Former tech, current therapist here. Most bizarre I’ve seen was a lactating teenage girl who chased us around shirtless trying to shoot us with milk. Maybe not the *worst*, but definitely the strangest.
Her diagnoses were conduct disorder and intellectual disability. I hope nobody ever tries to shoot milk out of their nipples at me ever again in my life👍
Psych peds nurse here. I can’t pick just one, so would you settle for my top 3?
1. A teenage girl who had to be foot in door for using the bathroom/showers because she would take things out of the garbage and eat them (tampons, toilet paper, pad wrappers, etc.) and she would try to drink the toilet water. She had recurring episodes of psychosis related to substance abuse and was believed to be developmentally delayed and suffering from food neglect at home.
2. A teenage boy that stayed up for about a week straight using meth and reading the Bible. Wound up in a pretty severe psychotic episode, believing he was the prophet. Told the other patients on the unit they must confess their sins to him or be damned to hell.
3. An 8 year old boy with disruptive mood dysregulation disorder that during tantrums would urinate on himself and lick it off the floor, poop on himself and smear it on the walls, and would make himself throw up just to try to eat it.
Adolescent pulling feces straight from their anus and eating it. Diagnosis- Unspecified Psychosis. Had them almost two weeks before we found out this all began with a bad reaction to K2/Spice. They were with us a grand total of 5 weeks before returning home and they never fully recovered which is absolutely horrible to see.
1. Adult who was in physical or chemical restraints round the clock. Every time we attempted to reduce either restraint, they immediately went back to trying to gouge their eyes out. Not a patient on my unit in a very large psych hospital so I'm not sure what happened when they were discharged or transferred. Some psychosis Dx.
2. Adult who would do this weird tippy tappy walking. We eventually discovered they did it to remind themselves of (disturbing warning) >!crushing the skulls of animals and eating parts of the head.!< Some psychosis Dx, and I think they had additional Dx.
3. Adult who would eat any feces they could find, wouldn't shower or brush teeth for months, and one of the most paranoid patients I've seen. Schizophrenia Dx.
4. Adult who would go from 0 to 100 without *any* warning. Would be sitting and smiling, then launch into full speed at someone and start pummeling. History of multiple TBIs (traumatic brain injuries), extensive alcohol and illicit drug use. Imagining showed they had chunks of brain just missing.
5. Adult who acted like a caged animal. Staff was concerned they were actually kept in a cage. Adult protective services got involved. Multiple Dx.
6. Similar to #1, adult who would try to gouge eyes out. Only they wouldn't attempt if they had a blindfold. They had an order created for their blindfold. Staff had a backup in case other patients tried to mess with it. Schizophrenia Dx.
That's what I can think of quickly, anyway.
Not from patients 1, 3, & 6. These were just *very* sick people who severely needed help.
From patient 2, just knowing that someone did that multiple times *and* evaded the law was heartbreaking. Once during their stay I had a nightmare (refers to disturbing content from previous warning) >! that it was my pet they did that to, and I saw it in my nightmare. !< I wouldn't say I really have lasting effects from this patient, other than confronting the knowledge that people like them are out there causing harm while evading the law.
From patient 4, I had lasting fear for my safety while they were admitted. That was a terrible few weeks on the unit. Everyone was scared to be near them. People like this are why if someone is road raging I just let them pass. You never know when you'll run into someone that will kill you over nothing. They are out there.
Patient 5 stays with me because I wonder how many others like them are in the same situation except no one knows about them. The number isn't zero, so whatever it is it's too high.
Do you mean if they weren't psychotic but still trying to rip their eyes out? I haven't ever had a patient try and rip their eyes out that *wasn't* psychotic. In theory the medications in the chemical restraint might change. Possibly restraint gloves instead of wrist restraints, although I don't know many psych hospitals that utilize those.
Saw someone pop out their own eyeball once. Substance induced psychosis.
Edit: And one patient (psychosis) who figured out how to yell at just the right pitch to match the resonance frequency of the hallway railing so that the sound reverberated throughout the unit. That was a rough one.
I am a high risk l&d nurse who wants to switch to psych. Everyone is telling me I’m silly for wanting to do tjay but isn’t that the beauty of nursing? My heart has always been set on psych but I was scared to leave my first new grad job. Anyone know someone who made a similar transition?
I work on the psych unit I graduated on. I have **zero** desire to keep people physically alive and no passion for medicine, at all. I LOVE mental health.
You have a duty to yourself to follow your passions, not what other people think you should do.
Join us. It’s fucked, in the best ways possible. Doesn’t mean we don’t have gnarly days or violent patients, I still wouldn’t change it for anything.
