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puravidaLV, BSN 7,841 Views

Joined: Feb 8, '10; Posts: 408 (26% Liked) ; Likes: 216

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  • Sep 28 '14

    RD can write diet and some vitamin orders. They cannot write other orders no matter what state.

  • Sep 28 '14

    are you saying the dietician wrote an activity order that restricted the patient freedom of movement? What was the infections condition?

  • Sep 28 '14

    So my best guess is it's a question about whether it's in her scope of practice to write what she wrote as an order. It seems that the order pertains to a skin issue and being restricted to the unit from what I gathered. The answer to that would be no in my opinion. Her education and scope does not give her the right to give orders concerning these issues. She can collaborate with the physician - persuade him to give the order. (I am wondering if perhaps it's food allergy related and that's what led to the order, understand if you can't elaborate.) At any rate, look up your state practice act. In Pa dieticians are actually regulated by the board of nursing. If you don't find it in the legislation you can try directing it to the agency in your state that regulates them. And I would also question the patient's physician. If the MD supports the dietician's order, then it will obviously stand. Good luck.

  • Sep 26 '14

    look at the product which would be the transpersonal relationships, oooorrrr the component ARE the carative factors which looks at humanizing and reflection of caring.
    You did....LOL

  • Sep 25 '14

    I'm from the coast originally (now live in MN) and have many friends in the Portland area. I love it, though the population is booming and housing is getting much more expensive when it used to be quite affordable. That's absolutely the only downside I can think of haha. Traffic is also getting hairy but there is very good public transportation so if you're near a MAX you're golden. If I lived right in Portland I'm not even sure I'd bother with having a car.

    It barely snows. It is humid and wet in the winter so the 40-50 temps feel colder than one would think. Ice is more of a concern than snow.

    Not sure about jobs there, I'd imagine they're getting a bit tougher to find with everybody and their dog (or chickens!) moving in, but then that would mean more healthcare staff are needed too

  • Sep 24 '14
  • Sep 24 '14

    I'm sorry. You're right -- it is 10 carative factors, not 14. And I should have said "caritas processes" instead. I was in a hurry when I wrote my previous response.

    Your 2nd post above is consistent with what I said about the 4 meta-paradigm concepts (health, person, nursing, and environment). Those 4 concepts were not key concepts in her theory. Someone else -- the author of whatever you were reading -- was using those 4 concepts to help analyze Watson's theory. That author concluded that Watson only defined 3 of those concepts, not all 4.

    The second article you discuss in your post is talking about the theory and different concepts discussed within Watson's Theory. That author is not just focusing on the 4 meta-paradigm concepts of person, health, environment, and nursing -- but rather is identifying all of the concepts discussed by Watson.

    Author #1 is asking: Did Watson talk about the 4 concepts in nursing's meta-paradigm?

    Author #2 is asking: What are the major concepts that Watson discussed?

    Do you see? The 2 authors are looking at the theory from 2 very different angles.

  • Sep 23 '14

    I haven't read much of her work, but what I've seen so far looks like the ravings of a schizophrenic. It looks like she rejects the medical model completely and believes in telepathy and mind reading over distances, and unmeasurable electromagnetic fields that are created when nurses care about their patients.

    What is a "mindbodyspirit" and what am I supposed to do with it? Does she even believe in germ theory?

    I'm having a hard time believing that this is taken seriously in graduate level classes.

  • Sep 11 '14

    Robin Williams made it public what he was dealing with. Healthcare personnel that he had access know that people use different ways to cope.

    When i first became a psych nurse we prided ourselves on including support systems in tx. We educated people about the roller coaster ride that goes along with treating mh conditions( i use conditions personally to help decrease the stigma attached when we referr to mental illness bc of what it conjures up) and of course a lot of folks are dealing with things and they dont have labels. But people that are upfront with their conditions is a gift to providers or support systems bc it is like a stop sign(the potential of suicide or other self harm is ALWAYS there regardless if they speak about it.
    Good education is imperative that looks can be deceiving. And most times those suffering want someone to address their pain. I have found mh profes sionals afraid to approach the subject bc they are uncomfortable with the answers, or fear feeling helpless (WE CAN NOT RISK NOT ADDRESSING THINGS BC WE ARE UNCOMFORTABLE) .

