Nursing Voices

Tuesday, January 02, 2007

Help Wanted: Psychiatrist

I’m very worried. When our unit’s medical director leaves in June, I might be without a job. He’s quitting because he can’t stand working for our hospital administrator, Mr. Grinch. The hospital is looking for a new doc, but right now, things aren’t looking good. Mr. Grinch’s reputation precedes him, and no one wants to work for a jerk.I’ve decided to help out. Instead of hiring a headhunter, I’m posting a help wanted ad. Here are the qualifications I’m looking for in a doc.

The ideal candidate puts patients first.

I nearly died one day when I heard our nursing director described our hospital’s psychiatric unit as a “product line.” Say, what? I’m not a factory worker, I’m a nurse. I know that health care is big business, and I understand the need to be fiscally responsible, but it would be nice if we could stop focusing on profit margins and start focusing on providing good patient care. I’m looking for a doc who is dedicated to the welfare of our patients.

The ideal candidate must believe in the power of Haldol.

I’m really amazed by how many doctors are afraid of using old time medications. There are some positive things to be said about using tried-and-true meds. I had a doctor tell me once that he didn’t prescribe Haldol anymore because it isn’t “politically correct.” He said that research has shown that new antipsychotics are more effective than Haldol. I bet a lot of those research projects were sponsored by the pharmaceutical industry. I’m not a big fan of many of the newer antipsychotic medications. They aren’t cheap, and many times they are less effective than older, less expensive medications. I’ve also seen doctors back away from giving hefty doses of medications when patients need them because they don’t want to be accused of using “chemical restraints.” Oh, please! When a patient is psychotic and out of control, they need drugs. Pharmaceutical wimps need not apply.

The ideal candidate must have balls of steel.

I want to work with a doctor who has moxie and who isn’t afraid to standup to Mr. Grinch. Sometimes Mr. Grinch tries to bully our current doctor into admitting violent patients who are totally inappropriate for our unit while trying to cut nursing staff at the same time. Our current doc isn’t afraid of telling Mr. Grinch to go to hell, and the ideal doc needs to be able to do the same.

The ideal candidate will make his or her own coffee and must be willing to bring in breakfast for the nursing staff every Saturday morning. I work every Saturday, and I have my standards.

If you are truly the ideal candidate, be assured that the nursing staff will stand behind you and work with you as a team. We are incredibility loyal to anyone who is loyal to us.

Please e-mail me if you are interested in this position.


Anonymous Sean said...

I work on a surgical unit, and post-surgical delirium is an issue.

I often wonder if some docs are conservitive with haldol etc because they don't understand the diffuculty these patients present.

They don't understand what it's like to spend a night running every five minutes to redirect the patient back to bed because he's crawling out again, or clean up all the blood after the patient pulls out central lines, IVs, foleys, drains etc., not to mention having to put all these tubes back. And I'm tired of being yelled at, swung at, threatened...etc. etc.

You know...same old story.

Honestly, I'd rather they were overly aggressive with meds for these patients, rather than cautiously conservative. These patients are dangerous to themselves and staff.

But, I know that some people are very weary of chemical/mechanical restraints. Call me old fashioned, but I'm all for them.

11:36 AM  
Blogger Mother Jones RN said...

Me too, Sean. Haldol started falling out of favor when consumer groups got their panties in a bunch about the use of psychotropics. Many of these groups do not understand that these medications are useful in certain situations, and can help people recover from serious mental illnesses. Nurses need to a play a more active role in educating lawmakers and the general public about healthcare issues.


12:00 PM  
Anonymous Kim said...

Call me nuts, but I prefer chemical restraints to physical restraints any day. And Haldol can be one of THE best medications a doc can order. The patient is more comfortable, they don't suffer the indignity of physical restraints and they are safer because they don't pull tubes and get out of bed and all the other delirium-related behaviors.

The patients are suffering! It's like witholding pain medication from a patient who has just undergone abdominal surgery and asking the to "visualize" instead.

Ugh! Haldol has a proven track record and I have no problems using it when necessary!

PS - hope you find the right doc!

12:30 PM  
Blogger Runs With Scissors said...

I'm with y'all .... and am even inclined to throw in a mg or two of Ativan here and there ....


12:47 PM  
Blogger poody said...

Good luck with the hunt. I am so glad to be out of the hospital setting. I know I complain about the job I have now but I cannot imagine working at a hospital in this day and age.The shortage for nurses was acute back in 2001. It has to really be sucking now!

1:36 PM  
Blogger jaz said...

What was that old song? "Where have all the cowboys gone?"

I know what it's like to long for a leader.

6:38 PM  
Blogger LJG aka Pennsylvania Independent said...

My goal for this year is to stay off meds and not be admitted to a psych unit.
I had to stop taking my meds because I had a fall out with my doctor because of insurance issues. My insurance won't cover very many meds. I did contact NAMI and they basically said I was between a rock and a hard place. The county mental health system is so inadequate that a psychiatrist isn't availible because they do not have one. They give you vochers which sounds all nice and fair, but finding a doctor in private practice who will accept the vochers is another story on its own.

9:27 PM  
Blogger Kris said...

What the HAL-dol?!

Or, they can be like the sleep-deprived residents you get in the middle of the night when Mrs. Sundowner has gone completely kazoo, has wrapped her large can of protein supplement powder in her belt and is swinging it over her head like Sir Galahad using a mace. Dr. Newbie, with a touch of fear in his voice, orders 1mg of Haldol IM. Then you politely ask him to come hold the patient while you administer the Mouse Piss in the Ocean dose to Mrs. Sundowner. At a hospital up north that I used to work at, we night nurses used to give what we called "generous 1mg" doses. Usually had little effect anyway. DUCK!!!!!

10:15 PM  
Blogger Joan Russo, Ph.D. said...

Dear Mother Jones,
I love your blog. Thank you for taking the time from your busy life to do such a nice job. I love the pictures and the content.

I would like to weigh in on the qualifications for medical director for your inpatient unit. I would say the ideal director, in addition to the qualifications you listed (in particular balls), the psychiatrist should be an intellectually curious sort, who fosters intra-disciplinary involvement in QI/QA and outcomes assessment, programming, and education for both the medical staff and patients. I would also love an MD who takes little to no money from pharmaceutical companies, and who could throw a great holiday party with the staff. Lastly, I just cannot stand narcissistic psychiatrists. So, please be down to earth and in harmony with the hospital’s mission.

9:41 PM  
Blogger Shrinked Immaculate said...

Where do I apply for ur job offer??

5:55 AM  
Blogger Mark said...

First you do know you all are working in a jail right? The combative psych "patients" do not want your help, and do not like being in jail.

Haldol has been documented in shrinking peoples brains which you know is called iatrogenic illness.

For all the lovers of Haldol out there, you try a single dose and see how you "comfortable" you are.Then take it for a week, then a month, then a year. When do you stop the drugging? When the lab tests come back on the unbalanced/balanced brain chemicals?

2:42 PM  
Blogger TheProfessionalStudent said...

Mark: You are crazy. Haldol does not shrink your brain! That is ridiculous. Anyway, I've been getting the Haldol DEC injections that last for 4 weeks for about 7 years now and with the other medications I'm on they work great! The Haldol injection probably saved my life. I have a little blog entry on my blog at about my experience with the haldol injections. I believe they are under-utilized too. I'm glad I don't have to be on a huge dose of the stuff though...mainly because of the increased risk of side-effects and the drowsiness stuff.

10:53 AM  

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