Talila72

The CDC position on the matter is that aspiration is not necessary. If you have the correct site, needle gauge, and needle length then your chances of hitting a vessel is really low to begin with. As far as Z-track, I only do it with a patient who is taking an IM willingly. In a psych emergency where the patient is really combative, I don't want my other hand on the patient and risk a stick. If the med is viscous it will start to come out but you can minimize this happening by injecting viscous meds slower (the way they should be injected to begin with) vs at lightening speed (I have seen new nurses in an emergency do this).

On my unit no one person was stuck on a 1:1, especially the really challenging 1:1 all day. The responsibility for staying with them was rotated through all the staff members, including RNs (though RNs usually only did 1h rotations vs 2h). Even with a patient that is not as disturbed as the one you described after several hours sitting your mind will have a hard time staying alert and may even relax if the patient seems calm or is sleeping. That is a recipe for potential trouble.

I am a psychiatric nurse and I also have Bipolar Type 2. I have been stable with only a little tweaking of my medications 11 years now. I had more issues starting to destabilize when I worked in a traditional hospital with 12 hour shifts that were rotating. I have never been triggered by working psych (I work adult inpatient) and it "cutting a little to close to home". When I am working it is all about patient care. In many ways I think I truly understand what some of my patients are experiencing but it only serves to make me more compassionate towards them. I have also picked up a lot of good information and coping skills that I can utilize to care for my own illness. Bottom line is I have been incredibly happy and fulfilled by psychiatric nursing and if it is truly your calling I would say go for it. As long as your focus is where it should be and you are taking care of your own mental health outside of work, I think you should be fine.

We have 8 hour shifts as well.

I studied martial arts many years before I became a psych nurse. I have never utilized any of it in nursing. The bottom line is you can ONLY use holds that are approved by your facility and that's only after every other technique to deescalate the patient has been tried.

I agree with many of the others. I assume they all can be dangerous. Even the most seemingly docile patient can turn violent.