I have mentioned before that psychiatric units are different from other hospital units in many ways. There are two basic other inpatient variants seen in the hospital- units that deal with med/surg issues of various types and intensities, and L&D units. Most of the inpatient units would fit into one of these categories for the most part, mostly med/surg.
Psychiatric units, unlike the above units, do not want our patients in bed, in hospital gowns and expect them to be up and about. Treatment includes groups, one to one interactions and various activities. Patients need to be considered medically stable, meaning they could be sent safely to their home if they did not need psychiatric treatment. If not, we are not able to provide appropriate treatment safely.
To illustrate the difference I compiled a list of things one would never hear on a psychiatric unit. Or if one did, there would be hell to pay.
1) Give him 60mg of morphine IV STAT.
2) Make sure she is NPO (nothing by mouth) after midnight. She is scheduled for surgery at 7:00.
3) She is showing signs of fetal distress. I think we need to prep her for a crash C-section.
4) Suction!
5) I want the patient on total bed rest.
6) Call the family. I am not sure he is going to make it through the night.
7) Forget the alcohol withdrawal protocol! Just give him a beer with each meal tray. (An intervention that I actually did see a surgical team use on a routine basis to prevent an alcoholic from going into withdrawals. Not recommended.)
8) I don't care if he weighs 300 pounds or not. You still have to do a rectal exam on all patients admitted to unit 4west.
9) Mr X pulled his foley out last night- do we need a consult?
10) Ready, one three, everyone lift!
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