Latest Comments by oceanblue52

oceanblue52, BSN, RN 5,134 Views

Joined: Mar 4, '13; Posts: 467 (51% Liked) ; Likes: 587
from US

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  • 1
    Wannabenurseneko likes this.

    Quote from pixierose
    ^^ This.

    I used to work inpatient Geri psych. There was a lot of medical, as there were a lot of comorbidities. Wound care, subQ/IM for both insulin and psych meds, PICC lines, TPN, J/G tubes, etc.

    Now I work (a lot of) per diem in a pediatric psych ED. It's a completely different world than the inpatient psych unit that I was on. It's "go go go!" as we often get children and adolescents coming in every few minutes. We need to get them wanded and get them through a clothing change process ASAP, as quite a few of them have been bringing in items that have been dangerous to their own safety (and ours), such as lighters and razor blades hidden in their bras or underwear. We have them shake their underitems while we hold a sheet for privacy in front of them; it's amazing what has dropped out ... it's heartbreaking.

    Then we interview them, assess for safety (all the time ... this never stops). Get them medically cleared so they can eat .. and then they wait to speak to a clinician. There has been a lot of restraints lately; that's been rough. And we've had a lot of patients coming in with threats of violence to their schools; that's been horrific.

    I think the one common theme you'll see: safety. Whether it's q15 or 1:1 ... safety is number 1.
    Very good summation. Would like to add my own anecdote with strip searching a patient, came in looking pretty put together. A colleague of mine had her remove her underwear and hundreds (literally) of pills came tumbling out, mostly benzos. She was a voluntary patient and still don't quite understand her rationale for coming in.

    The lesson being...never assume a patient is not hiding something. They are crafty. Have a few other stories but will save them for another time.

  • 1
    Oldmahubbard likes this.

    RN here that works in outpatient community health, and am interested in becoming an NP. Your statement about trying to cure psychosocial issues via medication is close to heart. Very difficult and takes a lot of skill for a provider to separate the issues and medicate accordingly.

    Some community health centers do really well with Care Coordination between therapists, case managers, navigation, benefit specialists, nurses, and providers, and crucial to managing this issue. New NPs should inquire about availability of these services before accepting a job.

  • 0

    Right? Sounds like my dream job.

  • 0

    If you are trying to transfer within your hospital, you will likely need 6 months experience before they approve a transfer. A word of warning, it can sometimes be difficult to transition back into acute care after working in Psych; managers tend to think you've "lost your skills." Dumb because those soft skills you gain in Psych are needed in any setting. But I digress.

    If you are truly miserable, and not just having new grad anxiety, I don't see why you can't apply for jobs more to your liking. Think carefully about what you liked about your Psych rotation. I worked 5 months home health as a new grad and then transitioned to a new one. If you apply and get offers, vet them carefully. If you leave this job early you'll want to stick around the second one at least a year, ideally 2 or 3 to show stability.

  • 0

    Former (non-nursing/medical) researcher here. Consult with the person heading the study, or another supervisor. They should be able to counsel you on the most appropriate action. Like working in a hospital/clinic, you are correct that it is inappropriate to work directly with them as you would have access to their medical records. Sometimes arrangements can be made to accommodate both you and participants.

  • 0

    How had the application process been for PMHNP? Thinking about applying in the Fall...

  • 0

    Perhaps this varies state to state. But I don't understand what a physical license is, and why you would need that to practice nursing. Once you have a number shouldn't you be good to practice? That is all that should be needed to verify that you are licensed.

  • 1
    ICUman likes this.

    Can you stick it out another 6 months? A solid 2 years in critical care with Charge RN responsibilities should give you a good foundation on which to market yourself. Are there things you enjoy about your job? What attracts you to Public Health? Every specialty has its stressors; self-assessment can help you avoid getting into another poor workplace environment. What about something like the OR/pre-op? Home health? Is there a specific population you enjoy?

  • 0

    Hard to say what specialty would be a good fit for you...I would recommend going on a comprehensive job search engine such as indeed and then search for various specialties you are interested in. This will give you an idea as to the market and qualifications they are looking for. When I get frustrated at my job I do this, it puts things in perspective and reminds me that the experience I'm gaining will open more doors down the road.

    Will also add that the Psych experience you are gaining is very valuable. I've been in Psych several years (through nursing school). My favorite clinical instructor liked to remind me that patients with Psychiatric issues exist in ALL specialities and are not just confined to a Psych hospital. It's a valuable experience and will serve you well, and might even help your job search. Good luck finishing the year out, will be over before you know it.

  • 1
    LovelyLocs likes this.

    I worked as a Tech in a Psych hospital for a few years and had to make a similar decision. Pharmacology has always fascinated me so that was one reason. Counseling as a field is also quite saturated (way worse than nursing) and the pay almost never commensurate with the education. It's also an arduous process to get licensed. Could argue the same about nursing, but saturation is typically less of an issue within the Psych specialty. Ultimately I feel like Psych nursing offers better pay and other opportunities if I grow tired of it.

  • 6

    It is very difficult, if not impossible to get vaccines waived. Typically it is not the school but the clinical sites that have these requirements. From their perspective, it's puts their patients at risk and sets them up for increased liability. So even if you successfully petition the school, they will have a difficult time finding a placement for you. Clinical sites essentially have the final say, and with placement as competitive as it is I doubt the schools will allow you to matriculate without records. Did you get vaccinated as a child? Some of those records may suffice, with the exception of the flu shot and possibly TDaP. And keep in mind too that this fight will continue to follow you into the workplace. Not trying to be argumentative, just offering my observations.

  • 0

    Probably want to pick a more specific population, but rural populations is a very broad, interesting topic. Vulnerability stands to get worse as more hospitals are forced to close from funding issues. If you are on social media, follow some community health organizations in your state, they might give you some ideas. What sort of nursing are you interested in? Maybe that can help you narrow down a topic?

  • 4

    Work in outpatient Psych, best part is watching clients get stable after trying and failing a bunch of med combos.

  • 1
    shedevilprincss likes this.

    Quote from LifelongNursing
    In fact, if the patients bp is 170/90 normally, the patient nor his primary care provider are managing his BP adequately and would have been a perfect time for education.
    To be fair, managing BP to the gold standard of under 160/90 is not always feasible. A family member of mine is allergic to 2 different classes of cardiac drugs for symptom management, and she is maxed out on all other doses. Resting BP is usually around 169/95. The cardiologist didn't have any other suggestions either. Always good to get a history and check for understanding before delving into education.

  • 2
    Lizzie7800 and new gal like this.

    Take some deep breaths prior to check off. In addition to ignoring the instructor, have a good routine in place that is well rehearsed. Enter the room, address yourself, do safety checks, etc. "Setting the scene" can help you feel less anxious an approach whatever issue more naturally.

    As an aside, I also got very nervous about check offs. Enjoy the process of learning and realize that *most* instructors are just looking for safety and basic competency. All of us nurses on this site have gotten through something similar, and you can too.


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