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What's the Most Common Reason for a Patient to be Readmitted on a Psych Floor?

Psychiatric   (482 Views 12 Comments)
by AlwaysAnxious AlwaysAnxious (New Member) New Member

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Apparently, there's a huge problem with psych patients being readmitted to the hospital for treatment. What's the main reason for it? Most common reason for readmission?

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7 Likes; 5,045 Visitors; 110 Posts

In my experience, it has been persons with Borderline Personality Disorder.

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Davey Do has 35 years experience and works as a Behavioral Health RN.

1,839 Likes; 13 Followers; 71,739 Visitors; 5,772 Posts

According to a study done years ago, 80% of psychiatric patients who are recidivistic, or regularly readmitted, is due to the fact that they are treatment non-compliant; chiefly, they do not adhere to their medication regimen.

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77 Likes; 9,194 Visitors; 1,371 Posts

Being unable able to have needs met in the community - frequently exacerbated by stopping medications and/or restarting substance use. 

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

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Non compliance with medications and follow-up care!

 

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jlambirt has 3 years experience.

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There's also malingering. The teenagers disappear in the summer and the homeless go up in the winter. For a teenager, suicidal comments get them a few weeks out of school and freedom from any responsibilities. For the homeless, it's a free room with meals and safer than a shelter.

Of course, there's noncompliance with treatment and substance abuse too.

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

341 Likes; 4 Followers; 31,191 Visitors; 2,517 Posts

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

341 Likes; 4 Followers; 31,191 Visitors; 2,517 Posts

On 3/7/2019 at 4:57 PM, jlambirt said:

There's also malingering. The teenagers disappear in the summer and the homeless go up in the winter. For a teenager, suicidal comments get them a few weeks out of school and freedom from any responsibilities. For the homeless, it's a free room with meals and safer than a shelter.

Of course, there's noncompliance with treatment and substance abuse too.

Where in heaven's name do people get a couple of weeks in the psych hospital. We have to fight the insurance companies to get 5 days! Our teen cencus goes up in the summer and down around the Christmas holidays. Most of the homeless who come in when it's too hot, cold or wet outside really do need our services. They don't stay long when they find out we don't have hot and cold running Ativan and Norco. 

Hppy

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umbdude has 1 years experience as a BSN, RN and works as a RN.

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In my setting, most common reasons are: homelessness, substance relapse or detox, psychosocial stressors, symptom decompensation, and some malingering. 

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nurse lala has 33 years experience as a BSN and works as a RN Case Manager.

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From my experience, mental health readmissions are usually related to resistance accepting mental illness.

Chronic mental illness demands dedication to treatment to stay out of the hospital. Mental illness has a larger burden than other diseases because of stigma. The person usually must come to terms with their own morbidity and learn to negotiate societal beliefs in order to comply with psychotropic medication and/or behavioral therapy. 

The long term goal of care is to increase understanding of the disease process and develop skill to maximize and maintain functioning. One needs good if not exquisite support to achieve these goals. The early stages of acceptance of being mentally ill is a dance forward embracing compliance, and back into denial. All made more complicated by access to housing, finances, travel and healthy social support.

 

 

 

 

 

 

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1 Like; 66 Visitors; 4 Posts

Thanks everybody for your answers, I really appreciate it! I'm a new nurse going into psych. I'm really nervous and afraid. I feel like I know nothing despite studying my sanity away in nursing school. I'm so scared that I'll be so terrible that I just end up getting pushed around by all the other nurses instead of being helped and eventually, feel forced to quit... I hope it doesn't happen to me, but from everything I've witnessed, it just seems like a sad and common occurrence in nursing... -sigh- But I swear I'm more than willing to learn everything I have to in order to do things right. 😭

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hppygr8ful has 15 years experience and works as a RN - Adolescent Psych.

341 Likes; 4 Followers; 31,191 Visitors; 2,517 Posts

14 hours ago, AlwaysAnxious said:

Thanks everybody for your answers, I really appreciate it! I'm a new nurse going into psych. I'm really nervous and afraid. I feel like I know nothing despite studying my sanity away in nursing school. I'm so scared that I'll be so terrible that I just end up getting pushed around by all the other nurses instead of being helped and eventually, feel forced to quit... I hope it doesn't happen to me, but from everything I've witnessed, it just seems like a sad and common occurrence in nursing... -sigh- But I swear I'm more than willing to learn everything I have to in order to do things right. 😭

First and foremost relax and breath. Being a new nurse is tough. Being a new Psych Nurse is tougher! As with any brand new nurse it's going to take a solid year before you really feel like you know what you are doing. Right now you don't even know what you don't know. Each day you will learn something new and Psych patients have a lot to teach you. There are fellow nurses who are unpleasant everywhere. I do not like to use the term bullies as I mostly chock this behavior up to personality conflict. Watch your co-workers and emulate those whose style you like. Find out who is willing to mentor a new nurse. I am a new hire mentor where I work and any new nurse in their first year can use me as a resource to bounce thoughts and ideas off as well as just to vent about the job. IMHO all hospitals and facilities should have this resource. 

I would also like to say that you need to establish good boundaries with your patients and co-workers. Find a way to develop a good Work life balance. While I have many friends at work. I don't mix and socialize outside of work. No one has my cell phone number but the boss and one or two others. Unless I want to work my phone goes on "Do not disturb"from work calls the minute my shoes hit the parking lot. You need to eat right, sleep well, get regular exercise and make time for something fun.

I combine all of these into working my vegetable garden and the added bonus is fresh, organic vegetables almost all year long as I live in Southern California

Hope this helps 

Hppy

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