1st job as an LPN helping with eating disorders

Jules A, MSN · Sep 6, 2015

This is a tough crowd and keep in mind especially the anorexics can be extremely fragile medically. Watch them, their labs and vitals like a hawk for signs of decompensation.

There will be no shortage of Cluster B traits floating around so if you don't have a psych background I would do some research on that NOW. I'm guessing meds with the exception of supplements shouldn't be too strenuous will likely be SSRIs, SNRIs, maybe some low dose antipsychotics for augmentation and possibly benzos.

Congratulations on your new job and I'm thinking maybe ask the mods to move this? It definitely should be in the general nursing discussion board for more responses.

Editorial Team / Admin · Sep 6, 2015

Welcome to allnurses.com

Thread moved to General Nursing forum.

Good luck in your new job.

acim · Sep 6, 2015

Congrats on your new position! I thought I would be interested in this area of nursing and applied when I saw the position advertised but I didn't hear back from them =(I do hope you will share your experience when you begin.

Alisonisayoshi, LVN · Sep 7, 2015

Hi, I actually work with a charity that helps place people with eating disorders into treatment programs. I do peer to peer support with then as well. This is a TOUGH population. It just really is. It's a heartbreaking, tough, medically fragile population.

Some points:

1. We will do anything to avoid gain. Anything. Don't trust us, we lie. We will shuffle our feet if you make us sit. We will pocket food in our mouths. We will beg for bathroom trips alone. Anything and everything you can imagine, and a lot of stuff you've never dreamed.

2. We have a mental illness. We aren't making a choice. It can be hard to remember.

3. Follow your facilities polices on what to say and not say to us. Words can set our recovery back months.

4. Listen to us. You can learn a lot.

5. Research research research! We generally tend to tell pretty similar stories, read a few recovery blogs, there are a plethora out there. Hear what recovery gives us. It's easier to champion something if you know the good things it brings. I'd link an article I wrote about recovery, but it's identifying.

Lastly, I'm new too, and new is scary. You can do this, and you have a beautiful opportunity here to make an amazing difference in these people lives. Be open and willing to learn. Good luck.

Cna2lpnbutterflies · Sep 8, 2015

Thank you all so much, Jules A Alisonisayoshi, LVN and acim, LPN! Thanks for the great tips and encouragement, congrats and well wishes. I will definitely use your advice!

the 1st day was great, the nurse and other staff were very nice! And the girls seemed quite nice too, they were all SO varied with their personalities as well. Not that I expected them to all be the same, everyone is different. The self harm some of the girls had done was staggering! I hope that I will be benificial to them and likewise! Definitely an environment rich in learning for everyone!

mu main worry now is how I am going to be able to manage it all on my own.

Cna2lpnbutterflies · Sep 8, 2015

(Sorry I tried to change my but my clumsy finger hit post)

In the morning I'll have hardly more than 8mins per each of the 13 girls, to do vitals (lying down and standing) weight and mental assessments, plus Meds!

My ADD has always made it difficult to manage time well and I'm SO so worried I won't be able to stay on point! I'm concidering asking my psychiatrist whether meeting with a coach could be of any use for me.

oh duh! I could've just hit edit on the other post...

NOADLS · Sep 9, 2015

Document well. Ensure that the sequence of events and timing is included in your documentation because the population with eating disorders are chronic liars. When the next shift receives the patients into care, they will have your documentation to work with. It will be easier for the next shift if your documentation is thorough.

Example: "[insert name of young, white, middle class female here] denied induced vomiting after breakfast. Housekeeper reported finding fresh puddle of vomit under patient's bed while patient attended lunch. Writer observed patient's left knuckles bruised during lunch; bruises appeared fresh and draining scant amount."

With the above documentation, another shift could address the issue if the present shift did not have the time. This also serves as a method of keeping track of how honest the young, white, middle class female is.

Alisonisayoshi, LVN · Sep 10, 2015

Document well. Ensure that the sequence of events and timing is included in your documentation because the population with eating disorders are chronic liars. When the next shift receives the patients into care, they will have your documentation to work with. It will be easier for the next shift if your documentation is thorough.
Example: "[insert name of young, white, middle class female here] denied induced vomiting after breakfast. Housekeeper reported finding fresh puddle of vomit under patient's bed while patient attended lunch. Writer observed patient's left knuckles bruised during lunch; bruises appeared fresh and draining scant amount."
With the above documentation, another shift could address the issue if the present shift did not have the time. This also serves as a method of keeping track of how honest the young, white, middle class female is.

We are ALL liars in our disease, that's very true, but studies bear out that we aren't by far and wide, all white middle class females. I grew up poor white trash myself. Never had a dime to my name growing up, lived in a meth-y trailer, abuse and violence ect ect. Not in any way shape or form a middle class white girl. I hung with the Natives and the Latinas, was far more likely in most people's minds to become a gang member or a meth head, rather than a girl with bulimia. I learned a ton of my behaviors from the Latina girls, they ALL purged.

Alisonisayoshi, LVN · Sep 10, 2015

Thank you all so much, Jules A Alisonisayoshi, LVN and acim, LPN! Thanks for the great tips and encouragement, congrats and well wishes. I will definitely use your advice!
the 1st day was great, the nurse and other staff were very nice! And the girls seemed quite nice too, they were all SO varied with their personalities as well. Not that I expected them to all be the same, everyone is different. The self harm some of the girls had done was staggering! I hope that I will be benificial to them and likewise! Definitely an environment rich in learning for everyone!
mu main worry now is how I am going to be able to manage it all on my own.

We seem nice and quiet but we are manipulative as all get out. Trust me. And yes, the self harm is scary, I never self harmed aside from eating disorders, but in my charity work I come across a tone of cutting (I sometimes call it carving when it's scary bad).

You will get it done just like I get my SNF med pass done, slowly, but it gets completed. It will get better with time (I hope).

Cna2lpnbutterflies · Sep 17, 2015

True! There are girls of African and Latino decent at my facility. Thanks for pointing that out! I was appreciative of NOADLS advice but wasn't appreiciatve of the limiting of the demographic.

Cna2lpnbutterflies · Sep 17, 2015

Yes, I don't plan on trusting them; I've been warned to and have seen a bit of their sneakiness. Thank you SO much for all your input, I apprieciate it very much! And yes in time I'll get things down, I just hope I don't make too big of a mess of things at 1st. The idea of being the only nurse on site is a little bit unnerving but, I'll work it out. I have to.:)