More questions.......

Mashira · Mar 21, 2011

In my experience, the warning signs are generally staring you in the face. If they say, move or I'm going to hit you.... move. They mean it. Be polite and caring, it's too often that people believe that because someone is 'insane' they have no awareness of etiquette. They do, and they respond well to caring kind individuals that are setting limits for their benefit as opposed to rude staff that seem to be taking rights away for no reason.

Enjoy yourself! Working in Psych is one of the best places to make a real difference in my opinion. Make your patients feel safe, cared for, and ready to take steps towards better mental health and a happier future. Just because State is usually the end of the road, does NOT mean it has to be, or always is.

Some patients may never be 'cured' but that doesn't mean we don't take steps to help them reach the highest level of functioning they can possibly have. You'll do great, we're all rooting for ya!

Davey Do · Mar 21, 2011

blakese:

Mashira gave a pretty good general statement on the Patient population. It would be difficult to relay ALL of the necessary information but Mashira hit on the high notes.

One of the best orientations I've ever had was at a State Operated Facility. I felt very comfortable by the time I was released solo.

Since Mashira took care of the Patient business, I'd like to hit on my perspective of how State Operated Facilities are run.

In a nutshell: Like every other Government Run Business. Penny Wise and Dollar Dumb. Fix what's Not Broken and have an attitude of "Problem, Heal Thyself" or Else. If you're In with the In Crowd, you will be Out with the Exiting Crowd. There's seems to be a tendency to put Personalities before Principles with many of the Administrative Staff. And the Paperwork Runneth Over. And over. And over.

I spologize if I am being Negative. I don't mean to Rain on your Parade. But, it's like Marty Seligman said in his book, Learned Optimism, "If you want a positive viewpoint, talk to an optimist. If you want a realistic viewpoint, talk to a pessimist".

The very best to you.

Dave

ImThatGuy, BSN, RN · Mar 21, 2011

blakese:
Mashira gave a pretty good general statement on the Patient population. It would be difficult to relay ALL of the necessary information but Mashira hit on the high notes.
One of the best orientations I've ever had was at a State Operated Facility. I felt very comfortable by the time I was released solo.
Since Mashira took care of the Patient business, I'd like to hit on my perspective of how State Operated Facilities are run.
In a nutshell: Like every other Government Run Business. Penny Wise and Dollar Dumb. Fix what's Not Broken and have an attitude of "Problem, Heal Thyself" or Else. If you're In with the In Crowd, you will be Out with the Exiting Crowd. There's seems to be a tendency to put Personalities before Principles with many of the Administrative Staff. And the Paperwork Runneth Over. And over. And over.
I spologize if I am being Negative. I don't mean to Rain on your Parade. But, it's like Marty Seligman said in his book, Learned Optimism, "If you want a positive viewpoint, talk to an optimist. If you want a realistic viewpoint, talk to a pessimist".
The very best to you.
Dave

Davey hit it regarding state administration. I was often told I was too negative, but I was quick to tell my higher ups to get out of their office and come with me. Articulation and justification didn't accomplish anything. I improved my respective areas by being such a nuissance they gave me what I wanted to shut me up. Anyway, I'd work for the state again. I'd like to after nursing school. I want to continue my state retirement plan.

blakese · Mar 22, 2011

Thanks everyone. Actually I hadn't really thought of the State as the last resort. These days it seems like there are less and less programs offered. Sometimes it almost seems primary care. Thanks Marisha for the "straight-forward" advice. I can see myself wondering what they mean by "MOVE", and getting knocked out while I am thinking. LOL!!!!!! As for the paperwork stuff it's pretty bad everywhere at this point. I can hang. I am so looking forward to this. I will keep you updated and pick your brains as I go if it is okay with y'all. Have a good one!

NPvampire, MSN, RN, APRN · Mar 22, 2011

LOL Penny wise and dollar dumb. That's definitely the case. That post is a riot.

Yes, most warning signs will be faintly obvious. I try to keep everyone literally at arm's length for safety. I also don't tell the patients anything about my personal life. I hate it that both of our names are on our badges.

I would like to add: (at least TRY) to make friends or civil acquaintance with your techs/MHA/whatever because they are on the floor the most and know the patients the best. Many times they will be able to predict the patients' behavior long before the doctor or nurse mgr comes slinking out of their office AFTER the unit is torn up to bits.

The state, in my experience, can be the best or worst job you've ever had, and each state facility is not equal. I about cry every night over one of the ones that was closed down, and I've worked at others that make me want to spit nails. It all depends, as Dave said, on the administrators and how they handle or perceive problems...or just plain old make problems up out of nothing.

chevyv, BSN, RN · Mar 22, 2011

I agree with above posters regarding if a pt tells you they are going to hit you, you best believe it. I may not see the signs, but I've learned to listen to my gut. I work County and I love it!

blakese · Mar 23, 2011

So what did you all expect and never experience or never expected and it happened?

Mashira · Mar 28, 2011

Had an older male pt. last night (I work 11p to 7a) walk out of his room and down the hall stark naked screaming, "LOOK AT THE SNOWBALLS!" :lol2:

TheOldGuy · Mar 28, 2011

I hope you contacted the admitting for a referral to an opthamologist - floaters might seem like snowballs - which is one of the signs of retinal detachment - the fact that he is older increases his risk.

Mashira · Mar 29, 2011

Hm... perhaps I should have added he was pointing to his genitals? It thought it was easily assumed. Or you are being sarcastic... and I didn't catch on

TheOldGuy · Mar 30, 2011

LOL pointing to his genitals puts a different "rub" on things....!

I actually was expressing a little concern initially - having seen retinal detachment in the ER and how quickly vision can be lost.....