    If we can remember that we don't have the power to fix, but we have the power to be fully present. It is no guarantee, but t s an opportunity to help people weather the storm and arm them with tools and education that the storm will come again and we can get through. The problem with mh conditions I think is unrealistic expectations. Some conditions are acute and can be resolved others are chronic and transitory. We have to help people and their support systems understand this and provide a safety net.
    Anyone dealing with mh issues needs crisis planinng and it needs to be out there for the support systems to know.
    Good luck on your journey as a psych nurse. If you facility short changes you in the ducation dept bc most plces have gone to just a crisis model, no precetorship and extended care no longer exist unless it is s facility for those with unlimited financial resources.
    I would encorage you to provide youself with opportunities ie seminars, ceu classes any other resources to truly understand conditions treatment cultural aspects if you feel this is an area that you want to be.
    Please dont feel offended when i describe nw age nursing as running to escape the perils of med-surg nursing bc people deserve providers to take the area sriously. This trend has been there for th last 10-15yrs when insurance changed bc of long stays ,pts were more ill, doctors became hospitalists and so on. So nurses ran to psych to gt a reprieve thinking it was very esy, s ll you had to do eas talk. Thy had no skills bc hospitals decided that they coul f cut education drastically and do aeay with millieu theapy and reatment modalities, and it became a nightmare for pts and d support systems.
    I left psych when this occurred bc i eas trained under a different model and sa the devastation of pts not getting needs met. I changed to counseling and education bc i could still practice to meet people's needs ather than continue to practice in broken systems that there was no desire to fix.

  • Aug 6 '14

    Lots of green in the Portland area and lots of rain to keep it green. Snow and skiing on Mt. Hood. Nice clean water from Mt. Hood melt-off. About two hours from the beach. Lots of culture, arts and diversity. Lots of environmentalists, and health conscious people. I heard it's one of the most livable large city. It has some excellent schools, others not so much. Excellent variety of restaurants and shopping. More parks than most big cities. You need to look into which part of Portland or metro area you live. Some areas aren't very safe. Other parts are much better. LOTS of traffic. Good bus system.

    I lived there 35 years and then escaped to a small coastal town. I hated the crowds and traffic and love my sleepy little town.

    If you were a hospital nurse, I would recommend St. Vincent for employment. I have relatives who work there. For a mental health NP, I would have no idea what to recommend.

  • Jul 18 '14

    Today I was nervous as ever as I prepared to take the PMHNP exam. I studied really hard from the ANCC book, Kaplan and Saddock Exam Review Guide and briefly Barkley (borrowed from a friend). The exam was strange. It was truly comprehensive and looked at all aspects of nursing. Be open minded and relax, you will be successful as well.

  • Jul 10 '14

    The most important piece of advice is to stay calm. Take breaks when you need to. Be okay with the fact that it least 25-50 the questions you will not know the answer to. That's okay. The test itself is rather vague and wide and topic. What we study for is in a way not really on the test. But somehow the studying gives you what you what you need answer. I will not say this is an easy test because it is not. But the test is doable. I passed. Good luck!

  • Apr 23 '14

    I passed! This is the best feeling in the world!
    I just took the ANCC exam for Psych NP and here are my thoughts on how to pass this test. I would like to reiterate that this information is from MY experience and may not be reflective of others who have taken and passed this exam.

    I studied for 8 weeks using the Fitzgerald Review. I continued to work full time (3-12hr shifts). In hindsight 4-6weeks is probably good enough and I was scheduled to take my exam at the 6 week mark but then I got nervous and rescheduled.

    Review Materials
    I purchased the Fitzgerald Review, the ANCC Psych NP book, the ANCC Psych NP practice questions, the ANCC test taking skills, and the questions. All of them helped in different ways but ALL of them are not necessary to pass.

    • The Fitzgerald Review was a great overview of the is through and detailed
    • The ANCC Psych NP book is the nuts and bolts of the psychiatric nursing.
    • The ANCC Psych NP practice questions. These questions are expensive but worth it. This exam is more of a reflection of test taking skills than material. In other words the test questions aren't hard but you have to apply the knowledge and pick the best right answer.The ANCC website has free practice questions and if you can't afford the $109, do the practice least 2 of my tests came from the free practice questions.
    • ANCC test taking skills $30. So basic. So worth it. There are 200 questions, you are bound to lose concentration/focus...this overview refreshes your memory on how to answer questions, what to do if you lose concentration, what do to if you are stuck between two questions, etc. Is this information a game changer? No, it's information that has already been out there and may be in some review books but as I was taking the test I could hear the narrators voice in my head when trying to decide between 2 answer choices.
    • The questions are nothing like the exam but it will help you go over topics more obscure topics like ethics, communication, negligence, etc. I ended up buying the 10 pack of questions...really you only need about 3-5 after test 6 the questions just got sloppy and unrealistic.

    If I had to pick all over and I was short on cash, I would pick the ANCC Psych NP book for a review and the questions. I would also see if my college library has the Kaplan and Sadock Comprehensive Review, Deja Review Psychiatry, Case Files Psychiatry for practice questions. The questions from these books are unlike the questions on the exam but if you can answer them you know the material.

    Setting up a Study Program
    Decide each week what you are going to go over and put it in your calendar as an "event" so a reminder pops up on your phone. Review a new topic or two for a few days then rehearse/review then go on to a new topic. If you are feeling overwhelmed about how you are going to remember everything... check out Remember everything you want and manage the rest by Helmut Sachs. This book is excellent in teaching you how to think about material so you can recall it whenever you need it.

