starting on psych/med floor from ICU any advice:how cn I prep

[Amayalu]

I read some amazing threads this is sucha agreat site. but how exactly is a behavioral med floor run; its not like a med/surg where they get better and go home. or ICU stable and then to stepdown or floor. Any input would be great thanks

Nicenursse (also newer nurse 1 year grad) please and thank you

[NPvampire, MSN, RN, APRN]

It really depends on the hospital, but many times a patient will come in after going off their medications or becoming psychotic for the first time ever. The docs will place them on medications, monitor them for about 3-5 days, and release them if stable, with a follow-up appointment in the community. If they are unstable, or have nowhere to go home to, discharge takes longer. When they first arrive, many are very depressed, violent, manic bouncing off the walls, or catatonic/not-eating/responding. After a few days of medications most patients improve to a degree. They may, and often do have co-morbid medical conditions, most particularly diabetes, HTN, syphillis (goes into neurosyphillis if untreated), hypercholesterolemia, and dental issues. Most psych requires the patients to be medically stable before they are admitted to psych, and if they get sick, they are usually shipped out or up/downstairs in a hurry. You are correct, there is usually no psych step-down. But sometimes hospitals will have a temporary observation unit for those acutely psychotic because of drug or alcohol, or post-status suicide attempt (usually an OD) where the docs will just monitor them for "23 hours" and not really admit them. Both inpatient and temp obs will discharge patients out of the hospital, although some hospitals have long-term units available. Most "medical" hospitals with a psych floor try to get them stable and get them home. Unfortunately, many come right back when they can't/don't/won't get/take their meds.

Some hospitals do psychiatric evaluations for those accused of crimes, under court hold/order, and will treat a patient for months until the evaluation is done and they go back to the judge.

[Amayalu]

Wow! Thank you Vampire.

Crazy as it sounds this seems way more intence then the ICU

[Shanna M]

I work in a psychiatric hospital and we are affiliated with a local hospital. Pt's are admitted to PMU (psych med unit) after suicide attempts, to get medically cleared to be admitted to inpatient-sometimes family will bring pts with their first psychotic break/manic episodes to the ER and then they get referred to us from there. When we have patients requiring medical care or that the psychiatrists want to have further evaluated for medical symptoms we will send them out to PMU.