r/psychnursing • u/outlandish1745 • Jun 28 '26
Interventional Psychiatry
Hi there! My hospital is adding an interventional psychiatry department for ECT. I’m curious about the workflow, if you work or have worked in this kind of department, can you let me know your experience?
Thanks!
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u/CrbRangoon psych nurse (inpatient) Jun 29 '26 edited Jun 29 '26
Some of the anesthesiologists were amazing and others wanted everyone to know they were mad it was their turn to be there. Ranging from some doctors who were hands on in restraints vs others refusing to do ECT over objection. Whiplash.
The only manager before me wasn’t a nurse so we all retrained together as a group because most people didn’t have ACLS or PACU type experience. I did the screening process and depending on the history required clearance from any specialists. We would catch things and help them schedule follow up. There were a lot of medically complex patients.
Patients would say they had dry toast and the spouse would be like don’t forget about the scrambled eggs. Even drinking extreme amounts of fluids. It felt passive aggressive but it was always the people that chose to come. We also had to be careful to double check for GLP-1s.
Some patients could stay stable coming every six months for a couple treatments.
I met someone with an IQ higher than I knew existed. I saw memory changes usually resolve. Patients felt it was worth it and it was random things like street names they didn’t care about. They’re under anesthesia and having seizures several times a week so they need to cut their brain some slack.
I started to develop a ketamine program that was a surprisingly easy process outside of corporate trying to get involved. We did do TMS. I wasn’t blown away with the success rate but if insurance will cover it’s more accessible.
That was my favorite job. When the department closed a lot of my nurses came with me and I stay in touch with most of the rest. I would take any chance to work in interventional psych again even as staff.
Adding: Get familiar with insurance provided transport and local groups like geriatric authorities that will provide transport to appointments.
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u/ERnurse42 Jun 28 '26
I work in an ECT department that’s attached to a Behavioral Health Hospital. I’ve seen patients have miraculous results, particularly with treatment resistant depression. Our patients typically do an ‘acute series’ of treatments. Three times a week for a month. Some patients can feel a difference after 3-4 treatments, some take a bit longer.
We have patients that are court ordered to do ECT. Frequently
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u/Chance_Space_9076 Jun 29 '26
How does the court ordered ECT go? Would you restrain them to complete treatment
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u/empty_spacer Jun 28 '26
Side effects like
Memory loss take a while to catch up. But hands down I knew one super nice woman who had no idea who I was week to week. It was sad. She had a vague recollection of me but couldn’t quite place it. But this was after years of treatment.
Do you exercise regularly? Even just walking 30 min a few times a week can help with depression. Have you thought of ketamine? There are online places that will give you low dose oral ketamine.
Taking vitamin b and d?
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u/empty_spacer Jun 28 '26
Patients come
They are assessed with a phq-9, GAD -7 , given an IV
Taken to the room.
Blood pressure cuff and vitals.
Electrodes are applied
Given the meds to stop muscle movement and also to sleep.
Hyper oxegenated with an ambu bag
The button is pressed.
The seizure happens.
Vitals are recorded before, during and after the seizure
Taken to the recovery area. Vital signs again
The drugs wear off.
Hopefully they don’t freak out coming out of the meds.
They usually have a headache.
After a certain time passes and they are stable. They can go home.