Features of care for mental patients
A psychiatric nurse must know what hallucinations are, delusions and delusions, paranoia, manic, depressive, apathic and catatonic states in order to quickly orient themselves, help the patient not to harm others and themselves, dissuade them in time, but ifit is not possible, to invite a doctor.
For patients in a psychiatric hospital, they try to create conditions in which the necessary peace would be provided. Noise as a strong stimulus, especially with prolonged exposure, depletes the human nervous system. It is known that noise tires and a healthy person, causes him a headache, quickens the pulse, etc. It is clear that the noise and vanity is especially harmful to the mentally ill person. Mentally ill do not make noise, this makes headaches worse, irritability, flashes of excitement, and the symptoms of the disease may worsen.
All the work of the maintenance staff in the psychiatric hospital department is set and performed so that it is quiet and in no case no noise is allowed so that nothing worries the sick. Thus, in conditions of silence and rest, the brain of the mentally ill patient is protected from the action of harmful stimuli on him. To create peace, all newly admitted patients necessarily have a certain time to be prescribed by the doctor in bed. Bed rest of the patient calms and retains its strength, allows you to better observe it.
The correct alternation of wakefulness and sleep provides the person with a normal work of his brain and protects the nerve cells of the brain from exhaustion. Therefore, the strictly established daily routine is so useful;It is clear that a clearly established daily routine is especially indicated by a psychiatric patient in a psychiatric hospital. For this purpose, a mandatory schedule for all patients is set in the psychiatric hospital departments with an exact indication of the hours of morning ascent, eating, walking, therapeutic work, cultural entertainment, sleep, etc. Such a precisely established regimen contributes to the fact that in patients the normal activity of their nervous system is restored. If the patient goes to bed and gets up on schedule, at certain hours, then he gets used to falling asleep at the set hours, his brain gets a rest during sleep. If the patient goes to bed and gets up at different hours, then his rest is disorderly and insufficient. Compliance with patients strict order of the day regulates their behavior. Only accurate performance of the regimen of the day will lead to successful treatment of patients. On the contrary, any violation of the order leads to the disruption of medical measures and hinders the work of medical personnel.
All patients should be kept clean and washed regularly, in addition, they can be prescribed hygienic and therapeutic baths. With a hygienic bath it is necessary to wash the patient quickly and well, beginning with the head, then wipe the sheet and quickly dress. When the treatment bath is monitored by the clock, so that the patient does not overstay the appointed time. Follow the condition of patients in the bath( general appearance, complexion).Special supervision is conducted for patients with epilepsy. In the bathroom and back patients accompanied by a nurse. Weak patients should be washed, combed, fed, followed by physiological items, in a timely manner, to submit a vessel, a duck. If the patient walks under himself, he should be washed in time, dry dry and put on clean clothes;such patients under the sheet lay an oilcloth. In bedridden patients, bedsores may appear, in order to prevent them, they often change the position of the patient in bed. Make sure that there are no folds, crumbs. Under the rump, a rubber circle is put, the reddened places are smeared with camphor alcohol. If a decubitus is formed, lubricate it with Vishnevsky ointment, with suppuration - treat with napkins moistened with dioxin. Follow the purity of the mouth, skin, nails.
Care for Depressed Patients
When caring for depressed patients, they are strictly monitored day and night: you have to accompany them to the toilet, washroom, bathroom. Inspect clothes and bed, are not hidden in them dangerous items. Medicines are allowed only in the presence of the sister, so that the patient does not save them for suicide. Watch that such patients in a timely manner to eat. Depressive patients need rest. All kinds of entertainment worsen his condition, and you do not need to persuade him to watch TV.Depressive patients often have constipation, they are given timely enemas.
Patient Care
Restless patients are placed in special offices, where there are chambers for the heavily restless and weakly restless. If the patient is very nervous, then it is necessary to remain calm to the medical staff. It is necessary to strive softly and gently to calm the patient, switch it to another thought. If the patient starts to beat his head against the wall, it is held, soothing agents are used.
The retention is done as follows: the patient is placed on his back in an extended position, on the sides of the bed there are two nurses - two are holding hands and two legs. For retention, you can use a blanket, a sheet. You can not hold the patient by the ribs, press on the stomach, touch the face. It is better to stand on each side of the bed in order to avoid kicking the patient. You can not sit on the patient's feet while holding. In case of dangerous excitement, one should approach the patient by holding a blanket and a mattress in front of him, to mitigate a sudden impact from the patient. Each situation depends on the nature and extent of the stimulation. Retention techniques are acquired in practice under the guidance of a physician and experienced nurses. After intramuscular injection, a restless patient of neuroleptics has a dream. The patient is turned over on the abdomen, the head is sideways and held during injections. If the patient again tries to jump out of bed, run, attack, antipsychotics appoint a course. Restless warm baths are prescribed for restless patients( water temperature 37-38 ° C).The patient is taken to the bath;go behind, take his hands and quickly cross them in front, under the breast;while the medical staff with a nurse stand on the side so that the patient does not hit with his foot.
There are six types of psychomotor agitation.
1. Hallucinatory-paranoid, occurs in hallucinatory-paranoid states. The patient defends himself against enemies, attacks them. Persuasion does not work here. Apply sedatives.
2. Depressive excitation occurs in a depressed state. The patient beats against the wall, scratches his face, bites. Here, affectionate words can help, additionally prescribed psychotropic antidepressant drugs, the patient can be held with the participation of one orderly.
3. Manic agitation in manic-depressive psychosis. Against the background of talkativeness, noisiness, a patient can attack others. Persuasions do not apply, only psychotropes in combination with narcotic drugs.
4. Excitation in the state of delirium( with infections, alcoholic or other poisoning).The patient jumps up, runs, drives someone away from him. On the face is an expression of fear. Words can act on the patient, use sleeping pills, cardiac remedies.
5. Catatonic excitation under catatonic states. The patient's movements are ridiculous, incoherent speech. The words of the personnel have no influence. Requires retention, use antipsychotics in combination with soothing drugs.
6. Excitation in the twilight state of consciousness occurs in patients with epilepsy. He fights with fire, experiences terrible events. The patient is dangerous, attacks the people around him. Words are useless, the patient is held back. Approach carefully, try to take the patient by the limbs, put him in bed and hold until the end of the attack.
Helps enema from chloral hydrate. Recently, epilepsy with the twilight state is rare.
Care for neurological and mental patients has similarities and differences. The goal is to alleviate the sufferings of the sick, improve their health and help to recover faster or achieve a long-term remission. The work of a nurse is associated not only with physical, but also with mental stress, but if you succeed, the work will not seem difficult and difficult.