Thank you for your service: this kind of calculation is always an excellent addition to posts like this.

butt capitalism moar EFFICIENT tho!!!11!11!!!

Ok I’ll bite…?

Yuuuup. We try to give them by mouth first to check for those kinds of things, but sometimes

1. they’re just missed. I came in one week and got my same patient back and they’d had EPS for the almost entire time I’d been gone and nobody noticed because (aside from the drug being the lowest risk antipsychotic for EPS) the patient was complaining their teeth hurt and nobody made the connection it was because the EPS had been making them grind them! I only checked because I’ve had EPS before so cogwheeling is like the first thing I check for (after the big stuff like heart attacks and strokes obvs) for any complaint involving the head neck or arms. (I’ve heard everything from “my tongue feels too big” to “I’m blinking too much” to “the aliens implanted a chip in my neck” and “my arms have gone numb” that all presented with cogwheeling and were cured by benadryl or benztropine!) If I hadn’t by chance had that one weird professional quirk and also been assigned to that specific patient no one would have known.

2. Sometimes the horrible side effect drug is the only thing that stops them from throwing literal fucking haymakers multiple times a day, so you just pile on more meds to try to control the side effects and… pray. No joke, farm kids on meth are hell. All that strength and not a lick of sense or reason left.

Well to me that can go a couple different ways. I realize I forgot to clarify above that my knowledge of meds outside of psych drugs fades pretty quickly beyond the easy ones like metoprolol and pantoprazole, so I can’t really speak to the specifics from the back end of drug testing and approval of long acting medications from other drug families without a lot more reading that I am not doing on my day off (it was my least favorite class the better part of a decade ago).

On the other hand I could absolutely see an IM med being approved at a higher relative dosage and/or with a slightly harsher side effect profile in veterinary medicine even if just to reduce occupational dog bites by increasing the time interval. That could also just be empathy for someone who has had to stab an actively struggling patient (and been the reluctant stab-ee myself believe it or not).

q6months? Current long acting injectable birth control lasts like 3 months and antipsychotics are sometimes lucky to last 1! (After researching the existing PrEP LAI, it looks like it usually lasts 1-2 months) 6 months is some hella staying power. I shudder to think what having an antiviral in you for 6 months at a time does to your liver long-term, but I suppose it can’t be worse than full compliance with the pill. Wonder if I’ll be giving this in a few years (LAIs are usually a dayshift problem though). There’s good odds psych has the most sex workers in the hospital, it turns out people who can’t reliably name an abuser are really easy to traffic to all kinds of ends.

Situational awareness. I’ve had people look me up and down and ask how I handle the patient population I do considering I’m kinda skinny-fat and like

a) I’m a lot stronger than I look, especially with adrenaline in me one time I picked up one of the weighted dayroom chairs because I needed to get to a patient and it was in my way

b) 99% of it isn’t even fighting people anyway it’s mostly just having an ear for bullshit. One time we had a patient set off one of the safety alarms in their room and waited in the dark behind the door for someone to come answer it. I got there, saw the darkened room with the weird alarm going off and just noped the fuck out and called security.

If you have the common sense of every guy in the horror film that says,“Absofuckinglutely not” (and you don’t mind being paid pennies) psychiatric nursing calls to you.

Brains that run faster than average are very cool and impressive to people who don’t have to live in them.

I looked him up on YouTube because I wanted to see what you meant and all the comments say he’s been replaced with AI.

Damn. That show got weird.

What red flags? He’s a solid, hardworking, and nonjudgmental family man! Unless in the later seasons I haven’t seen he becomes a shithead?

Zuko from AtLA, but part of that was also a deep experiential empathy for his character growth arc. Also sometimes having undefined gender issues at the same time makes it really hard to tell whether a feeling like that is attraction or envy.

One of my favorites in highschool and made EDM my favorite genre (well, that and playing speed over Beethoven in DDR). My faves now are apashe and avicii. If anyone knows any EDM that incorporates classical elements (especially strings and/or piano) I am ALL ears.

The logic behind it is that it’s a bribe “tip”-based system. The “tips” often provide more than a living wage, so it really works out better this way!

Nursing/Psychiatry: here’s what to pack for your friend in the psych hospital!

• T-shirts, logos fine, avoid anything explicit/vulgar
• stretchy pants, no drawstring or that can have the drawstring removed and don’t need a belt
• a sweater without a hood or zipper
• socks
• slide on shoes (no laces)
• a puzzle book with more than one type of puzzle
• a book in a genre they like
• a coloring book
• a notebook to write in
• crayons
• a stress ball
• one of those silicone bubble popper toys
• snacks/food that are still sealed or that have one of those doordasher stickers fast food places use sometimes.

DON’T bring:

• anything with long strings or cords
• anything sharp or pointy or made of glass or ceramic
• plastic bags
• bedding/pillows
• anything valuable or sentimental other than maybe a smartphone, and ID

I often wish more of my adult psych patients’ parents had done some reading about psychosocial development and how to support the child at each stage but more importantly I pretty much always wish they’d cared half as much as you did to even ask that question.

Black women especially. Up until recently it was actually taught in nursing and medical education that black people feel less pain for the same amount of emotion expressed (aka they’re exaggerating). It turns out when you assume a woman is exagerrating postpartum abdominal pain, that’s how she dies of a hemorrhage.

You all may also be interested to know that the “traditional” lithotomy position (laying back w legs up in the stirrups) is actually one of if not the worst position to give birth in. I put it in quotes because it’s not even actually traditional. As a preferred birthing position it only dates back to the 17th century (before that it was used for kidney stone removal, where the name lithotomy comes from). Before that women typically squatted, kneeled, or were on all fours. Lithotomy became popular because it was more accessible to the male physician, and because the French king at the time wanted to watch his wife give birth, and that was the position in which he could best watch. So… do with that information what you will.

Not surprising to me in any way, I did exactly that while in school (among other unlicensed healthcare roles).

This is actually pretty solid. I’m firmly in the “passion” category, and while I’ve gotten better at it over the years, I often struggle to remember other people just have careers and jobs, and find true fulfillment elsewhere. Now that said, my passion pays somewhat poorly (but steadily!) and isn’t even slightly competitive (I’m even considering leaving the field at this point) but it’s something I care a lot about being done well.