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Is a patient really suicidal? I have worked in a mental health hospital for 21 years. My experience with suicides is that the patient who is the quietest and does not make threats are the ones to worry about. Multiple previous serious attempts are a clue also. If the patient scratches their arm - nothing serious. When patients have taken overdoses they usually admit that they were just trying to get "high". One patient sticks in my mind. She had been in and out of our facility for as long as I was there. Once she submerged her head in boiling water - was very scarred from that. Then, she cut off one of her hands. This pt was in-house when she succeeded in hanging herself from her locker. It was an ordinary day with no special significance. She ate her meals, did her evening care, went to bed as usual. On the first round, staff found her. You can not always tell. However, it sounds like you have made every effort to help your friend and you just have to believe that you have done your best. This person sounds typically borderline and if she would suicide, it would probably be by accident. Good luck!

Psych RN for 19 years, Definitely a Narcissistic Personality Disorder. I have done extensive research on this subject - my ex-son-in-law is a Narcissistic. It is definitely a psychiatric diagnosis and is listed in the Diagnostic Manual as such. Obsessive/Compulsive Disorders are often paired with the Narcissistic and share many traits.

Speaking of one to one's. Do you have that many? Our hospital is having a real problem with staffing for the one to one's. In a force search, we have just developed a "mediation team". These are the best of our employees who have demonstrated ability to defuse and re-direct patients. They would be called as a kind of "show of force". Rarely are our police called in.

I work in a state psychiatric hospital in North Carolina. I have worked at this hospital for almost 19 years. I find the pay to be comparable to other hospitals - better than the forensic (prison systems) in North Carolina. Unlike the physical illnesses - which can be treated and discharged, i.e., a cholecystectomy, psychiatric patients are generally not "cured". This is both a negative and a positive. We get the revolving door syndrome and you get to know your patients and their illnesses well. There is laughter and tears. I have very much enjoyed my experiences in my career as caretaker of "the forgotten ones".

I work in a state psychiatric facility. All of our patients are searched and scanned as they enter the facility. They are searched again when they arrive on the ward. If we suspect contraband after a patient is admitted, we require a physician's order to search. Patient and a member of the same sex as patient must be present during the search. Despite our best efforts, patients seem to be able to obtain and/or keep contraband.