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Content That Barnstormin' PMHNP Likes

Barnstormin' PMHNP 8,130 Views

Joined Mar 8, '12. Posts: 351 (65% Liked) Likes: 949

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  • 7:48 pm

    It depends on the hospital - some offer staff guidelines for those interviews with questions to ask . But some are very informal and they want to just see "how and who you are" and it is my experience that those tend to ask more about "what would you do in xyz case".

    Those peer interviews are also important for the person who comes to the interview.
    I went to a peer interview one time and thought the job would be great (ICU) but when I interviewed with the staff I realized right away that I would not be able to work there and after 30 minutes I thought that I would only take this job if the last one available on earth...

    My suggestion is to prepare some questions you want to ask them and to be open. Dress professionally.

  • 10:47 am

    You should not react to this person. Do not contact the BON. Only take action if they contact you.

    How is this person "practicing as a nurse" if she has just graduated?

  • Aug 29

    This was bizarre to read for a few reasons.

    Take a look around the forum at all the new nurses posting cries for help because they don't know how to manage the sheer weight and stress of their new job. They're up to their eyeballs in responsibility and they're scared. Here you come, not knowing how good you actually have it, and complain about not getting more critical cases. Why can't you just be content with what you have? Will you be paid more for getting the sick babies? I don't understand why you're mad about NOT having a hard job.

    Do you realize how much you're inadvertently learning just from being in the environment that you're in? Learning from the more experienced nurses who know way more than you do? Why can't you appreciate that? Do you think the end of the line for you will stop at feeder-growers?

    I'm in school now and one of my biggest fears is getting my first job and not being able to mentally handle all of the things I have to do at work. Most new nurses have to trudge through the stress for over a year until they feel comfortable at work, and you're over here complaining about work being easy.

    Man...I hope I'm in your predicament one day.

  • Aug 29

    I wonder how exhausted these managers are of being the revolving training ground for would be NNPs who grab their 2 years and run?

    I'd probably keep my long term nurses in place as long as I could and gradually let out the line on the new grads who have proven likely to leave anyway.

    Kudos to the manager who prioritizes their long term staff with earned scheduling.

  • Aug 29

    Quote from caliotter3
    There are undoubtedly many, many unemployed new and experienced nurses who would be grateful to have a job taking care of feeder/grower babies. They also have the humility that makes them welcome on a unit when they get their chance. Give these little babies your best and you will find yourself progressing, your efforts will be noticed.
    Yup! NICU is one of the hardest specialties to get into even with years of nursing experience. Even though most of my assignments have been feeder/growers with some bubble cpap, I still look forward to going in and "loving" on the babies. Plus taking care of 3-4 stable kids help with time management and prioritization and communicating with parents in less stressful situations.

  • Aug 29

    Quote from Wuzzie
    I read your OP and your second post. Stepped away from the computer for about an hour to think about this response because I don't want to appear as if I'm piling on but some things are becoming clear to me.

    First: anybody who describes their experience as "x number of years in healthcare" is often conflating that experience to try to make it something that it isn't which is usually actual patient care experience. So what exactly was the experience you speak of because it really does change things? Being evasive does not win points here.

    Second: Being a NICU mom is stressful but it isn't the same as being a NICU nurse. The only advantage you have is that you can actually be sympathetic (rather than empathetic)and you have a greater understanding of what your patient's parents are going through. This is a wonderful thing but is not even remotely related to the clinical aspect of patient care.

