sarmedic70

I left nursing for all the reasons (well most) of what this article shared. I was a RN for quite awhile (nearly 10 years) before I opted to go LOA. Right now I am working in my Criminal Justice degree; however, I don't have the satisfaction as I did as a RN (despite management, excessive demands, no lunches/breaks (and not getting paid for it - of which is illegal), covering another unit if a RN is on break or there is no RN, the list is endless. I do work as a RN in EMS but only part-time limited shifts. So, I have my somewhat involvement in nursing. I am not so sure I want to return back to nursing at this stage of the game. And I am always on the lookout for something else. I spent 39 yrs in the military (combined active duty and reserves - non medical - went to nursing school while a Reservist).I don't foresee things changing nor improving in the medical field for RNs and foresee it only getting worse unless things change drastically from nursing management, overall management to this patient-satisfaction nonsense driving by the "insurance" industry (of course, I want my patients to be satisfied, but it has gone overboard - as some of the others had shared). It is just nuts.

Totally agree on pretty much all of the points made as to why RNs quit. I lasted for a few years till I had it. I spent 39 years in the military (combined active duty and reserves), became a RN (while serving in the Reserves afforded me to go back to school and obtain my RN), and as a result have been appalled as to how RNs are treated by peers, nurse managers (from unit on up to the DON), and overall management. I never ever would have treated my fellow soldiers in such a way as what I have seen in nursing. There are many factors as to why the way things are still remain the same. We all have seen and experienced it. So you know what I am talking about. I loved my patients and I loved being a RN, but I will not tolerate "status quo" and poor management and caring of nurses who have a difficult job enough as it is from so many levels. This article presented hit the nail on the head as to the immense issues still faced RNs. I try to warn new nursing students as to what they will be faced with. Not to be a "Debbie Downer" or be negative.....but to prepare them for the REALITIES of nursing. This is something that is NOT taught in nursing school. I loved working with nursing students when they were doing their clinical rotation through my specialty area. I would ask them what their goals were, why they want to be RNs, etc. I spent as much quality time with them that I could. I wanted them to see the POSITIVE side of nursing BEFORE they entered into the field. However, the reality check is just what this article shared. Hopefully, one day, things will change. I have talked to several friends who have remained in nursing (due to being close to retirement) and have said things have not changed, but actually have become worse. Makes me very sad to say the least. I still think nursing is a VERY noble PROFESSION but until management changes (from the bottom up), we are going to continue with these continued issues and see many discussions and articles, such as this one.

I cannot say that I am surprised. I have had the same thing happen to me. Same sort of response of not being RN experience, yet they will hire newly graduated RNs with ZILCH emergency medical experience right out of nursing school. Go figure. I would always hold my tongue from saying things such as "Can you intubate? No! Didn't think so, 'cause I can!" (In ERs nurses do not intubate for the most part, and it usually a respiratory therapist or anethesiologist for the most part. That is for starters. I further want to say/ask: "What about critical thinking skills? WHO do you think gets the patient stabilized BEFORE being sent off to the ER, working under very nasty conditions, sights, sounds, smells, chaos, etc.? Ahem.......me! Do you think that takes critical thinking skills to decide load and go or stay and play - i.e., TRIAGE! especially if is a mass casualty situation." It is just not toward military medical veterans that this mentality prevails but also towards any EMS types. I was not a combat medic (even though I put in nearly 39 years military non-medical service in), but I was a medic and did the medic-RN bridge. I am so fed up with this sort of mentality to say the least and seeing "baby" nurses getting these positions. The only thing I can think of, in lieu of the "canned" response it is not nursing experience, is that there is that perceived threat of the medic having more experience, knowledge, and skill base than the RN(s). I feel that is a lousy reason, but that is probably the reality of it. I do wish you the best of luck and hopefully somebody will hire you and see the true value you have to offer to them overall. I am no longer pursuing going into an ER (even though I still work part-time paid position for a major county as a RN/medic) and remain with psychiatric nursing that I am doing now. My goals have somewhat changed overall in what I want to do in nursing IF I remain in nursing. Well wishes to you!

