When ever I teach a newbie nurse how to be a "psychiatric nurse" (in these days when all we really practice on a psychiatric unit is "meat ball" psychiatry), I remind the Newbie that (in true Reader's Digest fashion) there are only four diagnosis that we work with.
The four diagnosis (yes, this is way over simplified--but it works):
So what are the best interventions for these four broad diagnosis? Here are Allan's Rules for Running a Psychiatric Unit:
1. Depressed People need to move. And yes, I mean physically move. Walk. Run. Crawl. Skip. Hop. Rollover. Saunter. Just Move...Just do it. Heavy, sweaty exercise is the very best intervention for a 35 to 45 year old female. Better than therapy and anti-depressants. Depressed people need to get out of their sofas, put away the chips and get out the door. Move!
2. Anxious people need to breathe. Always, always help anxious people to focus on their breath. Listen to it. Slow it down. Relax. Stretching and Yoga...visualizations...anything. Get the anxious person to breathe deep and you will help them.
3. Psychotic People need to sleep. Load them up with the very best sedative psychiatric meds and let them sleep. This works whether it is substance induced psychosis or a full blown schizophrenic break. Let them sleep! Let them sleep through meals. Groups. Activities. Breakfast. Lunch. Dinner. Snacks. Sleep is the most regenerative activity for someone disconnected from reality. Usually, after a few days (and a few doses of a good anti-psychotic), they will be much better.
4. Manic people need to be contained. Mania is a very tricky bugger. They are psychotic, but even more than that, they are hyper-kinetic, socially inappropriate, never sleep, are often hyper-sexual, are grandiose, are bizarre with a capital B, are delusional, unreasonable, lack all social boundaries and are extremely intrusive. Imagine Robin Williams on Meth-Amphetamine and you'll get the picture. You can throw all the meds in the world at these folks (we usually see manic phases as the seasons change) but it does no good. They just won't sleep when in full-blown mania. It's amazing to watch.
The best intervention is to "contain" them. Separate them from others---and let the illness run it's course. They'll be better usually within two to three weeks.
With these four rules, a nurse can run any mental health unit, any where in the USA.