Hello, psych nurses! So one of my patients had an MI, and she is mentally ill. Her working diagnosis says "Bipolar", but I'm thinking there is more to her behavior than that.
Her psychiatrist, the hospital psych doc who rounds on inpatients, is making changes to her medication regimen, and she is not happy about it, and neither is her mother, who sits in the corner and watches the patient's interactions with nurses, occasionally interjecting a comment or two. The mother is incredibly enabling, and the patient's behavior seems worse when the mother is present.
The moment I step onto the floor, I am dealing with her, with no time to check on my other patients or even look up labs, imaging, meds, etc. She is on her call light demanding to see her nurse immediately. She states she is having a "seizure" caused by "withdrawal" and demands that I call the doctor. She is lying in bed, her legs are shaking, and she states that her teeth are chattering, though I am not observing that. Her vitals are WNL, and it's been over a week since she last had the medication that she states she is withdrawing from, plus she is on an anticonvulsant. She states that she is miserable, and that she "will have relief". Now, I did call the hospitalist, who refused to come see her or prescribe anything. He believes that this is a psych issue, and that this is the psychiatrist's call. I attempt to call the psychiatrist with no success. The patient is accusing me of "not relaying the extreme urgency of the matter", and that is why the psychiatrist will not call back. The mother of the patient is asking me how I can find out whether the psychiatrist is in the hospital and when he plans to round (he rounded earlier that morning). I tell her that there is no way for me to know where the doctor is and that I have no control over the doctor's actions, and that I am doing everything I can for the patient.
All in all, this is very frustrating for me, because I am not used to dealing with this sort of thing. We do get psych patients occasionally, but I've only had one other that was more demanding than this, and it was a nightmare. I thought to myself that I needed to just be calm and set firm limits and go about my business as usual, so that is what I did. When the patient would call me in to complain of a "seizure" (all the while, her vital signs are WNL and she's lying there looking at me and talking to me) and make accusations about the supposed lack of care she is receiving, I would simply listen, nod my head occasionally, say "Uh huh" and "I can see you're upset", then reiterate that I am doing everything I am able to do, then calmly walk out of the room.
By the end of the night, she was apologizing for her behavior and complimenting me for being such a "good nurse". Still, up to that point, it was incredibly frustrating for me.
Any helpful tips, in case I have her again tonight?
