Blogs

vital signs in psychiatry, necessary? for what reason?

By Cirre Emblen posted 01-04-2012 10:39 PM

  
I am a Family Psychiatric Mental Health NP (2010 graduate) and a Family Nurse Practitioner (1984 graduate).  I work in  a county outpatient mental health clinic for indigent adults.  I am currently the only NP and I work with two psychiatrists. We are butting heads about obtaining routine vital signs from patients.  They argue that one should not obtain data without having a plan for managing it, and they both say that they would need to research management of hypertension to feel comfortable making decisions about what to do with various blood pressure readings they might obtain.  I say that routine vital sign monitoring is a basic part of evaluation of any patient.  Additionally, I argue that many psychotropic medications can effect blood pressure, pulse, respiratory rates.  Can anyone shed light on this topic?  Are there standard protocols for monitoring vital signs for psychiatric patients?  If so, what are the reasons and what are the sources.  If not, I guess I am ready to stand corrected.

Thanks!
Cirre Emblen, FNP
2 comments
664 views

Permalink

https://community.apna.org/blogs/cirre-emblen/2012/01/04/vital-signs-in-psychiatry-necessary-for-what-reason

Comments

Dana Meinhardt
02-04-2012 12:43 PM

I agree that VS need assessed routinely. We had a change of culture to the psych hospitalist model and have NP that follows all medical issues and does physical H&P. Our policy is VS Q shift X 3 days, then QD on dayshift remainder of stay (unless of course indicated more often).People initilly complained, but now most realize no pt is 100% psych or 100% medical. Our psychiatrists seem very comfortable with monitoring HTN & such. One provider chooses to leave more of the medical to NP, which is her primary job and expects this. However, like you state looking at the whole picture is good priactice.

Michael Frost
01-20-2012 04:26 PM

it is a basic assessment item and important for many psychiatric medications. Further in AZ it is a required element on initial evaluation and every six months. other items include ekg for specific agents, anc for others, etc. Mike