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A&Ox6, BSN, RN 15,348 Views

Joined Apr 16, '12 - from 'Starbucks'. A&Ox6 is a Psychiatric Nurse/Student Advisor/Writer/Speaker. She has '2' year(s) of experience. Posts: 603 (51% Liked) Likes: 920

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  • Jul 19

    Quote from cracklingkraken
    I wouldn't say I have a phobia of clowns. I certainly hate them and think that they are the creepiest things ever, but not to the extent of a phobia. I HATE spiders though. If one was on my windshield while I was driving, I might crash. No joke.
    "Why did he have to say follow the spiders? Why couldn't it be follow the butterflies?"
    ---Ronald Weasley

  • Apr 18

    I tell people I'm a registered nurse. When they ask where, I vary my responses. HERE/AT HOME/IN MY MIND/STARBUCKS. They have such a hard time understanding that it is a license, even I don't work, I am still an RN.

  • Mar 22

    Quote from RN543
    I have to chime in here. I've worked in psych for 6 years now and it's my passion. But psych isn't for everyone. If you don't love psych nursing, then you aren't doing yourself or your patients any favors by continuing in the specialty. When I encounter staff that are unhappy working in psych, it's often because of the expectations they had before they started. It's a wonderful thing to pursue this career because you want to make a difference. If that's you then it shows you are a caring person with a desire to help people. The problem is that some people have not accepted the fact that we aren't going to save or cure EVERYONE. It's likely that only a small percentage of our patients will improve and go on to lead productive lives. But I'm not going to stop trying. We need to remember that first of all, we don't always hear or see the success stories (b/c our successful pts may avoid readmission and we might never see them again)... So it's hard not to focus on the negative things we see and hear. But also remember that even the little things u do make a difference to that patient... Even if you're not a miracle worker...

    For example, a new patient comes in (depressed and suicidal) that is scared, embarrassed, ashamed... But you show compassion... You listen to them without judgment... You offer a meal to that patient that hasn't eaten in days. U put them at ease and make them feel a little better about what they are going through. You praise them for the choice they made by seeking help. So maybe this patient doesn't make a miraculous recovery... But it doesn't mean u didn't make a difference. Maybe a year from now when they are standing on that bridge about to end it all... They will remember you and how you made them feel about seeking help. Maybe you will be the reason they won't feel too ashamed to ask for help. You may have saved someone's life and never even know it.

    I just try not to judge. Someone who has BPD may be a little annoying but I won't let that show... And they are just as deserving of my time and my compassion. And at least in my area, the majority of my patients also have addiction issues. There is no easy fix for mental health disorders and addiction. And then you throw in external factors like homelessness, unemployment, legal issues, relationship/family problems... And the odds are hard for anyone to beat. The truth is we don't have the community resources (at least in my area) for these people to get back on their feet. Even when our facility's case manager finds a halfway house or other placement for one of my patients, they typically don't have the money to afford it. When I have a patient that is readmitted... Of course it saddens me that they are not doing well and had to return... But the only other negative thought I have is how we as a facility failed that patient. Was the patient discharged too soon? Did we not plan appropriately for their discharge? Is their something we can learn from this rather than being negative and judgmental toward the patient? Why would I get annoyed that my admission was a patient that was just here a month ago? Because he's abusing the system? Because he's taking a bed from someone else that really needs it? Oh please! Who are we to decide who is more deserving or who needs our help more than others? Sometimes it's nice to have the same patient again because I already know them... Maybe my assessment will be quicker... I may already have a good rapport with them, etc. And maybe they don't quite "get it" the 1st time, the 2nd time, or even the 20th time. But maybe on the 21st time you admit that patient they will come with a new perspective and insight and will follow up with their aftercare plans. You just never know. I learned my best lessons not from lectures... But from my own screw-ups. Sometimes our patients need to fall before they can pick themselves back up.

    In my opinion, there is a lot of discrimination and a lack of compassion for mental health and addiction. But how is this issue (non-compliance, readmissions, etc.) any different than any other nursing specialty? What if you take care of a patient that had a massive MI and goes back to eating cheeseburgers and has a 2nd heart attack within a few months? Or you have a diabetic patient that refuses to follow their recommended diet or take their medications consistently? Would you feel the same disdain for them? Are they just abusing the system too?

    Listen... I look at nurses that work in ICU or nursing homes or oncology or just about any other specialty... And I think how do the do it? But I'm sure a lot of them look at psych nursing and think the same. If it's not your thing then it's all good. But even if u think ur negativity is not being noticed by ur patients or co-workers... You're probably wrong. I decide what kind of day I'm going to have each day by my own attitude I walk in with. If you're attitude is negative, your negativity will likely be contagious.

    You would be surprised at how much of a difference it makes to carry a smile and a positive attitude... Your positivity will be contagious too. And pretty soon you will be impressed with the difference you are making around you.
    You make some great points, and I agree overall with what you say. However, some hospitals are so desperate to stay full that they admit individuals who will be much better served seeing a therapist or psychiatrist on an outpatient basis.

