cherubhipster 6,810 Views
Joined: Nov 29, '07;
Posts: 197 (16% Liked)
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I love what I do. I'm helping a population that is frequently stigmatized and written off both by healthcare organizations and society in general. I feel like I'm making a difference. Granted, it's sometimes hard to see that difference, or that difference may be long in coming...
I'm also lucky to be working in a very supportive environment and for an organization that takes mental health and psychiatric nursing seriously.
I'd agree with what Meriwhen wrote. I found it especially nice that there was more time to spend with the patients during evening shifts than during daytime shifts. That's when I could made a difference by interacting with them as a human being rather than as the pill-pusher and paperwork-doer.
I don't know much about psych nursing but I've just started training in the OR and I can say it's a lot to learn and really does take a year or so to be comfortable at it. If you are looking for advancement in the OR you can choose to become certified in a specialty, become a first assistant, or even NP that assists the surgeon in surgery. Of course you can always go the management route too. I can say from my experience coming from med-surg, I absolutely love the OR. The things you get to see are amazing. I'd say the only drawback you will find will be dealing with difficult personalities, and that can be anyone from the team including fellow nurses. You definitely can't be a pushover. Of course you can say that about any nursing job you get too. Hope this helps.
Wow - talk about opposite ends of the nursing spectrum! I think you need to ask yourself whether you'd be happier in a very structured & rule-bound environment (OR) or one that is really ambiguous (psych). That is not a negative opinion on either area.
I really appreciate the attention to details & adherence to established practice that characterizes perioperative nursing. I certainly don't want anyone getting 'creative' with my choley, would you? I love the technology associated with OR as well as the cool factor of seeing anatomy up close and personal. The biggest downside for me was having to work that closely with egotistical surgeons.. srsly. I never could get into psych -- hey, I had a hard time differentiating the patients from the staff unless I looked for the wristbands
Probably, the deciding factor should be where you want to go in the future. OR nurses are highly prized, particularly if you are qualified in specialty areas such as CV so this would increase your work options. Psych nursing is a bit more uncertain because of the unknown impact of health care reform on this area... less reimbursement will mean fewer hospitals. In my area, Psych NPs are employed in ambulatory and inpatient settings, but I don't think there is such a thing as a perioperative NP, so you would probably have to switch to another area for a while to get the clinical experience to qualify you for an NP program.
Best of Luck to you! Keep us posted on your decision.
1) Do you like working nights?
2) Was it hard to adjust at first?
3) Do you get enough sleep during the day and on your days off?
4) Do you still have time to spend with your family and friends?
1. LOVE working the night shift. No management and for the most part co-workers are really laid back and fun. The only frustrating part about night shift are the few people who think it's okay to come to work and curl up and go to sleep for the bulk of their shift.
2. I'm a night owl, but I'll still admit that it's hard to adjust. It takes at least 3 months for the body to really get used to working nights.
3. I try to. It depends on what else I have going on. If I have school, appointments, things that pop up it's sometimes really hard.
4. Friends? Family? Whats that? When I am in school it's hard to do anything other than eat/sleep/work/go to school, but does that not happen to anyone who's going to school and working. Since I've had a couple of semesters off of school I've had a lot of time for friends and family. You just have to adjust times.
I agree with what Nurse LoveJOY88 posted.
I have been a nurse at an ALF on the dementia unit for over 4years. I love it most nights.
At the ALF I work at we give all our own meds. Unlicensed personal are not allowed to administer meds or treatments.
Good luck with your interview
Just emphasize your compassion and love for the residents. They love to hear that you are a team player, competent , and willing to grow.
They will probably ask you about a difficult situation and how you over came it.
I like ALF. I find myself able to do alot more teaching with residents that are Alert and oriented.
Good luck and keep us posted.
As far as the psych NP, if that subject comes up in your interview, you can spin it that you have or will receive training in Geri Psych. That way, you will be alert for any changes in the residents that might indicate cognitive or mental changes. Early detection can mean the person will get treatment earlier.
>>>>>>Just because you want to go into psych nursing doesn't mean you should<<<<<<<<
As a nursing student myself who has asked questions on this board i would say that for some people they may not know if they would or would not do some of the behaviors you mention, w/ out trying it out first & seeing? How could you really know for "SURE" as a student???
