nina539

That makes me really sad to hear. In the last year we had a psych nurse, a psych tech and a med-surge nurse (responding to a mistakenly called code) all assaulted by the same violent pt. 2 concussions and a broken nose were obviously cause for concern. Until we could get this pt moved to a more secure long term facility we kept him secluded from other pts with additional staff/security. Our doctors fully supported the nursing staff through this and this person will never again be allowed for admission. You have my sympathy, it must be terrible to not have the support of the doctors you work with. To get back on topic, we do have a list of PNG which my facility keeps. All the doctor has to do is give the word and they are added to an unofficial list. The problem is when the pt presents at our ER or another. Then its up to the doc to explain why we are not admitting them. The usual reasons are because these are pts we have seen time and time again who do not benefit from our acute setting. Our unit has not been "therapeutic". Although ultimately if someone meets criteria it is really difficult to deny them treatment.

I have to agree that mood is what the pt says it is. I have found in my experience that it can be helpful to chart something like "[patient name] reports they are feeling ..... (sad/angry/upset/frustrated/etc..) and then follow up with something like This writer noted he/she to be .....(whatever you saw) based on ..xy or z. I think what's important in your documentation is to be specific as to whom the opinion belongs whether it be the pt's or your own. Personally, I tend to go with the more is better idea that to give others reading your documentation a clear view of what occurred.

I work inpt psych and our dress code is just scrubs or scrub pants and t-shirts, no specific color. Most of the older nurses tend to stick with very traditional scrubs while some of us newer nurses have taken the scrub pant and t-shirt route. We have had many of our pts tell us they feel more comfortable talking to us because we look less "clinical". I definitely agree that all black scrubs sound like a terrible idea, however on the other hand with mentally ill pts you never really know what "outfit" might upset them.

I am an LPN on an acute psychiatric unit. My nurse manager has given me and my fellow LPNs the task of coming up with ideas for educational/informational sessions with our patients. I was hoping maybe there was someone out there who has some ideas or perhaps links to sites with ideas. I am working with adult patients and most of the sites I have found are geared more towards adolescents and children. Any ideas are welcome. I just need a starting place. Thanks in advance!