    Actual Test
    This is a test of your applied knowledge. A lot of short scenarios where you have to know the information about medications for disorders, medication interactions (think inducers of CYP450), ethics, therapeutic communication (lots of questions on this) also as jamonit '13 stated in their post topics included "cohort observational studies, beneficence, sensitivity/specificity, Prochaska's, independent variables, and ethics/cultural questions." You have to know some basics of other conditions like thyroid disease, elevated lab values for a cardiac condition or autoimmune disease (think common diseases occur commonly). The test will ask you questions less like "A person comes into your office and hasn't sleep in three days, has a lot of energy, and has just spend $10K on antique postage stamps does this person has bipolar 1, bipolar 2, cyclothymia, dysthymia". Go to the ANCC website for practice questions...they are the real deal.

    In hindsight I could have taken this test at the 4 week mark because it really was more about applied knowledge. But I walked in very confident that I had done/reviewed everything I could and that was half of the mental battle.

    Mental Health While Studying/Taking the Exam
    When I first started studying I thought, "man how am I going to remember all of this information" but week by week I was retaining the information. As my confidence grew so did my belief that I could pass this exam. I never held on to thoughts that I wouldn't pass..sure those thoughts crept up but I didn't entertain them. I'm also a big advocate of meditation/visualization; everyday I would meditate to reduce anxiety and to set my mind up to visualize a positive outcome. If you have never tried meditation, Oprah has a great FREE 21 day meditation experience with Deepak Chopra..its for beginners and it is great...go to her website. Also "Tapping" is a great way to alleviate stress...for more info on Tapping go to youtube or look up the Tapping Solution on

    Remember you can do this!! I hope this information helps.... I scoured this site looking for a concise understanding of what this test would be like and I found a few posts scattered here and there so I wanted to post this more comprehensive post for all of the upcoming grads! Good Luck!

  • Nov 7 '13

    Here is the list that I made of the schools with online programs whose traditional programs are approved by my state's BON. It include FNP, ANP, and ACNP programs.

    Case Western Reserve University, Cleveland, OH (ACNP, ANP, FNP)
    Clarkson College, Omaha, NE $477 (FNP)
    Concordia University Wisconsin, Mequon, WI $570 (FNP)
    Delta State University, Cleveland, MS $698 (FNP)
    Drexel University College of Nursing and Health Professions,
    Philadelphia, PA $770 (ACNP, FNP) $$
    East Carolina University, Greenville, NC $7175/semester (FNP)
    East Tennessee State University, Johnson City, TN (FNP)
    Frontier School of Midwifery and Family Nursing, Hyden, KY (FNP)
    Georgetown University, Washington, DC (ACNP, FNP)
    George Washington University, Washington, DC (ANP, FNP)
    Georgia Southern University, Statesboro, GA (FNP)
    Gonzaga University, Spokane, WA (FNP)
    Graceland University, Lamoni, IA and Independence, MO (FNP)
    Northern Kentucky University, Highland Heights, KY (ANP, FNP)
    Radford University, Radford, VA (FNP)
    Rutgers College of Nursing, Newark, NJ (FNP)
    Saint Louis University, St. Louis, MO (ACNP, ANP, FNP)
    Seton Hall University, South Orange, NJ (ACNP, ANP)
    SUNY at Stony Brook (Stony Brook University) (ANP, FNP)
    University of Arkansas for Medical Sciences College of Nursing,
    Texarkana, AR (FNP, ACNP)
    University of Cincinnati, Cincinnati, OH (ANP, FNP)
    University of Massachusetts (FNP, ANP, ACNP)
    University of Missouri, (FNP)
    University of Missouri-Kansas City, Kansas City, MO (formerly: Univ. of
    Missouri at Kansas City) (ANP)
    University of Nebraska Medical Center, Omaha, NE (ANP, ACNP)
    University of Pittsburgh, Pittsburgh, PA (ACNP, FNP)
    University of Rhode Island College of Nursing, Kingston, RI (FNP)
    University of South Alabama, Mobile, AL (ACNP, FNP)
    University of Southern Indiana, Evansville, IN (FNP, ACNP)
    University of Wisconsin at Madison? (ANP, FNP)
    Vanderbilt University, Nashville, TN (ACNP)
    Wright State University, Dayton, OH (FNP)

  • Aug 30 '13

    I love, love, love 12-hour shifts. Try to pry them from my cold fingers!

    As a bedside nurse, I simply do not want to see needy patients or their demanding family members five days per week. I do not want to see the faces of my managers or coworkers five days per week. I simply do not want to be at the workplace five days per week.

    I'd rather work a compressed schedule of three 12-hour shifts to have four days off per week. I also liked working two 16-hour weekend double shifts to get five days off in a row every week.

    But five 8-hour shifts per week at the bedside? That would be hell on earth for me. I wouldn't want to do it unless I was on the verge of homelessness.

    Quote from jdubs99
    I need to be able to exercise and take care of myself in order to be happy at work!
    I work 12-hour night shifts and take care of myself. In fact, I exercise five to seven days per week. After my shifts end in the morning, I head straight to the 24-hour gym for a workout.