ACT team as a new nurse.

[ccoombs]

Hello, I graduate in less than a month with a BSN and I have a prior degree in Sociology. The director of nursing for the local ACT program has been pretty active in trying to recruit me. The job seems very appealing (great hours, no nights, weekends, or holidays unless on call, work at your own pace, independence, better drive etc.) but I have heard from a few people that it would be a good idea to gain a few years experience on an inpatient unit prior to moving to community. I've been doing my senior capstone clinical at the state hospital, working with highly acute patients and a high census. some days practically running the unit on my own because the RN would be so busy with the 23 hour unit. so I do have that as experience. Also I took an additional class in psychopharm, so I have a good knowledge of psychotropics. I'm kind of torn at this point. Thanks in advance for any direction.

[Davey Do]

Hi ccoombs.

I guess when you say "ACT", that stands for Assertive Community Treatment, which is a program of transitioning instutionalized psych Patients into the community?

If so, your background is, at the very least, adequate. You are probably well aware of this population's behavior and movements, so Inpatient experience isn't a necessity. A good, sound working knowledege of diagnosis and pharmacology is a must. But it sounds like you've got those bases covered.

I was on an ACT Team back in the late 90's as the Communty Nurse. My responsibilities changed as the program evolved, but they were mainly focused on the medicine compliance/medical aspects of the Clients. It was an exciting and rewarding position, like being a Home Health Nurse for psychiatric Patients.

Good luck to you in your new position.

Dave

[ccoombs]

Thanks for the response Dave. I'm supposed to interview next week, so I'll see what they have to offer. I have another offer to work the unit that I am precepting on, I love it there and my preceptorship would make for an excellent orientation. The downside is that the drive is 50 minutes, and the nurses work every other weekend leaving little time for my family... but I know that's often the life of a nurse.

[gnursjr2]

Be Careful:

I was recruited for an ACT program. They neglected to tell me that I would be going out on crisis "on call" by myself in the middle of the night, into a dangerous, gang/drug infested community if a client called. I was thrown into dangerous situations by myself with very little training. Many of the clients I would pack meds and deliver them to their places of living were actively using Meth, THC, ETOH, etc, you never knew what you'd be walking into. I felt my license was in jeopardy d/t the clients using street drugs in addition to the psychotropics we were delivering to them. I did have one client who was very high functioning Bi-Polar lady, it was great for her. Being on call sucks, you have to sleep with the cell phone on your pillow all night. I do think we helped a very small amount of clients, but the majority NO!

I went back to Psych inpatient, and have not looked back. Its the best fit for me. I recommend doing inpatient as a new grad especially. If you do the ACT first, you'll never have that "inpatient" everyone is looking for.

I know this will sound negative, but its the truth, my experience first hand with ACT and the whole new grad thing. Hope I've helped a little bit.

[Davey Do]

I was recruited for an ACT program. They neglected to tell me that I would be going out on crisis "on call" by myself in the middle of the night, into a dangerous, gang/drug infested community if a client called.

I don't blame you, gnursjr, for not continuing to work in a program that required you to put your welfare in jeopardy. I could not cite a circumstance that would require a Team Member's need to put themself in such a dangerous situation.

Transitioning previously institutionalized Patients into the community does not mean that we took the place of the Police or EMS. For example, if a situation requiring an intervention occurred while I was on call, I would merely advise housing Staff and/or Clients on actions they needed to take.

If I did go into potentially dangerous situation, I had the Police department's support. This supportive plan with the Police department was set up before the ACT Program went into effect.

This is an interesting discussion. Thank you.

Dave

[ccoombs]

The interview went pretty well. The job has a pretty extensive orientation and an on call week once a month. Initially I worried about the breadth of experiences that the job would provide to me as a new nurse but it sounds like their nurses do a lot of different stuff. Overall I left with a pretty positive impression.

[ccoombs]

Never heard back regarding the the ACT position but I was offered an inpatient position on the unit where I did my preceptorship. They were willing to hire me as a tech until i am licensed at which point they will flip me to the nurse role. I actually like the idea of working as a tech for a bit since I will be supervising and delegating to people in that position. Also it will be nice to work :)