For example: I was a cosmetologist many moons ago and decided to go to school for E.M.T. & when I told people my plans they laughed literally in my face and said "you can't handle that your just a hairdresser!!! you'll faint at the first sight of blood, ya-da...HAHAHA". Well, I had some of my own doubts about it and definately didn't need anyone else to reinforce my fears.
well, that ticked me off to know end and i still did what i said i was going to do, worked on an ambulance, then in an E.R.. I never fainted & handled it quite well, even though other people didn't think I could do it & I wasn't "SURE" myself!
Soooo, now that i'm interested in psych, I feel that "same type" of judgemental attitude from some people.......
Do I know for "SURE" that I won't exibit any of those negative behaviors you mentioned??? No, because I'm not doing it & my psych clinical was only 5 weeks long. did I exibit any of those behaviors during my clinical....no....but does that mean I won't ever?....
My point- I don't think it's as cut and dry for students as you make it out to be? now, if you're already in the profession and are exibiting these behaviors, then that's another thread all together I think?
First of all my dad was not "the drunk" as so eloquently put. He was an alcoholic which we all as nurses know is a disease and that did greatly effect our family and my view of many things but he was a Good man with a big problem. He was the kind of man who would take the coat off his back and give it to the homeless man on the street with no questions asked. He tried to quit many times but the addiction was stronger than he was. He died in a rehab center trying yet again to stop. He also spent the last 3 years of his life volunteering in a soup kitchen 3 days a wk. So he was FAR MORE than "the drunk".
Second my mother is an amazing woman who has worked hard her entire life. She was and is a good mother. When she met my dad and they married he did not drink. He started drinking years after they married and immediately after my grandfathers death. Marriage vows include "till death do us part", that doesn't mean till I get tired of you or you don't behave the way you should or you have a problem I don't want to deal with. She tried to stay with him and help him to get better. She wanted a happy family and she knew the man she married was in there somewhere. She also wanted us to have our father. She felt that a father who was sober 1-3 days a wk was better than no father at all.
As far as "moving on", I agree that was the past and this is now. I didn't mean for my post to sound like an excuse or whatever I just wondered if others having come from similar backgrounds had experienced the same issues as adults. Besides I think we are all in a way products of our experiences. To simply say that was then and this is now so move on leaves far too much out. Things in your past no matter who you are or what those things may be are what helps to create and mold you into the person you are and who you will become. Yes you can "overcome" bad things but that doesn't mean they don't still in some way effect you.
I attended alateen when I was growing up. I have considered formal counseling and maybe I will one day. I am working on self-esteem and will continue to work on it. Again I was interested in hearing if there were others out there who had come from similar backgrounds and if they felt it had an impact on their nursing careers and how they viewed themselves in thier jobs.
I certainly hope we all remember to be respectful and sensitive when discussing issues such as alcoholism etc with our pts/pts families or anyone else. People with problems such as alcoholism are still human beings who deserve love and compassion and so are their family members who stand by them and try to help them (not talking about enabling them). After all you can still love the person even if you don't like the behavior.
When I started in LTC as a new grad, I found there was a lot to remember, but once you got a routine down, you were golden!! Is your facility computerized? I'm sure that will make a huge difference in the documentation aspect. Mine was not, so I would keep my report sheet with me at all times. In report, ask the reporting nurse who needs pulse ox's done q shift, blood sugars, treatments, and how each resident takes their pills (i.e.: whole in applesauce, crushed, g tube, whole with nectar thick liquids, etc.)
Once I had my report, I would look through my ADL book and assign vitals, bowel assessments, etc to my CNA's. Usually you only chart on "skilled" pts or pts with acute problems that day. Use your discretion. Then I would do my blood sugars and start my med pass. While passing meds to each pt, do a very quick assessment: "how are you feeling today? Any pain? Quick look at the whole pt". Med passes take several hours in LTC so try not to get off track! Delegation to your CNA's is key!!!! They are your life savers!
After first med pass, start treatments- wound care, dressings, designate creams to CNA's if possible because you won't have time and they are more likely to apply it when they do basic care!
Also, before I forget- make a list of what you need to report to the MD for that shift. My MD would only call once a shift so you had to relay all info to him at that time and he was not happy if you had to call him back! Write down on a piece of paper, or highlight on your report sheet what you need to tell him that day- for labs write the previous few labs so he gets an overview and trend...