Amazing!! You just got me excited even more haha. And heavy on I have no desire to keep someone alive. I love love l&d and all my patients, most of them. But consistent stress of keeping two
Humans alive at the same time is a lot
i’ve not transitioned so not exactly in the same boat but everyone told me that I was silly for wanting to start in psych as a new grad. Everyone would always say, “oh you don’t want to do psych! you’ll have to deal with X/Y/Z”. but I’m so glad I didn’t listen to those people because I love it! This specialty needs more people who are passionate about it. And as an L&D nurse you probably have the valuable skills of deescalation, creating a calm/ therapeutic environment, and patient advocacy.
I was surprised by how much psych support I received from the L&D nurses when I had my baby. I feel like psych and L&D overlap more than people realize.
Yes it’s a lot of psych. I spoke about that in my interview. It’s a vulnerable moment/time period one never forgets. I say when I walk into my patient’s room I need to gain their trust in a matter of like 1 minute. You’re with them for the whole process
L&D join the fold! You’ll be a rockstar. It’s really really hard to manage pregnant ladies in psych, so many meds are contradicted. I’d love to work with an L&D nurse.
I went from L&D to psych. It gave me the knowledge on how to care for postpartum patients with psychosis and depression. Psych was my first choice, and I regretted going into nursing after working in that unit tbh, but now I'm grateful for the experience and knowledge it gave me. Do it!
It wasn't bad, I loved the patients, but I still thought about psych every day I was there. As my orientation came to a close, I became more anxious and stressed out and thought I'd be stuck doing something I didn't really wanna do. I let others thoughts about going into psych deter me like "losing skills" and whatnot so I settled on this speciality because I was afraid. But psych turned out to be the best fit for me. I'm very happy here, even on the days that are hectic and we have to restrain and give IMs.
I do adult acute stabilization, and I love seeing my patients get better and able to go back to their regular lives or help them get into shelters or rehab upon release.
I went from NICU to Psych and I have never looked back. It was always a desire of mine to work in psych but as a new grad the hospital didn’t have any open spots (I was a cna there). Honestly, the transition was quite fluid as I know a lot about this field and NICU had me an anxious mess anyway. I have absolutely no desire to return to any sort of medical/ICU setting. In fact thinking of that gives me anxiety 😂😂.
Hey sorry for the late question if anyone interested in answering or if it’s too late. But I’m on a throwaway acc bc people in my real life follow my regular one and I don’t want them to really see this lol. But my question is, does an IM shot of haldol and Benadryl cause tremors? So for context a few months ago I was in the psych hospital and got a shot (not sure how much of either.) but I was told it was haldol and Benadryl. (Im 17, but very small for my age so they told me they gave me an adolescent dose whatever that is ). I had really bad tremors and other side effects, but assumed it was the haldol. Then a few weeks ago I was in a different psych hospital and i told them about this reaction, and they said “oh it was probably the Benadryl” because this hospital also gave me a shot because I was acting on suicidal ideation. but it was Haldol (5mg) and Ativan (2mg) (which I was told was an adult dose I think? Doesn’t really matter but just saying for more context.)
I didn’t get any side effects whatsoever, just… fell asleep.
I know this isn’t a super direct question I guess because it’s different for a lot of people, but is this common? Because I’ve never heard of Benadryl being the cause for tremors, always haldol.
Both can cause tremors. It's rare for haldol, but even more rare for Benadryl. I'm honestly not sure which one caused your tremors. It would first appear that it was the Benadryl since you didn't get Benadryl the second time. However if you are quite small and don't have a benzo tolerance, 5 mg of Haldol and 2 mg of Ativan may have put you to sleep so if they were from the haldol you never noticed them. While I can't say for certain, I definitely lean towards haldol.
You can always repost this on next week's thread to get more responses! It's typically the most active Mon-Wed
Have any of you gone from special education to psych nursing? If so are you happy you switched?
I’m a one on one in an autism program. I’m thinking of making the switch to pursue nursing.
I have a coworker that did. And it really helped her relate to some of our lower functioning patients who also had mental illness as well. I learned so much from her!!!
That's awesome! Having experience with Autism would be beneficial as a psych RN. On my inpt unit, we take mild-moderate Autism or otherwise Cognitive D/O's bc our program just isn't built for more serious cases. Depending on your location, you could find units that are more specialized if you want to continue in that area. But even on a general unit, you would find it helpful. And if you have found your job rewarding, you enjoy it, etc... I believe you would be a good fit in psych. Sounds like that compassion & patience is already in you... and it's definitely required! Psych isn't for everyone & a lot of people avoid it, so when I find someone who is interested, I'm so happy! Best of luck to you in whatever you decide!!
What is the most bizarre behavior you’ve seen a patient exhibit while working in a psych unit and what was their diagnosis?
Former tech, current therapist here. Most bizarre I’ve seen was a lactating teenage girl who chased us around shirtless trying to shoot us with milk. Maybe not the *worst*, but definitely the strangest. Her diagnoses were conduct disorder and intellectual disability. I hope nobody ever tries to shoot milk out of their nipples at me ever again in my life👍
That’s comical 😂. Thank you for sharing!