    Third: You had an issue with a preceptor back in April. You challenged her. As a new grad this is not a good thing to do for a whole lot of reasons. There were way better ways for you to handle the situation. Yes, I'm aware that your facility's policy backed you up but if you read the responses across the board virtually every one agreed with your preceptor, after all even PO feeders get NEC and, as I'm sure you're aware, increased residual is often the first sign. Basically, you stepped in it...royally. But after all, you were right so you won...right? I'm suspicious that this may be one of the reasons you are only taking care of feeder/growers. You ticked them off. I'm guessing none of the nurses who take the ICU babies are going out of their way to show you interesting things that they think you might like to see/learn. That's a huge red flag. Any of the more experienced nurses taking an interest in fostering your growth? No? Then you posted this and it pretty much made everything clear. You stepped in it here too...royally. I know you wanted us to agree with you and tell you that the mean old charge nurse were wrong but if ALL of the charge nurses keep assigning you the sub-acute babies then there is something else going on. I believe this post tells us what it is. You've shot yourself in the foot here and probably at work but you CAN fix it. A little introspection would be a good start. Then find an experienced nurse that you think might have a soft spot for new grads and throw yourself at her mercy. By that I mean, tell her that you are really interested in learning all you can about the sicker babies. Tell her you'd like to progress a LITTLE bit farther and you could really use her help. Ask her if there is anything that she is aware of holding you back and then LISTEN to her. If you win even one ally the chances of you being successful are very much increased. As for here, although I'm afraid you don't really care, an apology for the attitude and name calling would probably be a good thing. A little humility would be a great thing. All of us experienced nurses really do want to help the newer generation but sometimes the best thing we can tell you guys is the last thing you want to hear. But in hearing it you grow as a nurse. Now, I fully expect a vitriolic, angry response from you or some other poster for what I've said but before I get flamed I would like you to understand the spirit in which this post was written. I've been where you are and only after many years of doing this did I gain insight into what I did that might have caused me some (not all) of the grief I've been through in my career. I truly do hope you can figure all this out so you have a long and happy NICU career. Now donning asbestos undies.
    Standing ovation

    A much needed bit of advice and very eloquently put.

  • Aug 29

    Quote from RNinCali15
    Sour,

    Not sure how you think insulting my capability as nurse is constructive.

    I provide excellent patient care, and know exactly what a healthy patient looks like. I have over ten years experience in healthcare, and have four children. I also have a deeper understanding/appreciation on the NICU, something in which few nurses can say they have. Each of my kids were in the NICU, and one of them was a golden hour. So please, save that anti-new grad bulling attitude for a prepubescent new nurse.

    Take your bad attitude and anti-progressive nature someplace else Ms. Grump.
    I read your OP and your second post. Stepped away from the computer for about an hour to think about this response because I don't want to appear as if I'm piling on but some things are becoming clear to me.

    First: anybody who describes their experience as "x number of years in healthcare" is often conflating that experience to try to make it something that it isn't which is usually actual patient care experience. So what exactly was the experience you speak of because it really does change things? Being evasive does not win points here.

    Second: Being a NICU mom is stressful but it isn't the same as being a NICU nurse. The only advantage you have is that you can actually be sympathetic (rather than empathetic)and you have a greater understanding of what your patient's parents are going through. This is a wonderful thing but is not even remotely related to the clinical aspect of patient care.

    Third: You had an issue with a preceptor back in April. You challenged her. As a new grad this is not a good thing to do for a whole lot of reasons. There were way better ways for you to handle the situation. Yes, I'm aware that your facility's policy backed you up but if you read the responses across the board virtually every one agreed with your preceptor, after all even PO feeders get NEC and, as I'm sure you're aware, increased residual is often the first sign. Basically, you stepped in it...royally. But after all, you were right so you won...right? I'm suspicious that this may be one of the reasons you are only taking care of feeder/growers. You ticked them off. I'm guessing none of the nurses who take the ICU babies are going out of their way to show you interesting things that they think you might like to see/learn. That's a huge red flag. Any of the more experienced nurses taking an interest in fostering your growth? No? Then you posted this and it pretty much made everything clear. You stepped in it here too...royally. I know you wanted us to agree with you and tell you that the mean old charge nurse were wrong but if ALL of the charge nurses keep assigning you the sub-acute babies then there is something else going on. I believe this post tells us what it is. You've shot yourself in the foot here and probably at work but you CAN fix it. A little introspection would be a good start. Then find an experienced nurse that you think might have a soft spot for new grads and throw yourself at her mercy. By that I mean, tell her that you are really interested in learning all you can about the sicker babies. Tell her you'd like to progress a LITTLE bit farther and you could really use her help. Ask her if there is anything that she is aware of holding you back and then LISTEN to her. If you win even one ally the chances of you being successful are very much increased. As for here, although I'm afraid you don't really care, an apology for the attitude and name calling would probably be a good thing. A little humility would be a great thing. All of us experienced nurses really do want to help the newer generation but sometimes the best thing we can tell you guys is the last thing you want to hear. But in hearing it you grow as a nurse. Now, I fully expect a vitriolic, angry response from you or some other poster for what I've said but before I get flamed I would like you to understand the spirit in which this post was written. I've been where you are and only after many years of doing this did I gain insight into what I did that might have caused me some (not all) of the grief I've been through in my career. I truly do hope you can figure all this out so you have a long and happy NICU career. Now donning asbestos undies.

