Attitude towards the mentally ill
A mentally ill person expresses ridiculous thoughts and misinterprets the world around him, but he well understands how people around him treat him well or badly. A good attitude to the patient is pleasant, and for him he often thanks the staff for recovery;on the contrary, a bad attitude worries him, he is offended and angry. A gentle word always alleviates a patient's condition, a careless word worsens the course of his illness. Medical staff during work in the department should always be calm, courteous, friendly. When you enter the ward, you should say hello to the sick, and when you leave, say goodbye. The medical staff must maintain an unchanging calm, self-control, patience, the face must not be affected by illness or irritation. A dull look affects patients who may be in a depressed state. Talk must be quiet, but do not whisper, as patients may be suspicious. Do not slam the doors, rattling the dishes, the key when unlocking and locking the doors. The type of each employee should be neat. Do not use workers to put on brooches, bracelets to avoid tearing them off in a state of arousal.
You can not treat patients with pity. This worries them and, on the contrary, contributes to the appearance of new delusions, feelings of hopelessness of their own condition. It is necessary to address the patient to "you", to call him by name and patronymic. This contributes to the emergence of trust in personnel. You can not show preference to someone, it just excites. Do not take offense at the patient mentally, because his behavior depends on a painful change in the activity of his brain. A mentally ill person does not understand jokes;Also, one can not carry out any assignments of patients, visit their relatives. These requests are caused by wrong thoughts, aspirations for suicide, ridiculous suspicions of the patient. These questions are decided by the doctor.
All staff of the department must seek from patients with trust, only then it will be possible to know all the thoughts of patients, which facilitates care and help. It is not recommended to argue and quarrel with the patient, as the patient considers himself right, and you can not change his mind. If the patient expresses the wrong thoughts, it is better to remain silent or talk about something else. Do not ask the patient questions about the family, material and official position, because the patient will see intent - a secret investigation is being conducted about his alleged crimes.
It is not necessary to maintain the taciturnity of excited and talkative manic patients. Such patients can speak without end;If you listen to them, it will push them into new and new thoughts. In such cases it is necessary to avoid prolonged listening to patients under any pretext. Since manic patients are angry, you need to do it delicately. Even to be silent it is necessary with skill, as the patient can think that they are unhappy, do not want to talk. Therefore it is necessary that the staff should always be friendly. Of course, if the sister sees that the patient wants to talk, if the patient himself calls her to a conversation, then one should never shy away.
Care of the patient becomes very difficult when he is suspicious and distrustful.
Sometimes the patient refuses to observe the established regime: for example, does not get out of bed, does not want to go for a walk. In such cases, the sister must try to convince the patient to do what is required of the patient. It should be said that this is necessary for health, that his relatives will be happy with him, that an example should be given to his neighbors in the ward, and then he will soon recover and return home. Sometimes the patient does not understand that he is ill;it is impossible to argue with him, leave the patient alone and inform the doctor who will take action. But, as a rule, it quickly passes, as the strength of the collective of other patients affects. When the patient does not obey the regime, but sees that the other patients are observing it, then under his influence he begins to observe the regime.
Personnel can not talk to each other when they are sick about their personal affairs, hospital events, out-of-hospital events. In a patient with delusional ideas, this can cause an outburst of excitement, since he misunderstands this conversation and takes it into his account.
Patients should be observed unnoticed, in order to avoid unnecessary anxiety of patients. Day and night medical staff should be equally vigilant. At night, you can not sleep, otherwise it can lead to misfortune. The patient can take advantage of the fact that the staff sleeps, and attack the neighbor on the bunk or cause harm to himself.
Observation and care of patients with various pathological diseases
A nurse should be attentive if the patient starts moaning, moaning, if he is feverish and his body temperature rises, there is a rash, swelling;such cases should be reported immediately to the doctor to prevent the possible onset of any infectious disease or allergic reaction.
It is especially important to follow the natural directions of patients. Many mentally ill patients have constipation, in which putrefactive stools accumulate. When constipation puts enemas. The nurse should organize a post in the corridor for the nurse, and she records when there was a stool or urination in the patients, what stool leaves after the patient, whether there are worms, impurities of blood.
Patients may have diarrhea. The feces of such patients are examined in the laboratory to exclude infection;when confirming the pathology of the patients, they are transferred to the infectious department, where they organize an individual post;if this patient is unable( if he is violent) to isolate in his department.
The nurse should establish strict control over the emptying of the intestine and bladder in unconscious and recumbent patients. Unkempt patients, defecating and pissing under themselves, take personal care.
Sometimes patients may have urinary retention as a complication in the treatment with neuroleptics. If the patient does not urinate, he is urinated with a catheter.
In the female department, a nurse leads a notebook about the onset of menstruation in sick women. On the irregularity of the cycle, the absence of menstruation or prolonged menstruation, accompanied by bleeding, you need to report to the doctor.