Thank you, YosemiteRN I am quite passionate, hello duh, about this topic of violence in the work place. You are so very correct as to how we ALL must be ever vigilant about those who are cavalier about the violence inflicted upon those of us who work the "front lines." I (and my staff) are so frustrated with how the "attitudes" are amongst most of our treatment team, demeaning our psych tech staff because they do not have masters' degrees (quite a few have their Bachelors in either Social Work/Sociology/Psychology and are awaiting to get into a Masters-producing course, one postponed furthering her education to raise her family and she has life experiences; however, none of that matters. I was sitting in a meeting a couple or so years ago reference how to reduce the numbers of our seclusions and restraints (this was when they were about 1/3 of what we have been having of late........hmmmmmmmmmmmmmmm)....and our PhD Neuropsychologist in particular made demaning comments about our staff and how they are just a bunch of high school-aged kids. Another RN, who was in a similar meeting later on, made the mistake of saying this to our staff of what was said from the treatment team and this neuropsychologist. That didn't help matters at all. Yet these same individuals who made these comments are the FIRST ones who spend very little to nearly no time on the unit. The neuropsychologist has been on the one maybe twice since I have been working there over the past several years; the therapists/social workers only come on unit for either a therapy group (less than 1 hr per week) or to grab a patient for individual therapy OFF of the unit or do points cash outs. The psychiatrist comes on the unit periodically but doesn't spend a lot of time on the unit at all and it goes from there. But yet, THEY are the first ones to say the staff don't know what they are talking about regarding the patients or criticize the staff. VERY little praise occurs. Staff are scared in some aspects of making the wrong decisions in intervening be it seclusion or restraint. I always tell them to always inform the RN on duty and let the RN bear the burden of making the decision (it's the least I can do to assist and support them and ease their fears as much as possible). Staff are NOT provided adequate enough training overall, especially for our type of unit. Yeah, SMT of our unit had provided SOME training, but it was NOT exactly what the staff truly needed (and not the type of training that I had proposed to be conducted and even provided the materials as a guidelines). But of course, I am JUST a RN. If you get my drift. At any rate, we are expected to "deal with" the violence on our unit and constantly get hit, kicked, bitten, scratched, peed/poo'd on, smears on us, punched, you name it......this happens EVERY DAY. Not to mention the vile and vulgar names thrown at us by the patients and swearing at us. But they are "excused" because..............and we are expected to "handle it" because................ We are limited as to what we can do on our unit, as determined by the treatment team/SMT even though federal law mandates otherwise and our staff know that. That makes our job that much more difficult as well..............Well, I need to get off of my soapbox. Nothing will ever change to say the least on many levels. Yes, on other units we hae had staff severely injured, but NOTHING changes......it is always asked "What did staff do/not do?" and rarely about what about what the patient did..........but because the patient has a mental illness.......that justifies it all, as it would appear by the attitudes of administration on down. Well, i can only hope and pray that some day somebody will "get it" and take on the mantra that was posted by missarahRN: "Mental illness is not a risk factor for being violent nor is working in a psych facility a risk factor for being a victim"........Cheers!

