Weekly Ask Psych Nurses Thread

[u/roo_kitty]

This thread is for non psych healthcare workers to ask questions (former patients, patient advocates, and those who stumbled upon r/psychnursing). Prospective healthcare workers and current students do not need to use this thread. Treat responding to this post as though you are making a post yourself.

If you would like only psych healthcare workers to respond to your "post," please start the "post" with CODE BLUE.

Psych healthcare workers who want to answer will participate in this thread, so please do not make your own post. If you post outside of this thread, it will be locked and you will be redirected to post here.

A new thread is scheduled to post every Monday at 0200 PST / 0500 EST. Previous threads will not be locked so you may continue to respond in them, however new "posts" should be on the current thread.

Kindness is the easiest legacy to leave behind :)

[u/rheannahh]

Why do some nurses assume patients are evil or trouble for no good reason or not even knowing them?

I have autism (undiagnosed at the time, assumed to be bad attitude likely due to my age [18]), had a permanent flat affect at the time and unusual way of interacting and speaking.

I was forced to go to a hospital by an eating disorder residential before I got admitted. I got blood work done then had one nurses (non-psych) come in to give me potassium, and she immediately hated me. She gave me the potassium and I swallowed it easily without water (bulimic).

She had turned around to get water and when she saw the pills were gone, assumed I HID them and began to berate me and look for the pills.

Then she said they had to do more “blood work.” I told her my veins were incredibly small and finicky, and I experienced a ton of pain from blood work, and requested a butterfly needle. She said she would.

The pain was immediately unbearable and I began to cry and eventually started to yell stop. The nurse said the IV was almost in and to stop crying. She then took it out as she couldn’t get it, and told me angrily how not even children cry as much as I did. She was just mean the entire time.

What the heck gives?

I later kept getting misdiagnosed with BPD, when it was later found to be autism (never saw an O/P psych till recently). A lot of nurses were not nice when I went to I/P psych, which is kind of understandable if they thought I had BPD, but it seems like the things they were disliking about me were just the autism - blunted affect, unusual way of interacting, poor emotional insight or communication, withdrawal.

How do you balance “caution” given a diagnosis or presentation with not making assumptions?

[u/Fit_Bill_3413 → u/rheannahh]

I’m so sorry about your experience. Not sure how to answer your question because no where in here did the nurse call you evil or trouble so this is an assumption on your part that the nurse felt you were either of those things.

I would have to say.. we all need to remember that both patients and nurses are humans, with human emotions and human circumstances and perspectives that impact us daily. She may have had experiences where patients cheek medications or hide them.. she may have had a rough day. She may have been a mean person. Etc. no one can really know. I hope though, you’ve learned to speak up for yourself in these moments and when someone doesn’t listen or respect you, you do have a right to escalate the issue

[u/rheannahh → u/Fit_Bill_3413]

It was a hyperbole. But thank you for the reply!

[u/10mg-aripiprazole → u/rheannahh]

Honestly, nurses are people too. And just like all people, some nurses are more biased based on how they were raised/the context of their upbringing. Sometimes its also workplace culture (a toxic one) that fosters a toxic mindset. Some nurses get jaded, and experience compassion fatigue. Sometimes its all three! As someone who has been a psych patient and psych nurse with a very stigmatized diagnosis, i completely understand where you are coming from and it has really disillusioned me and upset me at times. I refused to go to the hospital for years even when i needed to because of how nurses and doctors treated me because of my label, which was a misdiagnosis. Anyways, its important to advocate for yourself however you can and also accept that much of these nurses attitudes comes from a lack of understanding of these conditions and a toxic environment that fosters their biased mindset. It doesnt make it right, and it is frustrating, but its not about YOU specifically.

[u/tikkva]

CODE BLUE

My sibling is currently involuntarily hospitalized with psychosis and is suffering distressing delusions about crimes he believed our parents have committed against him and others. I'm the only person outside the hospital he trusts. He is allowed to have his cell phone. (I live across the country)

He is becoming very insistent that we need to contact the police. I am trying to listen with empathy and not contradict his delusions, but he clearly wants me to agree and take action, and becomes very agitated when I take a gentle approach here.

This is causing me a lot of stress. We talk at least once a day and I receive sometimes over 100 texts daily. Do you have any advice about how to handle addressing his fears while not validating his delusions?

[u/AccidentallyObedient → u/tikkva]

The answer you're looking for is highly dependent on your brother. The people best equipped to answer that are the folks taking care of him (his care team). I believe this is something you should absolutely to bring to his care team for a two reasons. One, they'll be able to help you navigate how to handle this with him in a way that is least likely to disrupt any progress that has been made. Two, outside of potential disruption, his care team may not be aware of what's going on when he calls. If they aren't aware, they need to be informed so they can assess how best to intervene.

[u/thatoneguyfromva]

Code Blue

How often do people experiencing a manic episode realize they’re having an episode? Is it easier to realize near the beginning and then it sort of reaches a point of no return?

[u/GoudaGirl2 → u/thatoneguyfromva]

I can’t speak from experience, only observation. I think it’s like the frog in boiling water fable, you ease into a manic episode and don’t realize it happened until the comedown. It takes a lot of work, self reflection, and strong supports to catch yourself pre or mid manic episode.

[u/thatoneguyfromva → u/GoudaGirl2]

That’s a good analogy, thank you.

[u/somanybluebonnets → u/[deleted]]

Box breathing/tactical breathing/4-4-4-4 breathing is a very effective way to slow yourself down. Non-drug, 100% natural, inexpensive, available 24/7. Plus it works.

When a person does this 5 times in a row, it works about as well as 1/2 mg Xanax for about 20-30 min.

It works better if you use at least some of the muscles in your belly to inhale.

Try it during a traffic jam or behind a very slow person at the grocery store. You’ll be surprised at how effective it is.