I'm a new psych nurse, and so far I love it. But it seems that lately, I don't know if it is the holiday or what, the negative energy on the unit has been surging.
I'm on the adolescent unit, and we give out meds in the patients' rooms...privately. If we give them during lunch and dinner, all the kids make a big stink about who is getting what, and some even try to steal the others' meds.
I went into a patient's room yesterday to administer meds to the patient with the bed near the window. His room-mate was closer to the door, and has always been cordial and polite, if a little hyperactive. I walked past him to give the meds, and when I turned around to leave, he shut the door and said 'You can't leave.' A surge of panic rose in me. I had his roomate behind me (a big guy) and this one in front of me. The boy was smiling, but refused to move, he continued to block the doorway. I had to side-step him and squeeze past to get out.
This happened just one day after another staff member was beaten by an adult patient, resulting in head injuries.
The boy who blocked the door, as I said, has never been threatening, but reviewing his chart, I saw letters that he wrote about feeling the need to kill people, and indeed, he already had poisoned a relative (although she did not die). His letters are extremely violent, incongruent with his affect...discussing chopping people up and getting very detailed about the things he would do to a particular person. But again, on the unit, he smiles, jokes, and is cooperative.
Another staff member talked to him, and he did apologize to me, saying he was only joking around.
My questions: Am I over reacting? Is this just kid stuff? What should I have done differently?
i used to work in the psych ward of a jail as a deputy sheriff and the most important issue which was stressed was PERSONAL SAFETY. NEVER go into the rooms without first placing them in a non threatening position. I tell the patient to get on their knees on their beds and DONT MOVE, then do what i needed to do. Only once was I attacked and it was out of the blue. There was no indication or signs that this patient was going to attack, he just struck... this is why it is very important to not underestimate ANYONE! psych patients are unpredictable and your situation could have turned into a nightmare. Take a look at this article... see what happens when a security officer turned his back to a patient.
i used to work in the psych ward of a jail as a deputy sheriff and the most important issue which was stressed was PERSONAL SAFETY. NEVER go into the rooms without first placing them in a non threatening position. I tell the patient to get on their knees on their beds and DONT MOVE, then do what i needed to do. Only once was I attacked and it was out of the blue. There was no indication or signs that this patient was going to attack, he just struck... this is why it is very important to not underestimate ANYONE! psych patients are unpredictable and your situation could have turned into a nightmare. Take a look at this article... see what happens when a security officer turned his back to a patient.
From article, "The value of humor in calming", I just know the person who said this has not spent much time working under these conditions. How very callous. Here's my question: Are these inmates being adequately medicated? I have heard in some states it can take a court order to give medication w/o a pt's consent. In IL where I work, we are able(currently) to administer calming medication against a person's will if they are a threat to themselves or others. I work in the psych unit of a community hospital, so the setting and clients are different than this article describes, still we have had some doozies. We are doing ok w/the edict to reduce restraints & seclusions. We have our hairy episodes and we DO use these interventions when necessary, but, overall, our psychiatrists have been very good about proactively medicating those pt's who pose the biggest threat. I have also heard that there are only a very few antipsychotics and other psychotropics the state is willing to foot the bill for when someone is in a correctional facility. I worry sometimes that this country is on the brink of a huge crisis re: rx of the severely & dangerously mentally ill. Our state facilitys only hold pt's for a very short time and corrections doesn't seem to be adequately prepared to handle them. This is truly frightening. What can we do? Any ideas? Anyone? Long post, sorry.:uhoh21:
BJJnurse
10 Posts
i used to work in the psych ward of a jail as a deputy sheriff and the most important issue which was stressed was PERSONAL SAFETY. NEVER go into the rooms without first placing them in a non threatening position. I tell the patient to get on their knees on their beds and DONT MOVE, then do what i needed to do. Only once was I attacked and it was out of the blue. There was no indication or signs that this patient was going to attack, he just struck... this is why it is very important to not underestimate ANYONE! psych patients are unpredictable and your situation could have turned into a nightmare. Take a look at this article... see what happens when a security officer turned his back to a patient.
http://66.225.228.21/lawenforcement/content/040112kirby/midhudsondanger.htm