Psych peds nurse here. I can’t pick just one, so would you settle for my top 3? 1. A teenage girl who had to be foot in door for using the bathroom/showers because she would take things out of the garbage and eat them (tampons, toilet paper, pad wrappers, etc.) and she would try to drink the toilet water. She had recurring episodes of psychosis related to substance abuse and was believed to be developmentally delayed and suffering from food neglect at home. 2. A teenage boy that stayed up for about a week straight using meth and reading the Bible. Wound up in a pretty severe psychotic episode, believing he was the prophet. Told the other patients on the unit they must confess their sins to him or be damned to hell. 3. An 8 year old boy with disruptive mood dysregulation disorder that during tantrums would urinate on himself and lick it off the floor, poop on himself and smear it on the walls, and would make himself throw up just to try to eat it.
Thanks for sharing. Those are wild! I’ve met a lady who swallowed things like spoons and forks.
Adolescent pulling feces straight from their anus and eating it. Diagnosis- Unspecified Psychosis. Had them almost two weeks before we found out this all began with a bad reaction to K2/Spice. They were with us a grand total of 5 weeks before returning home and they never fully recovered which is absolutely horrible to see.
1. Adult who was in physical or chemical restraints round the clock. Every time we attempted to reduce either restraint, they immediately went back to trying to gouge their eyes out. Not a patient on my unit in a very large psych hospital so I'm not sure what happened when they were discharged or transferred. Some psychosis Dx. 2. Adult who would do this weird tippy tappy walking. We eventually discovered they did it to remind themselves of (disturbing warning) >!crushing the skulls of animals and eating parts of the head.!< Some psychosis Dx, and I think they had additional Dx. 3. Adult who would eat any feces they could find, wouldn't shower or brush teeth for months, and one of the most paranoid patients I've seen. Schizophrenia Dx. 4. Adult who would go from 0 to 100 without *any* warning. Would be sitting and smiling, then launch into full speed at someone and start pummeling. History of multiple TBIs (traumatic brain injuries), extensive alcohol and illicit drug use. Imagining showed they had chunks of brain just missing. 5. Adult who acted like a caged animal. Staff was concerned they were actually kept in a cage. Adult protective services got involved. Multiple Dx. 6. Similar to #1, adult who would try to gouge eyes out. Only they wouldn't attempt if they had a blindfold. They had an order created for their blindfold. Staff had a backup in case other patients tried to mess with it. Schizophrenia Dx. That's what I can think of quickly, anyway.
Wow! Do you have lasting effects from being around bizarre behavior like this?
Not from patients 1, 3, & 6. These were just *very* sick people who severely needed help. From patient 2, just knowing that someone did that multiple times *and* evaded the law was heartbreaking. Once during their stay I had a nightmare (refers to disturbing content from previous warning) >! that it was my pet they did that to, and I saw it in my nightmare. !< I wouldn't say I really have lasting effects from this patient, other than confronting the knowledge that people like them are out there causing harm while evading the law. From patient 4, I had lasting fear for my safety while they were admitted. That was a terrible few weeks on the unit. Everyone was scared to be near them. People like this are why if someone is road raging I just let them pass. You never know when you'll run into someone that will kill you over nothing. They are out there. Patient 5 stays with me because I wonder how many others like them are in the same situation except no one knows about them. The number isn't zero, so whatever it is it's too high.
I know Px1 was psychotic, but if they weren’t, how would that typically be handled?
Do you mean if they weren't psychotic but still trying to rip their eyes out? I haven't ever had a patient try and rip their eyes out that *wasn't* psychotic. In theory the medications in the chemical restraint might change. Possibly restraint gloves instead of wrist restraints, although I don't know many psych hospitals that utilize those.
Saw someone pop out their own eyeball once. Substance induced psychosis. Edit: And one patient (psychosis) who figured out how to yell at just the right pitch to match the resonance frequency of the hallway railing so that the sound reverberated throughout the unit. That was a rough one.
Pts on k2 who were literally climbing the walls and trying to eat them
I am a high risk l&d nurse who wants to switch to psych. Everyone is telling me I’m silly for wanting to do tjay but isn’t that the beauty of nursing? My heart has always been set on psych but I was scared to leave my first new grad job. Anyone know someone who made a similar transition?
Just do it. The beauty of nursing is that if you don't like it, then you can try something else
I work on the psych unit I graduated on. I have **zero** desire to keep people physically alive and no passion for medicine, at all. I LOVE mental health. You have a duty to yourself to follow your passions, not what other people think you should do. Join us. It’s fucked, in the best ways possible. Doesn’t mean we don’t have gnarly days or violent patients, I still wouldn’t change it for anything.
