Author: NurseGrit

I'm a psychiatric nurse practitioner specializing in healthcare advocacy in Asheville, NC.

Suicide roulette; my son won again

Suicide is the 10th leading cause of death in the US, where I live. But if you are in the age category of 10-34 yrs of age, like my son, who is 30, then suicide is the 2nd leading cause of death in the US.

Suicide Hotline 1-800-273-8255

Depression is the leading cause of disability worldwide. Just another fact since I’m talking stats.

Tonight my son is sitting in a psychiatric ER, again, while yet another medical team tries to decide what to do with him. 12 hours ago I made the dreaded phone call to the police department in the county where he was last seen to ask for help in finding him, a “welfare check”. After giving the dispatcher a recount of the last awful 48 hours they informed me that with the help of his cell phone carrier they could probably locate him by “pinging” his number. When they told me of that capability the situation suddenly felt more grim. In my mind I saw it all playing out… it wasn’t pretty. I thought I’d have more time to ground myself after reporting him missing (in the past it was more like hours). My experience with pinging was limited to what I’d seen on television or heard on the Radio Lab podcast “Serial”, when the police where trying to locate the body in Linkin Park by pinging her phone.

So, in the empty silence of my house I was overcome with grief because I knew he was about to be found, probably within a matter of minutes. A familiar and horrible heaviness suddenly enveloped me and for a few minutes I sat motionless at the kitchen table, staring at my phone. Then I started to sob uncontrollably, because I knew this was it. That awful time had come. He was gone.

My mind started drifting, imagining him in the hours earlier, before the pinging, when he was still alive. I saw him sitting in his car somewhere, maybe on Sullivan’s Island, or Folly Beach, maybe sitting on the edge of a dune, maybe with heroin. But I kept seeing him in his car, all alone. He was terribly sad, probably numb, and very confused. He had no one to say goodbye to, no one to hug one last time. No one to look into his blue eyes and say “I love you” one last time. No one to hold him while he ever so bravely said goodbye to the world.

I sat at the table asking myself “if only”… I should have… why didn’t I just…”. So I cried for him, huge tears of sadness and love and longing, and the weight of it all, all that grief, it felt like it would bury me.

My phone rang soon. It was his sister, saying he had been found at his dad’s house, and he was alive. He was taken to the Medical University ER and was admitted for psychiatric evaluation.

Now comes the aftermath of coming up with yet another game plan. Untangling it all to find a new plan.

Part of what I want to convey with this post is that suicide threats should never be ignored. There is no time for “thoughts and prayers”. Action is what’s needed and there is no time to waste. It’s a medical emergency — no different from a car crash victim, or heart attack. TIME IS OF THE ESSENCE.

Families: learn all you can about how to help someone suffering from mental illness. They need you in their court. If you don’t know, or if you need a refresher, go online and learn about what you can do to help your loved one. It’s a potentially terminal illness so why should it be treated differently? Below are some links to help get you started.

NurseGrit will revert back to the original topic, mental health. I hope it will help someone. Thank you for reading. National Institute for Mental Health. NAMI Suicide Hotline 1-800-273-8255

Holistic options for psychiatric NPs in long-term care



As a psych NP new to working in LTC settings I’m finding scant research on what to prescribe that has the fewest side effects. How can I incorporate holistic care into my practice? I prescribed chamomile for the first time but didn’t get the chance to evaluate it because the patient was discharged from the short-term rehab she was on. Aromatherapy is not being used enough, at least not in the facilities where I practice; how can I bring it to my practice in an easily delivered manner? I read where one psych NPs provided boxes of Lorna Doones for nurses to keep on the med carts and actually wrote orders for them to be used PRN. As long as diabetes isn’t an issue that might work but I haven’t found the nerve to use them yet!

If you have suggestions I’d love to hear them. If you know of resources, websites, articles, anything — please share.


