Nursing for dummies

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Obviously the title is meant to be tongue-in-cheek...

But I'm a new grad psych nurse. I just started my first job (it's PSYCH, keep in mind please) and am having some major anxiety and the cause is my lack of medical knowledge.

It took me almost 1.5 years to land a job, and I wanted to be in psych. By the time I started, I had lost a ton of my medical knowledge from school. I understand that it's my responsibility to keep my knowledge up, but I'm unsure of how to go about it right now.

Basically, I feel as if I learned nothing in school. I have recently had to refresh myself on some pretty basic stuff, and I'm feeling very unconfident in my knowledge.

I'm wondering how the best way to really refresh myself is at this point. Just randomly looking up info as I come across something I don't know doesn't seem to be cutting it - I feel as if I need to start over...

Do I do a nurse refresher course? Enroll in A&P again and just audit the course? I realize I can do a lot on my own, but I would almost prefer to enroll in something. If I do it on my own, does anyone know any great resources?

I hope this doesn't come across as irresponsible - I understand new nurses often feel clueless, but I truly believe I need to do more than your typical new grad here. The psych hospital does minimal medical care, so I am unlikely to learn much on the job.

I wouldn't bother getting too wrapped up in the DSM. Not too many clinicians/psychiatrists spend much time looking at it. They know the disorders and use that knowledge to Dx. It might be on their shelf but they really don't do much with it.

Also, the PRITE won't start testing for the full DSM-5 until 2015. The boards will be testing on DSM-IV TR criteria into 2017.

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I got my job right away, but still felt inadequate. I keep my psych textbook open & read, re-read & read again the chapters that applied to the patients I have. Same with my med-surge book, because with psych, you will get LOTS of people with medical conditions that require close monitoring. Increased ammonia levels, UTI, HIV, Hep.C, lice, scabies, MRSA wounds, thyroid disorders, Lithium levels & intoxication, EPS symptoms from psych drugs, seizures, etc. all play a big part on the acute psych care unit. Get to know your assessment terms -- I'm still looking at my handout at least 1x/wk to make sure I am using terminology correctly.

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I'm going to suggest a different direction. Talk with your patients,learn about psychosis from them . Theory can be interesting and can be helpful at times. On the other hand I'm interested in history and am aware of the really bad ideas that passed as knowledge. That we now see the light and are right,possible but I reserve a bit of skeptism . Also read, almost any good sorce can be useful.

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You can look at it from the patient perspective. What are my drug options? Can I drink with that medication? This medication isn't working what else can I take. It's working, but I've gotten really tired. Then there is the psychology, think about what might have triggered things like schizophrenia type disorders, BPD, bi polar etc. Was this person a victim of rape, trauma, poverty, etc.? Maybe they even want to talk about it. What does a delusion offer someone? Is it a warm teddy bear kinda delusion or is it the demons are going to take me straight to hell kinda of delusion? Most importantly, and here in lies the rub, nobody wants to be crazy and few enjoy admitting it. How do you propose to get someone to stay on their medication? Sure they'll eventually get discharged one way or another, but if you want to, and I expect you should, care about the patients, try to win them over in the long run.

So for a run down.... let's say you've got a schizoaffective patient with diabetes. He wants to take medication x but can't because of the possible blood sugar effects. Why should he take what he's on? Sell them on the drug. Say something to the effect, oh don't worry, I see a lot of patients really like being on Abilify. Be careful not to say something like "make a lot of progress". Chances are they aren't in a psych ward because they want to make progress.

Let's say Mr. Schizoaffective thinks they are the best inventor of all time. No need to burst their bubble on that one, let them figure it out on their own. They might think that people are outside trying to get in to make a TV news program about them. That's the kind of delusion of persecution that you'd want to attempt to correct.

There are also subtle differences between shivering and uncontrollable movements, some drugs make it hard to keep your body temperature constant. The list goes on and on. It doesn't have to be difficult, try getting into wiki and drugs. Learn to count to ten if you're getting flustered because being calm yourself is important for calming someone else down. At any rate I hope that helps a little. I'm not a true wealth of knowledge and sadly am only a student to be, but I love psych. I think of comparing psych drugs as a hobby. Something about it turns me on. Maybe it's all the people I know with a psychiatric condition. Good luck!

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You can look at it from the patient perspective. What are my drug options? Can I drink with that medication? This medication isn't working what else can I take. It's working, but I've gotten really tired. Then there is the psychology, think about what might have triggered things like schizophrenia type disorders, BPD, bi polar etc. Was this person a victim of rape, trauma, poverty, etc.? Maybe they even want to talk about it. What does a delusion offer someone? Is it a warm teddy bear kinda delusion or is it the demons are going to take me straight to hell kinda of delusion? Most importantly, and here in lies the rub, nobody wants to be crazy and few enjoy admitting it. How do you propose to get someone to stay on their medication? Sure they'll eventually get discharged one way or another, but if you want to, and I expect you should, care about the patients, try to win them over in the long run.

So for a run down.... let's say you've got a schizoaffective patient with diabetes. He wants to take medication x but can't because of the possible blood sugar effects. Why should he take what he's on? Sell them on the drug. Say something to the effect, oh don't worry, I see a lot of patients really like being on Abilify. Be careful not to say something like "make a lot of progress". Chances are they aren't in a psych ward because they want to make progress.

Let's say Mr. Schizoaffective thinks they are the best inventor of all time. No need to burst their bubble on that one, let them figure it out on their own. They might think that people are outside trying to get in to make a TV news program about them. That's the kind of delusion of persecution that you'd want to attempt to correct.

There are also subtle differences between shivering and uncontrollable movements, some drugs make it hard to keep your body temperature constant. The list goes on and on. It doesn't have to be difficult, try getting into wiki and drugs. Learn to count to ten if you're getting flustered because being calm yourself is important for calming someone else down. At any rate I hope that helps a little. I'm not a true wealth of knowledge and sadly am only a student to be, but I love psych. I think of comparing psych drugs as a hobby. Something about it turns me on. Maybe it's all the people I know with a psychiatric condition. Good luck!

Some

Some great replies in this thread but this one was awesome! From a student nonetheless!

Thanks a lot for taking the time - you really have a good head on your shoulders. I will definitely take this advice to heart.

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