Hey everyone. I'm a german nurse and I work with people that have several different kind of disabilitys. I assist people with cognitive, developmental, intellectual, mental and physical disabilitys, basically a mix of everything.
Every patient has the diagnose "intellectual inferiority" inplus other side psychiatric diagnoses such as "bipolar affective disorder, personality disorder, borderline and a ton of obsessive compulsive disorder". Not everything in one patient, but all have other problems.
Here an example of a client, I'll try to translate the stuff to english...
She is 24 years old, intellectual inferiority (70-80 IQ), has obsessive compulsive disorder (wants to be locked in the room after every hour for 5 minutes or else she starts showing autoaggressive tendencies or if you don't lock her in her room quick enough for 10minutes she starts biting other patients), has addiction to food and starts stealing food from other patients if you don't watch out for her or she starts digging around the neighbours garbage.
Thats basically one out of 16 patients I assist daily.
I'm a nurse but I basically have nothing nursing skills related to my job. I just assist them, talk a lot and basically help them in their day to day life (washing them, go shopping, educate how to use money, how to behave in public etc.)
Another Patient is this guy: He is 44 years old, addictive to alcohol and smokes a lot, use to work "normal" but drank so much he is kind of slow and is verbal aggressive, has bipolar affective disorder and is sometimes psychotic/ delusional (for example, he didn't shower for 3 weeks because he thought gas is coming out of the showers and got so scared he didn't leave the room for a few days), if you don't calm him while he verbal aggressive he CAN get aggressive towards patients and nurses. He keeps telling us we are giving all the clients poison when we pass meds.
Basically every patient is kind of like that, but some are very quiet and don't do a lot.
Its not a psychiatric unit, we are mianly a group home for handicapped people. Any ideas what this is in the usa and can I consider this job still as being a "nurse" eventhough I do nothing really nurse related (IV's, catheters, ...)? I feel like I'm not in a real nurse job anymore.
My team is a mix of "Gesundheits- und Krankenpfleger "(Health & Healthcare Nurses, basically a normal nurse) and social workers (maybe curative education nurses?)
I think why I'm feeling kind of not like a nurse is because of the big spare time from 8-11 I have... I could actually watch TV or play on my smartphone and nobody would care.
Here in America, we all sit around the nursing station and play cards.
Hm yeah, it sounds good and is good but if I'm honest my skillset is kind of "***ed" lol. Dunno if I'd rather go back to a normal hospital with more "stress" but more "knowledge" needed. I wouldn't say I don't need "no" knowledge what I do, its just a complete different kind of skillset. My job is easy because I "know" what I have to say or can say in a specific situation to keep a "de-escalation". Like my patient keeps talking about being poisoned, can't take a shower whatever I just kind of talk with him to show him that I understand him and his fears and suddenly I get him to the shower or take his meds. It just takes a lot of time and talking, which I noticed not a lot of people have. I had a co-worker from a generel med-surge unit come in and say things that actually made him more mad and trust him less which got the patient more and more aggressive. I told him it doesn't help much if you go in and tell him the meds aren't poison, because in his "reality" it is poison. I think I gained a lot of empathy and patience-skills at my current job. Especially when two of my other patients start doing weird things duo to dementia at the same time this guy is saying he is being poisened.
Maybe I'm wrong, but I think empathy and patience is something everyone can learn very quick, thats why I think my job is not hard... but some others tell me they wouldn't have the nerves for my unit which I clearly can't understand. We have a patient that is basically just screaming for no reason, she is screaming since she has been born and is now 59. Nobody knows why its just her thing. Thats something I listen to while at work the whole time too.
I am a psych NP in the US. Patients like this are scattered around a small number of group homes, and a lot of LTC facilities. The staff truly are unsung heroes. What you do is very much nursing.
As my first year RN instructor said about doing IV's "any addict can get into a vein".
Intermediate Care Facility for the Developmentally Delayed. The personal care and day to day assistance would be completed by unlicensed assistive personnel and medication and treatments and care plans would be completed by a Registered Nurse( 2,3 or 4 year educated) who may delegate to Licensed Practical Nurses ( vocational nurse who has been trained in a vocational or technical school over 12-18 months).
Intellictually I I understand your "I'm not a real nurse" feeling.
In my heart I bless you and what you do. I have a severely mentally delayed grandson. Thinking of the future when we "grandparents" are dead, and even his parents are dead, I would love to believe he'll be in a caring group home with nurses like you.
Technically smart nurses who have learned tasks...starting IV's, programming IV pumps with critical medications, etc. are a dime a dozen. Few nurses can, or are willing to handle what you do.
So my job is still nursing related? I sometimes don't feel like a nurse anymore if I compare my tasks with ICU or ED etc.
You use the nursing process. You're 100% nurse. I can relate. Ever since I started private duty nursing (all shift in one PT's home) I don't feel like a nurse anymore. Even on my ventilator/g-tube/PICC line case.
When I first graduated nursing back in the stone age we were in one of those layoff cycles that nursing sometimes goes through. I got a job in a group home with 6 disabled adults. The job consisted of passing oral meds, meal prep, laundry, cleaning up a lot of pee, dodging a lot of thrown poo …. that kind of stuff. I wrote a letter to our provincial nursing board, and asked them if this was a recognized nursing position. Their reply confirmed that yes it was, I was still a real nurse. The hours working in the group home were applied to nursing experience, and maintaining my license.
Once I went into acute care, and critical care specifically, the learning started all over again.
Crash_Cart
446 Posts
Here in America, we all sit around the nursing station and play cards.