    Just because an individual is competent to sign for a voluntary admission, doesn't mean that inpatient treatment is appropriate.

  • Mar 22

    Quote from Farawyn
    Again, I don't get this "legit" psych patient stuff.
    Humor me, and please explain the difference between a homeless guy with a hot urine and a court date as opposed to a "legit" psych patient.
    Far, as a former school nurse, this may help...

    You know the difference between the student who comes to you for a headache because they were cutting class and want a note to avoid an unexcused late/absent and a student who has 103 fever and is upset that he is being sent home?

    So I think that it is similar to the frustration we feel when a patient knows the magic words to be admitted in order to avoid being arrested or even a fight at home.

    I think that both can be seen in psych/mental illness. The difference is that inpatient psych admission is really for acute stabilization and safety. If someone has a need for treatment, I'm all for IOP/outpatient/group therapy/job coaching/ACT team etc. However, these patients are being admitted to psych because they say the magic S word even though all we can do for them is 3 hits and a cot.

  • Mar 20

    Quote from Farawyn
    It's Wrongway! NEVER say never.
    Farawyn,
    Thanks for reminding me what's what.

  • Mar 20

    Quote from Davey Do
    Well then...
    Thanks. Oh, and I'm NEVER slow...

  • Mar 20

    Quote from Davey Do
    Ha ha ha ha ha ha !
    I'm so excited. Finally made it into Davy Do's pictures.

  • Mar 20

    Wrongway Regional Medical Center has a beautiful chapel. It is known as GPS

  • Feb 28

    Quote from Farawyn
    Again, I don't get this "legit" psych patient stuff.
    Humor me, and please explain the difference between a homeless guy with a hot urine and a court date as opposed to a "legit" psych patient.
    Far, as a former school nurse, this may help...

    You know the difference between the student who comes to you for a headache because they were cutting class and want a note to avoid an unexcused late/absent and a student who has 103 fever and is upset that he is being sent home?

    So I think that it is similar to the frustration we feel when a patient knows the magic words to be admitted in order to avoid being arrested or even a fight at home.

    I think that both can be seen in psych/mental illness. The difference is that inpatient psych admission is really for acute stabilization and safety. If someone has a need for treatment, I'm all for IOP/outpatient/group therapy/job coaching/ACT team etc. However, these patients are being admitted to psych because they say the magic S word even though all we can do for them is 3 hits and a cot.

  • Jan 29

    Quote from Meriwhen
    I spend a lot of time in the ED doing psych consults, and I find that the ED's definition of "medically stable" varies depending on how badly they want a patient out of their hair.
    I would totally agree. I recently had a patient admitted for anxiety and depression. EKG showed an acute MI.

  • Jan 16

    Quote from TheCommuter
    Reality orientation for very demented patients does not work. If the 89-year-old lady thinks it is 1988, and her long-deceased husband is still alive, and Ronald Reagan is the president, it is better to allow her to think these things.

    Telling her it is 2016, and her husband's been dead since 1995, and Ronald Reagan's been dead since 2004 is unlikely to be therapeutic or go very well.
    And this is the reason that I have "delivered babies", "called the sitter" and "let the dog out" for my dementia patients.

  • Dec 21 '16

    I think that it is unlikely that anyone be equipped to answer this poll objectively. In order to do so, the same person would have had to attend both programs in totality. Also, this person could not have failed one and transferred to the other. I can say that having graduated City Tech I am retrospectively happy with the quality of education that I received, but I cannot speak to a comparison.

  • Nov 25 '16

    I was watching old episodes of Scrubs, which is awesome if you ignore anything medical. So much to write about, but my favorite is that JD keeps his car door in the radiology/MRI room.

  • Sep 17 '16

    I would probably say that it is a great thing to have. Just make sure that you have a protocol that allows you to use it in an emergency even without a patient specific order.

  • Aug 8 '16

    Quote from Farawyn
    Again, I don't get this "legit" psych patient stuff.
    Humor me, and please explain the difference between a homeless guy with a hot urine and a court date as opposed to a "legit" psych patient.
    Far, as a former school nurse, this may help...

    You know the difference between the student who comes to you for a headache because they were cutting class and want a note to avoid an unexcused late/absent and a student who has 103 fever and is upset that he is being sent home?

    So I think that it is similar to the frustration we feel when a patient knows the magic words to be admitted in order to avoid being arrested or even a fight at home.

    I think that both can be seen in psych/mental illness. The difference is that inpatient psych admission is really for acute stabilization and safety. If someone has a need for treatment, I'm all for IOP/outpatient/group therapy/job coaching/ACT team etc. However, these patients are being admitted to psych because they say the magic S word even though all we can do for them is 3 hits and a cot.


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