretty interesting, wouldn't have thought it myself. Thanks for your replies.

Here we never use it. We use a lot of klonopin and Ativan, but never valium. We still have it though, but I don't know why we don't use it. I read somewhere that the Ativan was actually more potent as an ansioltic than valium, is this true? I once asked a psychiatrist and he said the valium had more addictive properties than the Ativan and the Klonopin, but I couldn't find any source to check this.

I think she is wrong. Can't ask her today cause she's not in here today. However I wanted to make sure nobody else had heard anything. Thanks anyway, and if someone else knows anything else it will be appreciated. Who knows maybe she just want it to get her off her back.

yes. I also understand is not an hipnotic nor an ansiolitic. The thing that this patient was complaining that the seroquel 400mg that he was receiving was making him sleepy, and ask the psychiatrist to lower the dose. that was when the psychiatrist told the patient that lower doses of Seroquel were more likely to cause him drowsiness than higher doses.

I understand this, but what I need to know is if a low dose of seroquel, is more potent for sleeping that a high dose.

Is it true that the less mg you recieve of seroquel, the more drowsy you get? I remember a psychiatrist once telling this to a patient but I couldn't find any objective data on the internet or in the PDR.

wow! thank you very much! it is quite different than the one they describe me but it still great!! it will sure help a lot.

That's horrible! isn't OSHA supposed to do something about it? Kind of makes me think because in my hospital we do get our share of violence but never on these extremes!

thank you very much, it will certainly help. Still it would be nice to find the recording. One coordinator at my job told me some pharmaceutical company played it on a powerpoint presentation they where giving there but forgot what company that was...

I heard there was a recording that allows you to hear or at least gives you an idea of what a squizofrenic patient hears during what seems to be a job interview. May someone please tell me where to find the recording online? (considering if its for free use and you don't have to buy the tape)

The patient detox process varies depending on how long has the patient's been abusing from the substance and the quantity. From what I seen, in teenagers or adult patient that go on detox for benzodeazepines, is that they have a hard time falling asleep. Some of them become very anxious, thus making them moody and in some cases agresive if the anxiety is too much. In the end, I think it depends on how do your son manages or copes with stress or difficult moments. A usual day for a patient in Detox, where I work is assisting to therapies with Mental Health Technichians, Counseling from their appointed social workers, and a controlled dose of medication from the psychiatrist which he chooses depending on the grade of addiction. Usually they are busy the whole day. In my hospital, (and I suppose in the majority of other hospitals) we only use restraints as a last resource and only after all attemps of talking have failed. Also the patient safety, or the safety of those in the unit must be in jeopardy in order for restraints to be used during crisis moments.

It puts me in a stressful situation. For my part, I won't scold the assistants for reading or doing other stuff while watching the patient, because I can't expect them to do something that I know not even I will be able to do. Pretty sad too cause I study nursing to care for the well being of human beings not just my patients, and it definetly can't be healthy sitting 8 hours on a chair without sleeping or doing anything else for the whole week. It would really help if you know of any website or online resource that talks about the 1:1 vigilance and how to perform it properly. The administrators from my hospital, say they do that bacause its part of the Joint Commision Patient safety goals, but there has to be a better way to reach that goal that doesn's put a person under all that stess.

How does your hospital do it, and who does it? What's the apropiate distance that the staff must have from the patient? During nightshift while the patient sleeps, do they allow the staff to read a book or keep his mind busy? From where I work it's one hand distance and is usually the assistants that do it. However I hear constant complains that the distance is too close, and that it's not safe for the staff. Another usual complain is on nightshift when they want the assistant to watch the patient, without doing anything else besides, filling the activity log, which must be documented every 15 minutes. I find this abusive, because they expect me to make sure they don't fall asleep, but then they don't want them to do anything besides staring at the patient for an 8 hour shift!! Any online guidelines or a website explaining the 1:1 vigilance would be apreciated too!

Is it possible to make a specialty in Family Nurse Practitioner and then make another one on Psychiatric Mental Health Nurse Practitioner? I love psychiatry, and I like working on mental hospitals, but I also enjoy working with physiologic diseases as well, can I make two specialties? Or do I have to specialize in just one. If I can specialize in both of them, I was thinking on doing it on Family Nurse Practitioner, or Adult Nurse Practitioner. Im not sure I completely understand the differences between both of them, Can anybody explain me that too? Thanks in advance.:wink2: