Psychiatric Nurses and Safety

LemonAide · Apr 29, 2016

I love psych! The facility I work at uses handle with care. It's not just the training though you need have good working relationship with your co-workers. You have to be able to work as a team. You have to be patient and try to be as solid and consistent as you can. I make patients stay kicking distance away from me for the most part. If I can kick them they are to close. I never say this outloud I just do it. Don't deviate from the limits you set.

I've had my ass handed to me twice and both times I learned from it. I got my ass kicked by a six year old lol really and it was totally my fault. I deviated from my limits and tried to be comforting since we were ending up hands on every night with the same pt. Lesson learned work with your head not your heart. First time was by an adolescent boy same sort of scenario. I work with all ages of pts.

Good luck my family constantly worries about me.

direw0lf, BSN · Apr 29, 2016

My psychology teacher scared the crud out of me about working in a psych hospital with his stories about staff getting harmed, but I still am interested in it, and possibly peds psych. I work as a patient observer in the float pool, and let me tell you, it can get wild anywhere in health care!

djh123 · Apr 29, 2016

I spent a few days in a psych hospital when I was a nursing student, and saw some 'problematic behaviors', I guess I'd call it. But no, we didn't learn anything about how to diffuse behaviors like that in our nursing school, nor did anyone at the psych hosp tell us either. But as another responder said, you'll find combative - and/or 'psych' patients - in many other settings in nursing. At any given time, I have a handful in my LTC unit, whether due to Alzheimer's, bipolar, Parkinson's, TBI, or some exciting combination thereof :^). I used to think I was interested in being a psych nurse too, but I already do enough of it in my unit, and it makes me appreciate the residents I have who aren't psych patients (or who only have minor psych things to deal with).

fawnmarie, ASN · Apr 29, 2016

I just left psych nursing after a 12 year stint in a state mental health institute. I was never seriously injured on the job. I did witness some scary scenarios over the years. The clinicians in my facility went through a phase where they were afraid to appropriately medicate the combative patients. I often found myself pleading for emergency medication from the clinicians. When a patient is throwing chairs and flipping tables over, and is endangering the other patients on the unit, I don't think an order for 25 mg of Benadryl PO is appropriate. What I needed in a dangerous situation was an order for 150 mg of Thorazine IM with 2 mg of Ativan IM, and possibly 50 mg of Benadryl IM thrown in to sedate the violent patient. The clinicians went through that crazy "We don't want to give too much emergency medication" phase until one patient murdered another patient. Then, of course, they woke up! I eventually left that job when it became too dangerous. I have young children, and I can't risk getting seriously injured because an MD refuses to medicate a violent patient.

TheCommuter, BSN, RN · Apr 29, 2016

Moved to the Psychiatric forum.

Kayla_Martin · Apr 29, 2016

Thanks everyone for the input! I posted in the psych forum and didn't get any responses. It's definitely something that I feel is worth a shot!

fawnmarie, ASN · Apr 29, 2016

Thanks everyone for the input! I posted in the psych forum and didn't get any responses. It's definitely something that I feel is worth a shot!

Best of luck to you! I really did love psych nursing, and I hope you find you niche in nursing!

sailornurse · Apr 29, 2016

bob and weave like a boex.

What is a "boex"?

elkpark · Apr 30, 2016

What is a "boex"?

I'm guessing (from the context) that it's supposed to be "boxer."

tyvin, BSN, RN · Apr 30, 2016

I worked in a lock down unit for years and have had various physical encounters. They are unavoidable IMO. You have to know what you're doing. Prior to psych I took over 8 years of martial arts. It saved my butt in psych.

But seriously; it's all about body language and being able to read the patients. The psych patients know when they have a weak nurse and most will take advantage. It's all a mental game which they aren't afraid to take to the physical. As far as being taught how to handle out of hand psych patients...never happened in the real when I went to school.

They teach you theoretical stuff that doesn't apply to escalated encounters of the dangerous kind. They want to pretend that it doesn't happen as a norm. The most I was injured was when a little old lady got me by the throat and took me down with a security guard and the LPN all standing around. I had given the LPN instructions to get the Ativan ready (that stuff is so slow to draw) and I let my guard down. I'm a 5'10" female who has a commanding presence but this 4' maybe 10'' didn't care ... BOOM. As I'm on the ground while she's choking me I'm looking at the LPN like; anytime now would be great to give her the Ativan. The security guard finally came out of his laughter phase and got her off of me...I never lived it down. I have been threatened in about every way you could possibly think of. That's not just from the patients; the families can get pretty intense as well. I have been frozen in place afraid for my life that if I flinched, I could set a person off. By the grace of the Gods, the little old lady was my worst physical encounter.

I mean this is right after Mr. Gorilla, 6'8" male patient, threatened the entire staff and the patients with bodily harm and shattered the nursing stations glass barrier by throwing a metal chair through it. I approached him and after 3 non-drug interventions I had to shoot him with Geodon (my favorite for this type of situation) right through his clothes (I just happen to have it in my lab coat; just in case). No volunteers to hold him down. In fact when you institute a call for more nurses from other parts of the hospital to come help, you usually get no takers, while the situation escalates.You must be inventive and think fast.

Don't let that scare you. I heard that a state psych hospital's nurses are suing the hospital because enough is not done to protect the nurses. It's the nature of the business unless you start posting guards in the hallways and in the nurses station. Now that would really irritate the agitators. There's no money for that anyway.

I love psych and learned quite a bit about people when working there. It is not for the faint of heart. All facilities are different. The one I worked at was in the boonies, so we got it all...every type of psych patient, detoxing patients from alcohol and from other drugs. Most of the psych patients that were admitted had stopped taking their meds and got into a situation that attracted the police. They take their meds and feel great, and than decide they don't need the meds because they feel so great...it's an unending cycle..

When I did my clinical in psych; it was a psych facility in the city, and much more mellow than my boonies one...like night and day. Mostly everyone thinks psych nurses are crazy to work in psych; yea, just a little...maybe. :up:

You should never be alone on shift, no matter how small the census. Good luck to you

allnurses Guide · Apr 30, 2016

Sure! There are de-escalation techniques, and hopefully security available. Won't stop a psycho from flying across the room, pounding you to the ground and pulling your hair out.. will they?

The facility where I work teaches MMA style holds and escape techniques to all staff. The trick is to keep your head together when under attack. You have to pass the training in order to work on the floor.

Hppy

allnurses Guide · Apr 30, 2016

What is a "boex"?

I meant boxer I hate auto-correct