TitaniaSidhe

Can't help you much even though I live in the valley I work in NJ. I can however tell you Muhlenburg Hospital off route 22 was bought by Healtheast Corp- they own Lehigh Valley Hospital off 78 & Allentown Hospital on 16th. & Chew St.-- St. Lukes bought the old Allentown Osteopathic Hospital so they now have a campus in Allentown on Hamilton St. & in Bethlehem. Then don't forget Sacred Heart Hospital on 4th. St in Allentown & Easton Hospital. That pretty much covers all thearea hospitals without going up toward the poconos or into NJ. Good luck.

Myself I just try to avoid skirts or dresses all together that way if I do have to struggle with anyone my underware isn't flashed to the world & it avoids issues with the sex offenders. Make sure you wear shoes you can run in & make sure you always have you keys readily avaliable in case you need to get off the unit fast. Always keep your word to a patient, if you say you will do something do it, positive or negative consequence. Be consistent.

Sounds like you are in the VA system since you refered to going out after homeless vets...I myself am in the NE- US Tri State Area, seems to me perhaps you might try asking around in VISION 3 as I almost SURE they have programs set up & can tell you how they are handeling it in say NYC- Manhattan, Bronx, Brooklyn. Would most definately be better to have an RN- preferably BSN for this position but I understand the unavaliability. You might also try posting this in the section for military & VA nurses you may get even more feedback there to help you. Good luck.

I have had this happen to me, myself & a NA found him hanging in the bathroom from the hand rail during health & safety rounds. We managed to get BP & pulse back but he never regained breathing & family made the decision to remove him from life support. It was quite upsetting for a long time after that incident, I had a difficult time going into that room to make rounds- most esp working the night shift. They of course had debriefing at work, myself I found it more comforting to talk about it with other experienced mental health workers who had been through hard events over the years, somehow I just felt that if you had never experienced a incident similarly traumatic well then how could you understand how I was feeling. My staff & peers were great, I am blessed to work with a great nurse who has had her BSN wsince before I was born & over 30 yrs. experience in psych nursing, all my NA's have MANYyears experience, we were there to support each oter & talk among ourselves. I have had sadly many pretty traumatic things happen on my shift over the years at the insititution I work in, sometimes it helps me to view chronicly mentally ill as having, in a way,(I know people are gonna jump all over me for this opinion but here goes anyhow) a terminal illness. For those on whom medications do not work well, no matter what you try & what combos you give. Most hallucinations are not pleasant & well if I had to endure years of seeing & hearing unpleasant, scary things I think after a while it would make me start thinking of checking out too. This particular incident was a patient who had made serious gestures multiple times over the years secondary to chronic major depression. I guess what I am trying to say is it helps to remember you do the best you can do on any given day for your patients & we can not be responsile for another persons actions, we can only do the best we can. Try not to feel guilty, I struggle with that for a bit...but yeah I do KNOW how you feel.

Extreemly irresponsible on the part of the treatment team not to address this behavior prior to discharge. First thought that came to my mind is he an only child or will he be exposed to other younger or smaller children for they will be at serious risk. I wonder if he displays other symptoms such as bed wetting, fire setting, etc.

Men search the male patients women the females. Strip & change into hospital PJs & slippers. All clothing is then washed, dried & returned. I have had patients come in with weapons, knives, ice picks...never a gun. I have seen them sew pills or drugs into the hem of pants or shirts, under the inside brim of caps, hidden in think hair or braids. No cavity searches but otherwise they are searched thoroughly. If it is someone I truely fear about behavior problems with I have security remain on the unit until the search is complete.

Been awhile since I last viewed this post....some excellent info shared & of course also some unproductive & argumentative replies. One thing sprang to mind, one can not learn with a closed mind for a closed mind is unteachable. *sigh* so young into the profession to be so jaded. Ah well I am working 3 shifts in the span of 5 days so am a bit fuzzy from swinging back & forth. It's evening shift today, busy holiday weekend with admissions. Happy 4th everyone, hope the BBQ's are enjoyable.

Again excellent post, very good info in this, a shame you always have one or two staff/tyreatment team members that allow a split to happen, very hard to keep everyone on the same page, possible but difficult. However I guess therein lies the challenge.

I agree, well said

have a friend with psorisis who swears by duct tape as the best for keeping it under control & not looking too yucky.

Just b/c one is in Psych does not mean that they do not need good med-surg or physical assessment skills. Matter of fact I would say that going into Psych requires even more astute physical assessment skills than average as many times a psych pt. can't or won't tell you if something is very drastically wrong with them physically. Myself I work locked, admissions & many times we get brand new admits with no history, we must gather all relevant info we can on our own, many times my assessment skills are essential. Mind you it is not the main part of the care we give like it would be on a medical unit but it definately is an essential skill to have. Additionally despite the fact that it s a Psych unit we can & still do have medical situations arise, even codes on a fairly regular basis (considering all pts. are "supposed to be" medically cleared prior to admission). You know physical altercations between patients which end up requiring stiches or bandaging. We even have patients on hemodialysis who go out to medicine 2-3X/week. After all just b/c the patient has psych issues doesn't mean they will not also have medical issues. I do dressings, draw blood, etc. I just don't do it with the same frequency as I would in med-surg. Lastly & this is for me, just my opinion. I went into Psych b/c I too have excellent people skills, I am damn good at what I do. I do also however feel that as a member of the nursing profession it is my responsibility to keep my basic skills up & stay current through education & hands on training. As professionals we do have responsibility to the profession we are a part of... Okay enough with my 2 cents. Wish you the best in your new job. Hope you find it to be your nitch.

In truth I am more burnt out on how administration is making our job more & more difficult with endless, tedious policy & procedure. They care more about protocol than the actual care the patients recieve. Not to mention being expected to do the job of 3 RN's. I miss the days when we could actually spend time interacting with our patients instead of fighting with a computerized med administration system which is ineffectiv & computers which are always breaking down.

Sounds like you handled yourself quite well. Anxiety is to be expected esp. being your first time in that sort of situation. The most important thing is to stay calm through dealing with the situation & get worked up later. Sometimes way easier said than done. For my last code we had a suicide attempt by hanging on our unit. Got him free from what he used to do it, no resp, no pulse, instructed NA to call the code, started CPR. Another nurse came from unit across the hall, she took over CPR I got a line in & started NSS at kvo. Code team & docs finally arrived & took over from there. We managed to get a pulse back but no resp on his own. Family had him removed from life support 2 days later. *sigh* it was a very unpleasant experience. I stayed calm until it was dealt with & the patient had recieved all care...then I had my bit of freak out about the episode. Never know what your shift will bring in psych.

Don't wish to create any problems here, please just close this thread. Thanks. -Heather

I have had forensic psych patients over the years on my unit(murder, arson, sex offenders), currently have a violent sex offender. Also had a patient who had been inpatient at our facillity numerous times convicted in NJ for serial murders of young run aways & prostitutes, he killed I am thinking 7 young women, had sex with several of them after death & burried them in his back yard. Some he dumped from his boat into the ocean. Now he is in prision but he was a patient of mine off & on for years. Dx. PTSD (VietNam ) & Polysubstance Abuse. If however you are looking for SANE stuff you may try posting the forensic nursing section rather than here.