Psych Nurse-LPN

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Specializes in Community Health, Med-Surg, Home Health.

An agency called me today and asked me if I would be interested in working per diem in a psych hospital. I have experience as an aide, but not as an LPN. Would someone give me an idea of what sort of day I may expect? I picture it as administering medications to about 20-30 patients on a floor, IMs for the agitated and checking orders.

Also, am trying to get an idea of the most common psych medications ordered. I remember the Haldol, Ativan, and a few others, but it has been a long time. Isn't there a drug where you have to check temps to be sure that they are not neutropenic? (I gotta look up psych drugs tonight).

And, one last concern: I worked agency for home care and as a vaccination nurse-these were assignments that I could basically handle. I know that working agency at a facility expects the nurse to be up and running (and also that most nurses are not too helpful with agency nursing staff). Is there a great deal for me to learn in psych beside the medications? I'm told that I'll probably have one day orientation.

Thanks!

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Specializes in Government.

I was waiting for someone more current to reply but I guess I'll give it a stab. I've worked full time as a psych nurse but not for many years. I keep up with the changes as much as I can. Psych is med-heavy as you've figured out. Med passes and PRNs are a big part of most unit days. I used to run groups as a facilitator on days but I'm told that's ancient history now. Keeping an eye on melt-downs, as well as a general sense of the unit is huge. On nights, I mostly tried to keep people from killing themselves and each other as well as doing police admits. Night admits were usually barely alert while day time admits needed a ton of time to decompress.

Fewer IVs than any other nursing I've done. Most people ambulatory. It takes a lot of patience with needy folks and a sixth sense about when someone is starting to deteriorate.

I miss it a lot. In my area, the psych hospitals closed one after another in the 1990s. There aren't many jobs left. I hope you like it!

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An agency called me today and asked me if I would be interested in working per diem in a psych hospital. I have experience as an aide, but not as an LPN. Would someone give me an idea of what sort of day I may expect? I picture it as administering medications to about 20-30 patients on a floor, IMs for the agitated and checking orders.

Also, am trying to get an idea of the most common psych medications ordered. I remember the Haldol, Ativan, and a few others, but it has been a long time. Isn't there a drug where you have to check temps to be sure that they are not neutropenic? (I gotta look up psych drugs tonight).

And, one last concern: I worked agency for home care and as a vaccination nurse-these were assignments that I could basically handle. I know that working agency at a facility expects the nurse to be up and running (and also that most nurses are not too helpful with agency nursing staff). Is there a great deal for me to learn in psych beside the medications? I'm told that I'll probably have one day orientation.

Thanks!

clozaril is the one where you do regular CBCs because of the risk for agranulocytosis--is this what you're referring to?

some other atypical antipsychotics you will see are geodon, zyprexa (and zyprexa zydis), seroquel

depakote, lamictal, lithium, and more recently, seroquel for the bipolars

as for what you'll do...I've worked where an LVN is the med nurse and where the LVN takes a group of pts.

although medication is important, communication is also vital, but if you've done home health I'd suppose you are at least somewhat an effective communicator/educator

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I hate this 5 min edit rule; I get called away from my desk and just can't get back some times...darn work expecting me to...work

anywho...I wanted to add that some pts on tegretol (which is also use for the bipolars) developed neutropenia, but I don't recall having to do anything special for those folks

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Specializes in Case mgmt., rehab, (CRRN), LTC & psych.

Be on the lookout for EPS (extrapyramidal system) side effects when administering antipsychotic medications.

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Specializes in Behavioral Health, Show Biz.

:nurse:

psych nursing safety alert meds!!!

1) lithium

toxic serum range: 1.2meq/l and above!

(drowsiness, slurred speech, extrem vomiting, diarrhea, muscle spasms, convulsions)

hold medicine---vital signs---notify md---medical emergency!!!

2) neuroleptics

a) neuroleptoc malignant syndrome

(extreme increased temp/hyperpyrexia, severe muscle rigidity, altered consciousness, alterations in bp)

hold medicine---vital signs---notify md---medical emergency!!!

b) tardive dyskinesia

notify md---vital signs---per md order, administer anti-dyskinesic med.

c) orthostatic hypotension.

encourage patient to change positions slowly. monitor bp lying/standing.

3) clozaril (clozapine)

(agranulocytosis, seizures, hypotension, tachycardia)

notify md. monitor bp, pulse; observe cbc, wbc levels.

4) tricyclic antidepressants

orthostatic hypotension.

moitor bp lying and standing.

5) mao inhibitors

no foods that contain tyramine to prevent hypertensive crisis--->stroke

there's much more info!!!

gotta run...:loveya:

blessings to you panga:d

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Specializes in Med/Surge, Psych, LTC, Home Health.
an agency called me today and asked me if i would be interested in working per diem in a psych hospital. i have experience as an aide, but not as an lpn. would someone give me an idea of what sort of day i may expect? i picture it as administering medications to about 20-30 patients on a floor, ims for the agitated and checking orders.

yeah, that's about right. =) actually, when i worked psych i always appreciated the lpn's that i worked with immensely. they were like gold. and without the lpn, i was the only licensed person on the unit (and that was the case sometimes) and i felt less comfortable.

also, am trying to get an idea of the most common psych medications ordered. i remember the haldol, ativan, and a few others, but it has been a long time. isn't there a drug where you have to check temps to be sure that they are not neutropenic? (i gotta look up psych drugs tonight).

haldol, and i believe thorazine?... can cause neuroleptic malignant syndrome, and one symptom is a very high temperature.

other meds that i saw an awful lot of were zyprexa, seroquel, abilify, and risperdal. those are newer anti-psychotics and not likely to cause nms or other major side effects that can be caused by an older anti psychotic like haldol.

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