For All Time

Music has such power to heal. Thank you to outofagreatneed for this post from June 23rd that I’m reblogging here on NurseGrit.

Out of a Great Need

This song…

pulls me back to the darkest days, during our younger daughter’s adolescence, when long drives helped her racing mind in the midst of the overwhelming symptoms of her severe brain illness.

We took long drives every single day for several…yes…several years.

We listened to music.  This is a song from one of the CDs she would bring along.

But this song does not upset me.

It reminds me that all of the quiet patience made a difference.

It reminds me of a bond that cannot be broken by a severe brain illness.

This song reminds me of the power of love.

It reminds me to NEVER give up.

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7 Step Diet and Lifestyle changes for Alzheimer’s Prevention


The topic of Alzheimer’s disease treatment has been a topic of conversation multiple times in the past few days so this is my blog topic today. While we wait for a cure for AD, there are steps we can take to hopefully better position ourselves from a prevention standpoint.

At the International Conference on Nutrition and the Brain, Washington, DC, July 19–20, 2013, multiple recommendations were brought forth with respect to diet and lifestyle changes for prevention of Alzheimer’s disease (Barnard et al., 2013). Below is their list of 7 steps to take.

  • 40 minutes of aerobic exercise three times a week
  • Eat a plant based diet
  • Minimize intake of trans and saturated fats. Trans fats are often found in snack foods (especially pastries and fried foods). Saturated fats mostly are in meats and dairy.
  • 15 mg of Vitamin E every day, coming from plants and not vitamin supplements. Vitamin E rich foods: Seeds, nuts, green leafy vegetables, whole grains.
  • B-12 supplement of minimum RDA (2.4 micrograms daily for adults). Age can lower B-12 so be sure you get levels checked. Your primary care provider can do this for you easily.
  • If you take vitamins/supplements choose those those without copper and iron.
  • Avoid aluminum products. Jury still out but it’s linked to Alzheimer’s (as well as cancer). Aluminum is in many products we often use: deoderant, cake mix, dyes, processed cheese, antacids, baking soda/powder, foil, cookware.


Barnard, N. D., Bush, A. I., Ceccarelli, A., Cooper, J., de Jager, C. A., Erickson, K. I., et al. (2014). Dietary and lifestyle guidelines for the prevention of Alzheimer’s disease. Neurobiology of Aging, Volume 35 , S74 – S78.

Image: Physicians Committee for Responsible Medicine


NC #1 in naloxone distribution

The Guardian  published an article today (Timothy Pratt, June 10, 2016) about naloxone rescue kit distribution efforts in NC. The state claims national leadership status in the number of lives saved with naloxone in the shortest period of time (not by police, ERs, or other medical first responders). Key to that effort has been getting the rescue kits into the hands of opiate users and their peersThe NC Harm Reduction Coalition (NCHRC) is the organization responsible for this monumental undertaking. Most states are making similar efforts but some advocates have expressed frustration about the lack of cohesive plans to reach those in need.

Peter Davidson, a professor at the UC San Diego School of Medicine who has studied opioid deaths said it’s “frustrating” to see that other states haven’t yet adopted North Carolina’s methods, which he believes should be a national model.

“We have a really good … public health response that works, and seeing it not being done more comprehensively is infuriating,” he said. “You’re watching the death reports come in, and you know they don’t need to be that high.”

Let’s all learn from each other with the common goal of not just saving lives but treating addiction adequately in the first place.



How one NJ hospital’s ER is combating opiate addiction: no routine opioids for chronic pain

New Jersey ER bypasses opiates for chronic pain

Timely for APNA 14th CPI — NY Times 2016 article describes how this ER is using alternatives to opioids for managing many types of pain.

As psychiatric nurse practitioners our clients often have chronic pain. Knowing about alternatives to meds for treatment of pain can be helpful info to share with them and/or could reinforce what they might be told by their PCP or pain medicine clinic, in terms of alternates to opioids.