Psycho-social needs being met by nurses?

aloevera · Jun 14, 2010

As an RN ins psych, we do not have a whole lot of time to spend with each individual patient doing therapeutic intervention.........

We may lead some groups, talk to each pt. to assess daily, but that is about it.....we usually have 20 ++++++++ pts., admissions, discharges, lots going on....

If you want a more one on one therapeutic relationship with pts., I would suggest you get in to social work/therapist...........

jcmoore07 · Jun 14, 2010

thanks for the info. This is good to know;)

Meraki · Jun 15, 2010

It depends on where you work. I work on a peds psych unit and I spend almost the entire shift interacting with my patients. I do a lot of individual psychosocial work as part of the therapeutic relationship and as a nursing intervention. We talk about their issues, their families, their illness, their lives and how to cope and manage. It is me who is there if they are having a hard time or are in crisis. I also do groups, and all the med/order/documentation stuff but probably spend 75% of my time out on the floor with the patients. Depending on how long the patients are admitted (and how many tiems they come back!) we form very strong relationships with some of the teens and kids.

Every unit seems to have different roles and responsibilities for the nurses - I find peds is typically more hands-on.

pandora44 · Jun 18, 2010

I, too, think it depends on the unit.

I work inpt adult short term acute (that's a mouthful). Most of my patients are depressed and suicidal but generally still able to function. Typical length for our unit is 2-6 days and my typical pt load is 4-5 pts. Minimum requirements are that I have a one to one with each patient during my shift to assess suicidal ideation, mood, thought processes, insight, judgement and speech patterns. The actual length of time I spend with each patient varies considerably and is at my discretion. Obviously if it is a very busy shift with multiple admits and discharges, very need patients or families, or just plain chaos on the unit, the time I have for each patient will be limited.

We have a saying on our unit: "Don't work harder than your patient." If I have a patient with some motivation and insight, and I have the time, I do what amounts to therapy with them. We discuss their stressors, motivations, coping skills, how to set boundaries, how to take responsibility for their behavior, etc. I often will assign homework to be reviewed during my next shift. I may spend 45-90 minutes with them each day. If their family is around, I might do an impromptu family session. On the other hand, a patient that is not motivated and has little insight, who is on my unit for "3 hots and a cot" will receive less of my attention. I may attempt to prod or cajole them into thinking about the issues that brought them to the unit, but I am not going to work harder than they are willing to work.