That's why they call him "The Streak"

[Nurse Ratched]

Any hints or tips on dealing with the patient who insists on getting naked (and visually traumatizing other patients and staff with said nakedness) while you're waiting for the Lithium/Depakote to kick in?

I swear you can't make this stuff up.

[StuPer]

I just thought I'd throw my tuppence in on this debate, I agree with TitaniaSidhe and Nurse Ratched... a tranq and antipsychotic are a good combination. The fact is despite the behaviour may not be directly harming anyone, it is a symptom of their psychosis, and may be treated. What also needs to be remembered is a ward, particularily a mental health ward is a community of patients, and as with the community at large, no 1 person has the right to behave in a way that disturbs or upsets other members of the community. The theraputic wellbeing of all patients overrides an individual... or as Spock put it "the needs of the many out weigh the needs of the one"

regards StuPer

[normj]

Vitamin A - the wonder drug that works wonders :).

I find that lorazepam frequently only disinhibits such patients.

[normj]

I am with TitaniaSidhe on this one. We have had this on several occasions. You have to also consider the other patients rights and safety. Usualy settles down quickly - the Ativan is good, but I find for Manic patients if you get some Haldo flowing (5 -10 mg) each time u give the Ativan - it works a lot better and helps them come out of psychotic state. Good luck

We call it a B-52 ...

2mg lorazepam

5mg haloperidol

50mg diphenhydramine

IM, all in the same syringe ...

Nighty-Night!! :stone

[lil'nurse]

This just happened where I work. Pt thought everything contaminated, including clothing, so had to take it off. It was noc shift so not too many people around, until the hallucinating detox came in and wanted to join in the fun, very agitated when we wouldn't let that happen. One in each seclusion room that noc.

[normj]

I just thought I'd throw my tuppence in on this debate, I agree with TitaniaSidhe and Nurse Ratched... a tranq and antipsychotic are a good combination. The fact is despite the behaviour may not be directly harming anyone, it is a symptom of their psychosis, and may be treated. What also needs to be remembered is a ward, particularily a mental health ward is a community of patients, and as with the community at large, no 1 person has the right to behave in a way that disturbs or upsets other members of the community. The theraputic wellbeing of all patients overrides an individual... or as Spock put it "the needs of the many out weigh the needs of the one"

regards StuPer

yes, and if all else fails, have them arrested for indecent exposure ... i don't understand why folks are so concerned about using restraints here ... we would put them in locked seclusion immediately ...

[Moishe Pupik]

Remember that song in the seventies? "....wearing nothing but a smile on his face....I said Ethyl don't look, but it was toooo late". Of course now it's the 21st century and we're all responsible adult RNs. Where I work, if it was a male pt he would be hit up with Haldol, Cogentin, and Ativan IM. Seclusion would also be an option.

[Thunderwolf, MSN, RN]

You know, nothing is more embarrassing for a patient than to remember how they acted when the manic episode has since passed and others remember (staff/other patients). Medication used to treat this symptom picture is very appropriate. Haldol/Ativan or the B-52...right on the money. I used to call them "dignity shots".