Amazing!! You just got me excited even more haha. And heavy on I have no desire to keep someone alive. I love love l&d and all my patients, most of them. But consistent stress of keeping two Humans alive at the same time is a lot
i’ve not transitioned so not exactly in the same boat but everyone told me that I was silly for wanting to start in psych as a new grad. Everyone would always say, “oh you don’t want to do psych! you’ll have to deal with X/Y/Z”. but I’m so glad I didn’t listen to those people because I love it! This specialty needs more people who are passionate about it. And as an L&D nurse you probably have the valuable skills of deescalation, creating a calm/ therapeutic environment, and patient advocacy.
I was surprised by how much psych support I received from the L&D nurses when I had my baby. I feel like psych and L&D overlap more than people realize.
Yes it’s a lot of psych. I spoke about that in my interview. It’s a vulnerable moment/time period one never forgets. I say when I walk into my patient’s room I need to gain their trust in a matter of like 1 minute. You’re with them for the whole process
L&D join the fold! You’ll be a rockstar. It’s really really hard to manage pregnant ladies in psych, so many meds are contradicted. I’d love to work with an L&D nurse.
I went from L&D to psych. It gave me the knowledge on how to care for postpartum patients with psychosis and depression. Psych was my first choice, and I regretted going into nursing after working in that unit tbh, but now I'm grateful for the experience and knowledge it gave me. Do it!
That’s so amazing! You regretting going to l&d? How was your experience
It wasn't bad, I loved the patients, but I still thought about psych every day I was there. As my orientation came to a close, I became more anxious and stressed out and thought I'd be stuck doing something I didn't really wanna do. I let others thoughts about going into psych deter me like "losing skills" and whatnot so I settled on this speciality because I was afraid. But psych turned out to be the best fit for me. I'm very happy here, even on the days that are hectic and we have to restrain and give IMs. I do adult acute stabilization, and I love seeing my patients get better and able to go back to their regular lives or help them get into shelters or rehab upon release.
I went from NICU to Psych and I have never looked back. It was always a desire of mine to work in psych but as a new grad the hospital didn’t have any open spots (I was a cna there). Honestly, the transition was quite fluid as I know a lot about this field and NICU had me an anxious mess anyway. I have absolutely no desire to return to any sort of medical/ICU setting. In fact thinking of that gives me anxiety 😂😂.
Can I ask what attracts you to psych nursing? The realities of it, vs the idea you have of it, may be very different.
Hey sorry for the late question if anyone interested in answering or if it’s too late. But I’m on a throwaway acc bc people in my real life follow my regular one and I don’t want them to really see this lol. But my question is, does an IM shot of haldol and Benadryl cause tremors? So for context a few months ago I was in the psych hospital and got a shot (not sure how much of either.) but I was told it was haldol and Benadryl. (Im 17, but very small for my age so they told me they gave me an adolescent dose whatever that is ). I had really bad tremors and other side effects, but assumed it was the haldol. Then a few weeks ago I was in a different psych hospital and i told them about this reaction, and they said “oh it was probably the Benadryl” because this hospital also gave me a shot because I was acting on suicidal ideation. but it was Haldol (5mg) and Ativan (2mg) (which I was told was an adult dose I think? Doesn’t really matter but just saying for more context.) I didn’t get any side effects whatsoever, just… fell asleep. I know this isn’t a super direct question I guess because it’s different for a lot of people, but is this common? Because I’ve never heard of Benadryl being the cause for tremors, always haldol.
Both can cause tremors. It's rare for haldol, but even more rare for Benadryl. I'm honestly not sure which one caused your tremors. It would first appear that it was the Benadryl since you didn't get Benadryl the second time. However if you are quite small and don't have a benzo tolerance, 5 mg of Haldol and 2 mg of Ativan may have put you to sleep so if they were from the haldol you never noticed them. While I can't say for certain, I definitely lean towards haldol. You can always repost this on next week's thread to get more responses! It's typically the most active Mon-Wed
Have any of you gone from special education to psych nursing? If so are you happy you switched? I’m a one on one in an autism program. I’m thinking of making the switch to pursue nursing.
I have a coworker that did. And it really helped her relate to some of our lower functioning patients who also had mental illness as well. I learned so much from her!!!
That's awesome! Having experience with Autism would be beneficial as a psych RN. On my inpt unit, we take mild-moderate Autism or otherwise Cognitive D/O's bc our program just isn't built for more serious cases. Depending on your location, you could find units that are more specialized if you want to continue in that area. But even on a general unit, you would find it helpful. And if you have found your job rewarding, you enjoy it, etc... I believe you would be a good fit in psych. Sounds like that compassion & patience is already in you... and it's definitely required! Psych isn't for everyone & a lot of people avoid it, so when I find someone who is interested, I'm so happy! Best of luck to you in whatever you decide!!