Callisonanne

"You can't make me take my medicine." - from a psychotic patient on med against will protocol

Our hospital police are sworn officers and carry weapons. I work in psych so they cannot bring a weapon into our section unless there is an active shooter. I feel very safe. Metal detectors don't even help as we had a stabbing at our hospital (on the medical side) with a ceramic knife. Things will always happen but in general I feel safe. We wear trackers with panic buttons that if activated tell the police where we are in the building and track our movement. I wish more hospitals staffed police rather than security officers. I respect both but sometimes you need a true officer.

One of our psychiatrists would use the dictation program but never proof read. Naturally it would often pick words that he said a lot even if they didn't make sense. A patient brought in a home medication that was non formulary. The doctor went to write a communication note by dictating "Family may bring in medication so that it may be administered in the hospital" The dictation program heard "Family may bring in medication. Suicide may be administered in the hospital." This psychiatrist had a VERY dry sense of humor. After he signed the order I called to verify if that order was in fact correct as it was missing the method. He said "how dare you question my order. Use whatever means you have available." We laughed about that order for a long time. He still refused to proofread.

I would also encourage you to talk to your local ECT provider and see if they would allow you to follow a patient through the treatment. When you get to see it you will say "oh....that's all it is."

As a psychiatric nurse I can say this - if I was ever in a place where I needed help I would take ECT in a heartbeat. The improvement I have seen in patients, sometimes almost overnight, is amazing. I have seen patients to the point of near starvation from psychosis wake up from treatment and eat a full tray of food.

Ditto what was said above. I am a psychatric nurse. I also happen to have some severe anxiety problems. I think the key is to not use yourself as an example in your practice. I know that I have a good understanding of anxiety but I make sure to not make the patients aware of that. If you had that peer in nursing school that told the whole class about all of their personal medical problems that is what you want to avoid. Maybe talk to your psych provider. See if they think you are stable enough for that type of position. Good luck with your decision!

I was a brand new grad and got hired to work in a psychiatric hospital right away. The only experience I had was the few psych patients I had in nursing school. You will always learn the skills but the passion for psych is what you really need. That's what keeps you calm after a day of being yelled at for 12 hours.

I have worked acute adult psych for 4 years and just switched to child and adolescent a month ago. I started in psych as a new grad. One of the most eye opening things for me was watching an experienced hospital nurse get floated to psych and actually start crying. I realized how scared people are of mental illness. I have also seen residents too scared to talk to a patient alone in the day room or hide in the nurses station. Psych is not for everybody. You can easily pick us out though. I was in target shopping and a teenager who was clearly autistic had a massive outburst with his mother. He was screaming, kicking, and verbally abusive. His mother calmly walked him to the car, while being hit and yelled at, and went home. As I turned around to continue my shopping I realized everyone else was horrified. I was as calm as a cucumber and my husband looked at me like I had two heads. It can take a lot to rattle someone who regularly gets yell at.

On a completely different spectrum - I am a psych nurse on an acute unit attached to the hospital. I will ask questions like "did they come in really sleepy or was that after they admitting to suicidal thoughts and were left alone with their purse". I also ask questions like "yes their blood sugar is 400 but did you give them something?" I don't have the same capabilities as you if a patient has a severely high blood sugar so I need you to stabilize their body before I can stabilize their mental status. I will never ask obvious and stupid questions but there are questions I'll ask that you would normally never have to deal with. Especially if a patient is psychotic and combative and you give them po seroquel. They are now coming into a unit of 14 other psychotic patients and need to be a bit calmer and or sedated.

It completely depends on what type of psych unit you work in. We have patients going through ECT so we do picc lines and IVs. Patients come in with wounds, catheters, and ports. We draw labs and use feeding tubes. We also have patients with ng tubes and feeding tubes due to not eating in 2 weeks from psychosis. We have hypertensive crises and patients on dialysis. My biggest advice is volunteer for everything and get all the education you can. I can learn a skill in 1 week (just as nursing school taught me). In 4 years I can talk down the 300 lb psychotic patient who wants to throw a chair and bash my face in. In psych you can't do a physical hold without documenting it. The police come to our unit and ask us what to do not the other way around. Watch a psych nurse pick up NMS or a severe dystonic reaction in no time and treat it. Experience is always valuable.

My anatomy class used cadavers. One day we were removing the head so we could weigh it to disprove the whole "a human head weighs 8 lbs theory". We had removed the head from the neck which had also been cut sagitally. When someone held the head and one side started to spin a girl passed out and face planted the gurney. She ended up with stitches and never lived that one down.

This is interesting because my facility (i'm in NC) does teach the blocks for all different types of punches.

I've been working as a nurse for 6 months with 4 of those on night shift. I absolutely love night shift! Every time we get an admission one person does the search (psych facility) the next does the chart and the primary nurse does the admission interview. We can knock out a full admission in 15-20 min. flat. I also love that if I step off the floor for 5 minutes and a patient needs something my co-workers help out. I swear on day shift they'd page you just to give tylenol prn for a headache. Anytime I have a patient i'm iffy about my co-workers immediately offer to assess and put in their . Above all I love that management isn't there. On day shift they would come around with a laundry list of things that needed to be done.

I work as a psych nurse in a crisis stabilization center. Our interview rooms are super cold so I always offer a warm blanket during the admission assessment. Trust me when or if they have a psychotic break they always remember who cared for them :)

One of the ways I think about it is this. Pain is pain. As long as they have a prescription and their vitals and LOC are ok i'll give it. Withdrawal for an addict is also painful.