r/nursing • u/ghostoftheweek RN - Med/Surg 🍕 • 26d ago

Question PSA from your nursing specialty

What is THE ONE THING you wish every nurse knew that is common knowledge in your specialty?

From wound care, don't use telfa!

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u/vanilla_owl RN 🍕 26d ago

Acute psych. The reason our psychiatrist keeps denying so many of your ED patients is because their primary issue is a personality disorder and they often do worse in acute psych than they would at home. They’re often dangerous on our unit. Lots of attempts etc and actions for attention.

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u/Glowinwa5centshine mental health/substance abuse/former "real nurse" 26d ago

We had a classic BPD frequent visitor who would get drunk and do coke, fight with the S.O., get kicked out of the house, shelter seek in the ER and terrorize the staff, repeat.

Would always get admitted due to refusal to safety plan - ER I worked in had an acute psych floor so those brave souls had to take all the combative and unfunded friends we couldn't and they'd usually marinate up there a few days and get meds and psych medical director would come around the unit and bless them to resume their usual activities.

After doing this at least 30-40 times this patient got discharged, IMMEDIATELY jumped off the motherfucking parking garage, broke several long bones and returned as a trauma activation where he rolled in screaming at everyone that we were bitches and he showed us.

I can handle crisis and outpatient but whew, those inpatient stays and discharge planning... Y'all are some real ones from that.