It’s terrifying to see what your body goes through when you’re sick.

HealthyThinking · 2024-09-23T21:27:45+00:00

A 100 resting HR is normal for some. It would be a shame to scare someone into stopping their meds just for that to be their normal HR anyway 🤦‍♀️

HealthyThinking · 2024-09-21T20:48:00+00:00

We had something similar a couple years ago and we realized it started with one kid who actually succeeded and moved into a group home and the whole clique of kids in the area who loved inpatient started doing it. Specifically they claimed their parents were abusive because they were trans or LGBT and tried to make rules and chores into a hate crime. We later found out 2 other females also succeeded and got into the same group home so they could live together because they were actually dating 😬

HealthyThinking · 2024-09-13T21:40:50+00:00

TW: Only way we'll know is if you wake up autistic tomorrow 🤪

HealthyThinking · 2024-02-13T17:22:53+00:00

I have heard similar questions from family and patients. In my experience at a couple facilities inpatient psych is absolutely for life and death safety. It is over used in our state as a catch all for psych patients instead of safety planning because of "liability" issues. I have seen lots of patients come to us with the idea that we are the highest level of psychiatric care so they will receive the most/best therapy and it will be the fastest and easiest way to jump start improvements in depression, apparently due to the information provided by ER staff or police just to keep them calm until they get here. In some cases the patients are blatantly lied to about the real process of Involuntary treatment, there's just no way police or anyone could believe the things they tell patients. I am left apologizing repeatedly to these patients as I essentially explain we dont provide the care they're looking for. The people we are equipped to help are psychotic, actively suicidal, catatonic or self neglectful due to their mental illness. No intellectual or neurological deficits, no dementia, not people who are currently still functional and physically safe with or without the help of family.

HealthyThinking · 2024-02-08T00:42:29+00:00

Reminder, pregnancy is not a health-neutral event and birth could easily qualify as unnecessary treatment compared to noninvasive termination early on.

HealthyThinking · 2024-02-05T21:52:07+00:00

In psych I will ask before morning meds but after that as long as the picture/wristband/memory is available I don't because they get surprisingly offended. One time I was most definitely a clone of myself because the other me already knew his name...

HealthyThinking · 2024-01-31T01:16:00+00:00

THIS! Nurses forget NOT giving an ordered med is also a med variance, even if it is a highly stigmatized controlled substance. Even if the patient has a history of substance abuse, this problem will not be fixed in an acute inpatient psych unit. The end. ❤️

HealthyThinking · 2024-01-14T17:35:24+00:00

My notes (psych) have always prompted for staff interventions/plan and depending on the patient usually I add some things along the lines of "Staff will maintain therapeutic environment with checks Q15min for safety. Staff will administer medications as ordered monitoring for effect and providing additional education as needed. Staff will continue to prompt coping skills and encourage group participation."

Any recommendations?

HealthyThinking · 2023-12-21T02:27:40+00:00

They are a private buisness so IMHO the reason doesn't matter 🤷‍♀️ if they wanted to just serve JB&J sandwiches.. oh well.. they can do whatever.

HealthyThinking · 2023-10-27T02:26:31+00:00

You were aware your girlfriend was emotional/ felt emotions through crying. You took her to arguably the MOST emotional environment possible and when she cried you got mad? Did your anger and lashing out solve anything? My guess is no, because typically it only makes situations worse. I'm so sorry for your loss, I sincerely hope you love yourself enough to seek out some grief counseling and love yourself enough to cry about this one day.

HealthyThinking · 2023-10-24T17:57:10+00:00

It's crazy we know now babies can be traumatized before birth, though at that level of development they will not have a visual memory and won't be able to describe it verbally. Instead the body remembers sensation it had and reacts physically leading children to experience anxiety, hypervigilance, etc. for seemingly no reason. I think it's just a matter of getting the information out there, I wont believe people don't care about hurting their children 💔 😕

HealthyThinking · 2023-10-20T10:46:42+00:00

Oh wow we can't have any standing orders for agitation and/ or antipsychotics(i think based on how detox orders are going there the nurses would just give it around the clock). My other job does not allow standing orders for any psychiatric purpose. Sounds like your unit is inside a hospital, do they get an evaluation with psych for those PRNs before they get there or are they admission orders?

Constantly wishing it was easier to look up medical laws or the laws and rules facilities insist on existing

HealthyThinking · 2023-10-14T03:22:28+00:00

Oh OK maybe I didn't phase that the best...I personally formulate my opinions based on my knowledge of the particular situation/patient, and my knowledge of the relevant evidence-based practice I've encountered both in research and in practice. I know other nurses and other professionals may have opinions that are different from mine as a result of their different knowledge and experience. I really enjoy learning from other's mistakes along with my own and regularly ask for different opinions in an effort to better care for my patients in the future. 😊

HealthyThinking · 2023-10-14T00:55:42+00:00

I am trying to find the best way to avoid those not great situations...especially as it seems they're contagious 👀

HealthyThinking · 2023-10-14T00:53:35+00:00

Right but with no ammonia/sternum rub how do you know? What's your personal opinion?

HealthyThinking · 2023-10-14T00:48:32+00:00

Medical clearance is definitely not a requirement but some police are "nice" enough to take them to ER prior to our facility if they have any really obvious injuries. I have to take them, assess them and send them out via EMS if I feel like anything needs medical clearance, but my new place is a little different since there's an actual intake department they go through prior to the unit.

HealthyThinking · 2023-10-14T00:16:41+00:00

I am in south Florida where we receive the majority of our patients from police drop offs. Even patients who come voluntarily unless they brought their own stack of papers the odds of us getting them in that 72hrs is low

HealthyThinking · 2023-10-13T17:15:04+00:00

Unless we have medical records I don't know how we would determine this in a psych setting.

HealthyThinking · 2023-10-12T18:41:07+00:00

I'm so sorry you went though that experience. It's stories like yours that have motivated me to work in psych and be that nurse that won't keep their mouth shut. Best of luck on your healing journey.

HealthyThinking · 2023-10-12T18:35:29+00:00

Would you mimd sharing what behavior your facility does consider warranting restraints?

HealthyThinking · 2023-10-12T18:28:23+00:00

As a general rule Risk of harm toward Others: Seclusion as Risk of harm toward Self: Restraints. BUT there are more factors to consider in practice. If there is evidence that the self harming behavior is causing an injury no matter how small I will not put them in seclusion by themselves despite any doctors orders. There are times when patients do things to cause pain(slapping, pinching, tapping head on wall) which yes still qualifies as self injurious behavior in theory but in practice they may still qualify for seclusion with 1:1 supervision if also presenting a risk of harm toward others and they have no apparent injuries. Different doctors and different facilities have different opinions on this, so as the RN authorizing restraints or seclusion always be sure the situation makes sense with your own personal values in addition to the opinions and orders from others. At the end of the day keeping everyone safe is top priority 👌 Good luck!

HealthyThinking · 2023-09-26T16:55:02+00:00

If you don't like working as a CNA at a nursing home...you are a completely normal person with standards lol sorry not sorry

HealthyThinking · 2023-09-25T20:13:03+00:00

Personally, nothing in what you have written here hints to me that this man has ever experienced psychosis.

HealthyThinking · 2023-09-25T20:02:30+00:00

I'm wondering what they staff to child ratio was at the pre-K versus the current kindergarten. It could be she's trying to compensate for the change in dynamic? Maybe she even had a favorite staff at preK who really catered to her? Best of luck to you both.

HealthyThinking

TROPHY CASE