psychiatric unit interviw help!!!

[raindrop]

Can you think of what questions they will ask besides the general?? I am really sick of med surg and I want to try this. i loved my clinical rotation on psych. can you think of questions? and plese lead me to the right answers.

i think they will ask how i would approach a combative patient. well, on my *med surg* floor, if they are combative and we can't reason with them, wrist restraints go on them to protect all parties. i am not sure that is the way a psych floor approaches things or is it? what is the first thing to do, the 2nd, the last, etc?

[showbizrn]

:yeahthat:

1. Verbal Intervention

if ineffective,

2. p.o. meds

if ineffective,

3. IM meds,

if ineffective.

4. Physical Restraints (with one-on-one observation)

[lpnflorida]

Would you tell them for a combative patient that you would wrist restraints on first?

Combative patient, ask what is bothering them, offer medication, still not helping call code NP ( that is what it was called where I work) Then follow same steps, if again they fail, 1 person is designated leader who will instruct each individual as to what limb to grab and hold onto, then patient is placed on bed usually into 4 point leather restraints. Medication is administered if is deemed necessary.

The above steps are only to be used if a patient is only threatening to be combative, if in fact they have already thrown things, hurt someone, call code immediately, then leader will step in, everyone grab a limb, place in 4 point leather restraints. Medicated.

[Jules A, MSN]

Hi,

Just my two cents but I wouldn't mention restraints unless you are pushed for a "what next" after you've gotten to the IM. One of the facilities where I work doesn't allow them and the suggestion is frowned upon. My thoughts would be something like this:

Observe the pt for signs of increasing agitation ie. pacing, breathing patterns, balling of fists etc. and verbally intervene at that point. Ask if they are ok, would they like to take a walk with you, would they like to take a few minutes in the quiet room, would they like an oral PRN?

If they refuse and oral prn I would counsel them that they will need to keep their behavior safe and in control and to let me know if they don't feel that is possible. If they actually become combative I'd have staff escort them to a safe place which is the quiet room on my units, again offer an oral PRN and if they are still unsafe I'd go for the IM. One thing I usually do, and some nurses don't believe in this which is cool, is bring the po med along with the IM because often times when I show up with the harpoon they are suddenly willing to take the oral med that I was told to shove where the sun doesn't shine just moments earlier, lol. The down points to that is that you are then bargaining with them and also the orals don't work as quickly. Depending on the pt I usually go ahead and let them have the PO but definitely do a mouth check.

I love psych and hope you do also. Imo the most important thing is to be aware and try to head off incidents before they escalate. Good luck!

[bekindtokittens]

I went on an interview for a psych RN position a couple of weeks ago, and they asked me several "what would you do" questions.

One of them was "What if you observed a co-worker doing something that was against policy, such as giving out their personal phone number to a patient. What would you do?"

I replied that I would talk with the co-worker first, and if this didn't remedy the problem, I'd go up the chain...

And another. "You've taken five patients outside for a game of frisbee and the frisbee accidentally gets away from the group and goes into a nearby wooded area. A patient says "I'll get it!" and trots off towards the wooded area. There is no other staff in sight. What would you do?"

I answered that I would have all the patients come with me to get the straying patient and frisbee, not letting any of them out of my sight...

I loved my psych clinicals too, and I hope I get the job. I don't graduate for another couple of weeks, and probably won't get my license until mid-June at the earliest, provide I pass the NCLEX on the first try. *knocks on wood* They told me if they still have any RN positions open then, I'd have a job. Hooray!

Good luck on your interview!

[Jules A, MSN]

I went on an interview for a psych RN position a couple of weeks ago, and they asked me several "what would you do" questions.

One of them was "What if you observed a co-worker doing something that was against policy, such as giving out their personal phone number to a patient. What would you do?"

I replied that I would talk with the co-worker first, and if this didn't remedy the problem, I'd go up the chain...

And another. "You've taken five patients outside for a game of frisbee and the frisbee accidentally gets away from the group and goes into a nearby wooded area. A patient says "I'll get it!" and trots off towards the wooded area. There is no other staff in sight. What would you do?"

I answered that I would have all the patients come with me to get the straying patient and frisbee, not letting any of them out of my sight...

I loved my psych clinicals too, and I hope I get the job. I don't graduate for another couple of weeks, and probably won't get my license until mid-June at the earliest, provide I pass the NCLEX on the first try. *knocks on wood* They told me if they still have any RN positions open then, I'd have a job. Hooray!

Good luck on your interview!

Sounds like you hit a homerun! Now get studying for your NCLEX. Keep us posted and stop by the psych speciality section here also.

[Whispera, MSN, RN]

Think of situations that could come up in psych....I think you would be likely to be asked questions about what you'd do in such situations. That and to describe a difficult situation and how you handled it.

[bekindtokittens]

Sounds like you hit a homerun! Now get studying for your NCLEX. Keep us posted and stop by the psych speciality section here also.

Thanks, I hope I did! Only time will tell. And I am already quite the lurker over in the psych specialty section...

Raindrop, I hope you come back soon and let us know what happened.

[mary0507]

Hello everyone,

I haven't been here for a while.

Questions asked. I have done psych for 25 years and have heard a few.

What spice would you consider yourself to be?

What would you do with a surelly staff member?

The last thing they ever want to hear is restraints.

Things I am pickey about is.....do you have your keys attached to you? They can be used as a weapon or to leave the unit. Always remember the sh--t always comes back to the charge nurse. I carry wire cutters in my bag and everyone knows to go to the bag if they need them. Treat your patients with respect and compassion. Always know who is behind you. Don't go into a room alone. Never strip search a patient alone. Document every note so as it can stand alone in court. Don't ever think a patient or family member will not try to sue you; they will. Management will rake you over the coals if it means their behind or yours. Show your patients that you really care about them. They will know if you don't. They are mentally ill not stupid.