  • Aug 29

    I am pretty open about my late diagnosis of ADHD and the difficulties I have faced because of it. A lot of the hardship I have faced stems from the fact that there is so much misinformation out there about the disorder. There are a lot of disreputable people out there preying on the vulnerable and pushing unscientific “cures” and treatments. There are just as many good-intentioned people who are trying to “help” but have no clue. This article is the first in a series that I hope will shatter some of the misconceptions and bring the facts of ADHD out into the open.

    What is ADHD?

    FACTS:

    1. ADHD stands for attention-deficit/hyperactivity disorder. It is one of the most common mental illnesses. According to the American Psychiatric Association (APA), it affects an estimated 5% of children and 2.5% of adults.
    2. Usually, it is diagnosed in childhood, when the affected child starts having trouble in school. The condition is diagnosed more frequently in boys than girls. Unfortunately, there are some people who do not get diagnosed until much later in life.
    3. ADHD is broken down into three types: hyperactive-impulsive, inattentive, and combined type.
    4. Hyperactivity is defined by the National Institute of Mental Health (NIMH) as when “a person seems to move about constantly, including situations in which it is not appropriate, excessively fidgets, taps, or talks. In adults, it may be extreme restlessness or wearing others out with their activity.”
    5. The NIMH defines impulsivity as when “a person makes hasty actions that occur in the moment without first thinking about them and that may have high potential for harm; or a desire for immediate rewards or inability to delay gratification. An impulsive person may be socially intrusive and excessively interrupt others or make important decisions without considering the long-term consequences.”
    6. According to the NIMH, inattention is characterized by a person who “wanders off task, lacks persistence, has difficulty sustaining focus, and is disorganized; and these problems are not due to defiance or lack of comprehension.”
    7. ADHD severity and type vary per person. Males are more often diagnosed with the hyperactive-impulsive type. Females are more often diagnosed with the inattentive type.


    FICTION
    :

    There are a great many misconceptions about what ADHD is, and isn’t.
    1. “There’s no such thing as ADHD. That child is just spoiled.” ADHD is a condition, not a result of poor parenting. According to the CDC, ADHD is a neurodevelopmental disorder.
    2. “Everyone has a little ADHD.” According to the APA, even though ADHD is one of the most common mental disorders, it only affects approximately 5% of children and 2.5% of adults.
    3. "All children act that way!" While all children may display the symptoms of ADHD occasionally, affected children have the symptoms more severely, more often, and the symptoms reduce social function, school function, and quality of home life.
    4. "Only boys have ADHD." It is true that males are diagnosed more often, but females also have ADHD. Obviously, since I am female!
    5. "All kids with ADHD are hyperactive." Children with inattentive type ADHD often appear dreamy or lost in their own world.
    6. "There's nothing wrong with you, you just need to try harder." Believe me when I say that those with ADHD are most likely already trying as hard as they can.

    References:

    American Psychiatric Association (APA), “What is ADHD?”
    What Is ADHD?

    National Institute of Mental Health (NIMH), “Attention Deficit Hyperactivity Disorder”
    NIMH >> Attention Deficit Hyperactivity Disorder

    The Centers for Disease Control and Prevention (CDC), “Facts About ADHD”
    Facts | ADHD | NCBDDD | CDC

    CDC, “Data and Statistics”
    Data and Statistics | ADHD | NCBDDD | CDC

  • Aug 28

    Quote from Barnstormin' PMHNP
    Actually in NY they can practice without being board certified.
    but medicare is not reimbursing for whatever you do

  • Aug 28

    Quote from Barnstormin' PMHNP
    Actually in NY they can practice without being board certified.
    Nice.

