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margo123's Latest Activity

  1. margo123

    need advice

    Your advice is much appreciated and I know I must do something and soon. There was a staff meeting today and I was very vocal about my thoughts re all this. I told my director that I think this unit is a disgrace and a tragedy waiting to happen. She agreed with me and said, "I know but my hands are tied. I have bosses, too." I asked her if she thought they realized how many fundamental care principles have been breached and she said, "They don't care, they just want to fill beds." She made all kinds of promises about how things are going to be reworked to make it a safe unit. When I mentioned specifics, she got evasive. I think I'm pretty much out of luck getting anywhere thru her. She feels compelled to "go along" with her higher-ups. Her personality is one of the people pleaser and people pleasers talk from both sides of their mouth. After a half hr she announced that we had "talked enough" about this subject and moved on to subjects that are trite in comparison. I have considered the options you have suggested and think I'll put the wheels in motion next week. Thanks to all for the input.
  2. margo123

    need advice

    I really need some help here. I work on a small thirteen bed unit in a community hospital. My boss has opened up six more beds for observation patients. The original concept was for it to be a 24 hr. short stay area, during which time it would be decided if pt was able to be discharged or needed rolled over to inpatient status. This unit is tucked away at the back of the Gero Psych unit separated only by a curtain from the elderly patients. The unit hasn't been used as was originally planned. Pts are being held there who are too violent to be incorporated into our general population, borderlines are being held there. One bpdo set himself on fire last week. They had to do a take down on him in the Gero hallway when he escalated one day. All the oldsters were present. It was a miracle nobody got knocked down in the ruckus. This unit was initiated without any forethought. No extra staff was hired. We're expected to come in extra hours and staff it through mandatory overtime. I worked there last night and admitted four patients. I had one who was MMR, schz, and has second degree burns over 20% of her body, IV's, dressing changes, paranoid and fragile as all get out. Admitted a bpdo, who wanted to take the thermostat apart and carve herself, an alcohol detox came in early withdrawal, a 24hr detention with cut wrist who had come with screwed up paperwork on her detention papers. I had to iron that out with state police officer standing there glaring at me like it was my fault. I was loaned a new clerk for a couple hrs. She was too green to be much help at all. My equiptment was a small table, a laptop in the hallway. The charts were placed on the floor. There is NO confidentiality because the patients mill around where all the documents are exposed and try to read charting over your shoulder. All the supplies were located up the hallway about eighty feet, well out of sight and sound of my patients, so in effect, everytime I had to run to get supplies, I was leaving patients alone. I know that this breaks every regulation in the book and I'm putting my license and life on the line by working in that area. My boss poo poo's every concern staff mentions. She calls us "Queen Bees". I don't want to quit my job but I'm about ready. There are about four other nurses who are as fed up as me. The rest of the staff is fed up but too afraid to complain to the boss. Am I over- reacting here?
  3. margo123

    Info/opinion re ECT

    I've been working one day a week for the past eighteen months helping administer ECT. I think the screening process is key. Some of the personality disorders slip by our docs and usually we see no improvement with them. Our clients who have real depression make amazing improvement. We treat a lady who is bipolar and can become catatonic. It truly has saved her life. The turnaround she has made is astounding. Our list of success stories is a very long and gratifying one. Many of our clients are troubled with memory loss immediately following the treatment ie not being able to remember where the dressing room is, who drove them to treatment, etc. They report that this is transient. Virtually all of them report what they have traded in memory loss for the immense relief from depression is well worth it. I can't think of a single case where severe memory loss has happened. A few have complained of headache and/or muscle soreness afterwards. We treat this with Toradol and usually our clients are soon comfortable. I can say with all honestly, that I would have it if needed. I'd recommend it to a loved one if they were suffering. The positive effects can subside after a few months of stopping treatment (not always). Those clients come back for more ECT because they know they're going to feel better again soon. Hope this helps and the best of luck to you.
  4. margo123

    Psych observation unit

    This unit will have a capacity of 6 beds. That means 6 beds and a hallway that is the only area for the patients other than their rooms. Yep, no activity area available. The rooms have no tv, so the only distraction other than sleeping for 24hrs is to be out in the hallway. Not good.
  5. margo123

    Psych observation unit

    My unit has opened up a new observation unit intended for patients who may only need short-stay care. This might include somebody who has suicidal ideations and no beds are available on the regular unit, or a borderline who was just stitched up in the emergency room. It also could include somebody who just needs to talk, as we all know can relieve the current angst and then the patient is asking to be discharged. The unit really was formed because our emergency docs were pressing us constantly for beds we just didn't have. Management has opened this unit without hiring any new nurses. We're staffing it with mandatory overtime. Also, the beds are located on our gero psych unit. The only thing dividing it from the gero beds is a curtain. I have some serious concerns about safety. We're told that no patients with potential for violent escalation will be admitted there but anybody whose ever worked psych can tell you that you just can't always predict that. We're staffing this with one nurse, with the plan being that "you can always yell for one of the gero nurses if need be." Would love to hear your feedback on this.