Lately at work, we've had a major increase in the number of patients coming to our floor with psych, drug and alcohol issues. I assume this has something to do with the fact that many other local hospitals who previously had units devoted to "dual diagnosis" patients (those with both acute psychiatric and medical issues to attend to) have shut down said units.
This is very, very unfortunate.
Our community hospital does not have the resources to provide the kind of care these patients need... most notably, we do not have the staff. Many nights in the past several weeks we nurses have had to work the floor without the assistance of our nursing aides (who are precious and wonderful and necessary for our sanity) because they've been pulled to sit in on "1:1"s. When a patient is out of control, suicidal, or demented and trying to climb out of bed/pull out tubes/pee on their roommate we initiate 1:1 observation. This means that a nursing aide, or sometimes a nurse, should no aides be available, stays within arms reach of that patient 24 hours/day, and records what they are acting like every fifteen minutes. On Monday night, we had SIX 1:1s. We don't have six nurses aides in the whole hospital on night shift under normal circumstances. A nursing aide from evenings worked a 16 hour shift overnight to help manage this. It's absurd.
As a result, I'm learning to manage 7+ acutely ill patients without the assistance of an aide. Usually at least one or two of them has some psych issues going on. I've had several patients in that past month or so going through alcohol withdrawal, more than one pain medication addict, a woman in her 70s whose drunk daughter beat the hell out of her and attempted to drown her in the bathtub, and just about the saddest case of rapidly advancing dementia I've ever seen.
In light of this, when a nearby drug and alcohol/psych rehab hospital called me up and requested an interview, I obliged and have since accepted a position. I'll be working 4 shifts/month, and start next week. It's a nice place, 100% voluntary (which makes a big difference... everyone there is detoxing because they want to be, not because of a court order). I figure that the experience will interesting and will help diversify my young nursing resume. If I hate it, it's not a job I have to keep to survive. If I love it, all the better for my nursing career. I'm hoping to develop finer skills dealing with patients in pscyhiatric crises, and to become more familiar with the methods and drugs used to help with the detox process.
Part of me feels like I am absolutely insane for taking on a new challenge at this point in my life... but another, louder part of me thinks, if not now, then when? There's never going to be a point in my life where I'm not busy, not overwhelmed, not sleep deprived and behind on my to-do list. I may as well accept that and embrace the opportunities for growth presented to me.
Speaking of growth, do a raindance for me. This heat and dryness has to break soon.
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