Janet's Psych Nursing Story

This month Janet shares how her experience with one man reinforced an important concept:

I was a corrections nurse in a local jail. I found that many people in the jail had psychiatric conditions - from the trespassing charge all the way to murder. Some homeless people with psychiatric illnesses had nowhere else to go and would actually commit minor crimes to be caught and brought to jail. There, they understood the system and could get a roof over their heads and care for their psychiatric and medical needs. One of these people I will call "Victor".

Victor was well known in the jail and to me. I had been the first nurse to get him an asthma inhaler and through the six years I was there, every time he saw me, he asked for an asthma inhaler. Often he ended up on the psychiatric floor unable to deal with his fellow inmates in another area of the jail. Victor's Axis 1 was schizophrenia and he often would speak to me about the voices he heard. Victor knew that if he said he was going to commit suicide he would go to the psychiatric unit, or at least be evaluated.

"As a medical nurse, you cannot ignore the psychiatric, and as a psychiatric nurse, you cannot ignore the medical."

Many times, as the triage nurse, his evaluation would go through me since I dealt with all the medical/psychiatric emergencies. One day I was paged to the psychiatric floor and the officers were getting ready to taser Victor because he was not being cooperative. Victor was always cooperative and never defiant so I knew something was wrong. Unable to stop it, Victor got the electric shock. Immediately afterwards I went in and examined Victor and found a wound on his foot that had pus coming out of it. I got permission to do labs and found out that Victor was septic and he had to be rushed to the hospital.

Victor survived and came back to the jail and thanked me for sending him to the hospital. Victor had been not treated because his symptoms were assumed to be a result of his psychiatric condition spiraling downward and not what it really was. From that time onward I have tried to educate everyone on psychiatric illnesses and not to ignore the medical aspect. As I go on for my MSN, I hope to instill in my students that as a medical nurse, you cannot ignore the psychiatric, and as a psychiatric nurse, you cannot ignore the medical.

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