  • Aug 28

    Yuck! Sorry for the distasteful headline.

    I wanted to share an experience with my fellow NPs here.

    So I'm doing rounds the other day and had a young girl, 22yo, hospitalized with sore throat (weak admit btw). Anyway she was running fever 103, tachycardic 115s, 14k leukocytosis at time of admission, so she did meet sirs criteria. Anyway, the NP who did her H&P checked her for strep, mono, the usual work up. All of which was negative. Despite being on abx (unasyn) in the hospital and previously on amoxicillin for one week from an urgent care center, she had little to no improvement.

    So I'm reading the H&P and can't find the sexual hx (was never asked). So I enter her room, do my usual exam, throat is quite erythematous, no pustules, no exudate. I obtained her sexual hx. New sex partner 2.5 weeks ago, + oral sex, unprotected.

    We swab her throat for GC. Next day later she is + for gonorrhea. Given the hx I obtained from her I empirically treated her for gonorrhea anyway. I discharged her later that day and part of DC instruction was to dump the new boo, lol, and have him treated.

    So the reason I'm sharing this is to encourage you all to really think about your differentials depending on your patients age and symptoms, especially the new NPs coming out of school. Sore throat in a young person has many differentials, which can easily be overlooked as an STD. Always do a thorough history and physical, like they say you can diagnose 80-90% of problems with a good H&P.

  • Aug 25

    Quote from canigraduate
    ADHD is a neurobiological disorder, like schizophrenia.
    Quote from James W.
    Actually, it is improper to conflate ADD/ADHD with psychotic disorders,
    such as Schizophrenia.

    While there is a familial/genetic inheritance risk factor for both, & both do usually have negative outcomes if poorly addressed, if anything & in effect - they are are at opposite ends of the the mental illness continuum.

    Sure, the disorganisation, poor learning/social interactivity is in there in common, but the awful loss of reality via delusion-based paranoia & functional withdrawal, with predictable results - is not.

    As a life-career psychiatric RN who has found benefit from a proper family Hx review, & also Rx/Tx - which has been tailored to minimize unwanted effects - while still providing a markedly improved focus capability, I can state,
    I have had it pretty easy - compared to psychosis sufferers.
    I'm with cani on this. It was clear to me, as I believe it probably was to most people, that her point was not that ADHD and schizophrenia are similar disorders, but that, like schizophrenia, it is a neurobiological disorder, as opposed to, say, bad behavior or just "not trying" (which is how a lot of people seem to view ADHD).

  • Aug 25

    Quote from James W.
    Actually, it is improper to conflate ADD/ADHD with psychotic disorders,
    such as Schizophrenia.

    While there is a familial/genetic inheritance risk factor for both, & both do usually have negative outcomes if poorly addressed, if anything & in effect - they are are at opposite ends of the the mental illness continuum.

    Sure, the disorganisation, poor learning/social interactivity is in there in common, but the awful loss of reality via delusion-based paranoia & functional withdrawal, with predictable results - is not.

    As a life-career psychiatric RN who has found benefit from a proper family Hx review, & also Rx/Tx - which has been tailored to minimize unwanted effects - while still providing a markedly improved focus capability, I can state,
    I have had it pretty easy - compared to psychosis sufferers.
    I'm not conflating ADHD with schizophrenia. Jeez. I am stating they are both disorders with a biological basis. Any other words you want to put in my mouth?

  • Aug 23

    This qualifies as an opinion piece, not a true scholarly article. I question that opinion pieces should be claimed as "articles" as if vetted somehow. I think, anyhow, It's misleading on allnurses.com's part.

  • Aug 23

    I'm confused---if you write an article for AN, doesn't it have to get approved by somebody? Or can anybody write anything and call it an article?


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