December 10, 2010


Today is my birthday.  Celebrate with me by hugging a ball of wool.

This was the week from hell, and yet I thank God for it because it renewed my faith in psychiatric nursing.  Because my unit's census was low, I was floated to stepdown at the beginning of the week.  There, I got to work with some truly psychotic patients:  paranoia, active hallucinations, bizarre thoughts, ideas of reference...stuff that I hardly see on the detox or depressive units unless the patient is admitted while under the influence.  It took a little bit to switch from "high-functioning patient" mode to "psychotic patient" mode, but it all came back to me.  Those days were tough as hell, but I thoroughly enjoyed it. 

I worked one of those days with the director of the stepdown unit.  I had told her that I was enjoying my time there because lately I felt the urge to get a med-surg job but being here made me feel better about psych again.  She asked me why I wanted a med-surg job and I told her "just because it's expected you do it when you first get out."  She said that I didn't need it, especially if I didn't want it.  She also told me that she went straight from nursing school to psych 14 years ago, had no problems ever finding work, and never regretted it.  So that was a big boost.

Then I got sent to the ICU.  Things were really hopping there:  it was as though they found the most actively psychotic patients in town and wheeled them in.   I actually went there in a tech capacity since I was the extra nurse, so except for a couple of assessments, all I had to do was tech I was really in the trenches.  I had to set a lot of boundaries, including telling one to keep his hands off of me, but it was a good challenge. 

I finished the week off in the kids' unit.  Calmer patient population, except  for one very histrionic, paranoid, delusional teenage boy.  I have to give it to the techs on the kids' unit:  they know their stuff.  The kid was violent and screaming (and strong!), yet no code was needed as I gave the shot.  It was a little frustrating as for all my therapeutic communicating skills I could not persuade him to take the medication PO...but that's the nature of the psych nursing beast:  sometimes you can talk them down, sometimes you have to shoot them down. 

Now I have a LONG weekend ahead of me to relax.  I treated myself to twelve hours of sleep for my birthday, and it was the  best gift I could get after this week.   Third best was the week itself.   Second best will be whatever I decide to buy myself today.

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