I hope this helps! I enjoyed LTC and it is challenging!!! I'm just starting orientation on a critical car unit now and its so different! I'm nervous! But LTC has definitely helped in my managerial, time management skills!!! Good luck!!
I have been in LTC for 15 years and still use my "cheat sheet" every time, make a functional one and it will be your lifeline! Here are a few things that I find helpful... first make it short and sweet. One page with a list of all residents is preferable so everyone is available at a glance. Simple check off spots for med passes and treatments, most LTC facilities have huge MARS/TARS so I check off on my sheet as tasks are completed so I know I didn't miss anybody. A blank space after your simple check marks for daily notes i.e. who needs vitals this shift, who needs to be charted on, any appointments, changes in condition to track, new orders etc. This blank line can also be used to note any oddball med times so they aren't missed. An area for accuchecks, insulins, carb counts for your diabetics is a must. Especially on a day shift when tracking down a resident to get that blood glucose before they eat can be a challenge...just jot the results on your cheat sheet as you go along and you will save a ton of time. That's pretty much it for the front page, if you try to put too much on there it's difficult to read and stops being a useful tool. On the backside of my paper I have a three simple sections: one to note VS, one to remind myself of any phone calls I need to make/return and one to jot messages to myself as the day goes on. Very useful when you get a Dr call away from your desk and the residents chart, it is easy to note any verbal orders on your cheat sheet and transcribe them when you can get back to your desk. You will want to customize your cheat sheet to the shift you are working, I typically work nights but do work occasional days so I keep a cheat sheet on my computer at work for both shifts as their tasks are much different. Play around with the format until you find what works best for you.
I hope this helps a little, and if you have any questions feel free to email me! And good luck with the job, I hope you find you love it!!
This seems to be a new trend since the hospitals are not hiring us! I was hired as a charge nurse.... what about you guys? Tell me your experiences as a new grad R.N. in a nursing home!
Personally, I would look on it as a guarantee of work for two years and go ahead and go for it. You realize that you are in the rare position of even having a job offer at this point. I would take the job and worry about any ramifications afterward. And look for the best in the job. Amazing how content you will feel when that check goes to the bank each pay period and you think about your friends who are still trying to find a job. Good luck.
While I agree that I would be v. reluctant to sign a contract committing me to a particular facility for a specific minimum amount of time, I can also sympathize with employers who feel that they are tired of getting screwed over by people who take a job and then leave after a short period of time. And, reportedly, new grads have been doing more of this in recent years than ever before. I can recall when the standard length of time with a single employer to avoid the "jobhopper" label was at least two years -- now, people think a single year is plenty and a surprising (to me, at least ) number of people post here about going through three or four jobs in their first year or so of nursing. (My current employer has hired four new grads within the last year, and three of them are already gone ...) Employers are tired of paying the extra expense of orienting new grads just to have them leave, and more and more healthcare facilities are either asking new grads to sign contracts or simply declining to hire new grads. Which do you prefer?? (Being asked to sign a contract, or just not being considered for employment, period, because you're a new grad?) This was starting to happen even before the economy tanked, although the bad economy has made the situation worse. These days, it's definitely a "buyer's market" in nursing employment and employers can pretty much set whatever conditions and requirements they like (as long as they're not violating federal or state employment law) -- and I doubt things are going to get better any time soon.
Thank you for this. I know this is a little off topic, but as an Employee Health nurse that deals with all the new hires campus wide, it amazes me how so many of the "younger" set work for a few weeks and then leave. (this is in all departments, not just nursing)
Like elkpark stated above, it is EXPENSIVE to orient new employees. Disregard the actual training you will receive in your department....instead, think about the cost of a drug screen, back screen, immunizations, name badges, X-rays, etc. that's needed before you even sit down in your general orientation class. We also give out backpacks, free meals, snacks, etc to all new employees. So, as you can see, it can get quite costly just to get you in the building. So I can completely understand employers going to contracts.
Back to the topic at hand, sit down with HR and ask them any questions you have. If they can't answer them, then chances are it's not something they're going to follow up on. It seems to me to be a weak attempt to get people to stay.
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