Great and interesting/informative posts from all. Elkpark, I wish I could same was true where I work reference the decrease in violence. We are quite the opposite. In fact, it is a constant topic as to how our numbers have increased in seclusions and restraints as a result of the violence on our unit. A lot of "theories" have gone around from: number of patients, number of back-to-back admissions, types of patients, etc. We have had this number of patients on the unit before so that can be essentially ruled out. The current staff we have of which the majority did not work on our unit when we had that many patients as we have now, and were hired on when there were half that number, so it was a "shock" to them. THAT could be a factor of the "new" staff not having worked with the number of patients we have now compared to when they first were hired. There could be the possibility of the numerous of back-to-back admissions have contributed to the increase of negative behaviors in that it could have contributed to disrupting the milieu of the other patients already adjusted to the unit. But I personally feel it is much more than that in that we have had back-to-back admissions, and yes, the milieu was disrupted, but for a SHORT while. This has been ENDLESS. So that leads to the possibility of the types of patients we are getting now vice before. But then again, we had violent patients back then, too. But even with that, those patients could be worked with and despite their violence, staff still enjoyed them. NOW, it is a different story. I personally think (as do some of our more seasoned core staff) that it is a mix of the type of patients we have been getting coupled with the current treatment program that was "redeveloped" since I was hired on the unit. All of us who worked on the unit under the other programming have all agreed that when the "new" programming was instituted we saw a dramatic increase of the negative behaviors and that was with giving the new program time. Heck, the patients even verbalized various things about the new program of how they could have certain behaviors and nothing could be done about it (compared to the "old" programming). The treatment team feels that programming was too "punitive"............the old program developed REAL WORLD life skills and in the real world they are NOT going to get all of these options and chances. What we all feel we are teaching our patients is "enabling" overall. At any rate, I could write a book on all of this. LOL At any rate, I personally feel the KEY in reducing violence on the units is the ENTIRE treatment team is actively involved, working side-by-side with our psych techs and us RNs. A few years ago, when JAHCO was at our facility, another team (not affiliated with JAHCO) also was visiting. I believe they were out of MA. At any rate, they told us that they essentially reduced their number of seclusions and restraints to ZERO. HOW? the ENTIRE treatment team was involved actively ON the units. The rationale was that the psych techs and the RNs are involved with the patients 24/365, so why not the treatment team (at least during the patients' waking hours. I have brought that up from time-to-time, every time something is mentioned about how our seclusion/restraint numbers have gone up (which is quite often.......we were averaging over 10/day and then some....it has dropped down somewhat, but the violence still remains even though not to the point where intervention is warranted). It falls on deaf ears. Heck, one of our social workers/therapists, when asked to be on the unit, always has some excuse or another. She is scared to death to be on our unit. A few years ago, when it was directed that they be on our unit by their supervisor, as a result of having so many of our core staff off duty due to injuries, she refused to be on the unit and when she was had one of our OTs with her. But yet SHE is the first to complain abuot what staff is doing wrong and criticizing. She is a HORRIBLE therapist (as you can see by the outcomes of so many of her patients overall). She is doing NOTHING for and with her one patient we have at the moment and this patient has been with us for nearly a year. But that is another story. So, what make sense totally it is not being done at our facility. WHY? More-than-likely, as with everything else, it comes down to $$$$$ ...............and the fact the therapists/treatment team would actually have to work a weekend or evening............Hmmmmmmmmmmmmm.............and not have their Mon-Fri schedule of coming in after 0900 hrs and leaving by 1600 hrs (seriously)......Add to all of that, we are also in a staffing shortage not only on our unit (just lost two more staff...........they "quit".....translation: they would have been administratively removed from the unit/hospital), and the entire hospital being short staffed (amazingly always on weekends and holidays and holiday/weekends............FMLAs abound, etc.)...........and no consequences as a result, even with the requirement of having to have a doctor's note, especially on holidays, holiday/weekends. I have worked weekends that we were so critically short-staffed throughout the entire hospital that the DON came in to work and mandated that the Administrative Dir/Unit Nursing Directors come in (all of the units) to work as psych techs that weekend (all shifts).........vice something being done about this, this has gone on for as long as I have been at the hospital. Our DON is way too laid back overall is the general opinion. When that happens, we see an increase in the violence on the units. We are lucky if we have TWO security officers on duty, most of the time it is ONE for the entire hospital. And the patients pick up on that, and act out as a result. I guess, unfortunately, before somebody wakes up and truly listens to all of us about our concerns (and how we also have a right to be safe and protected) it will take something extremely bad to happen. Vice being proactive all-too-often it is reactive in approaches. We have a very close-knit unit with our staff. Many are waiting to get into masters-producing schools for their social work, and truly have a love for what they are doing. The come in day in and day out and put up with getting punched, spit on, kicked, scratched, bitten, peed on, etc.........and feel like there is always a dark cloud luming over their heads out of fear they could lose their jobs if something goes amiss in that so many things are in the gray area or how it is "interpreted" by the treatment team when they are watching things on the video cameras (of which can be a blessing but have also been a curse) vice the team actually BEING on the unit to see how things are from start to finish with the patients. We sure are NOT doing this for the $$$$, that is for danged sure. At any rate, just because people are mentally ill does not justify them to be violent towards staff nor justification that staff have to "take it" because they are working with the mentally ill. They KNOW full out what they are doing in MOST cases. I know that from the debriefings I do with my patients after a seclusion/restraint. Just as the patients have full rights to be protected and safe, there MUST be measures in place to have the same rights for staff, too. And it should be mandated by law as it is for the patients. I am tired of seeing so many of the professional publications constantly talking about work-place violence but yet I have to see what is truly being done about it. When I (and some of my staff) have presented suggestions as to how to protect us (simple things such as enclosing the nurses' station not only to protect us but also our expensive equipment in the station (camera monitors, cables, comptuers, etc.), they won't do it at all and flat out told us it is not going to happen. Yet our equipment is constantly being broken and damaged. That is really saving money when we are in critical budget crisis and having to constantly cut back on spending all over. Hmmmmmmmmmmmm...........................Well, again, I hope it doesn't take something so serious to happen before something is done to protect staff as equally as the patients are protected. WE ALL have the equal rights to feel safe and be protected. Maybe one of these days......as I keep telling myself. This has been a very interesting discussion forum. Great info! :-)

Yes, most definitely document everything in addition to having your staff document......this is a hard situation to say the least in that you are at a disadvantage with regardless to skills set in dealing with a possible psychiatric dx. I am utterly apalled as to the alleged lack of response from those above you with regards to dealing with assaultive patients. If the training and skills set are not provided to the staff then it is shame on them and THEY should be hitting the door. It is hard to say what is truly going on with this patient as to why she is being this way. There are a number of possibilities and she should be seen by a psychiatrist to rule out any possible psychiatric disorders. In the meantime, the suggestions given to you of going to your RM, if you have one, or to your BON, is an immediate thing you can do.. Also, you have every right to have charges filed on this patient. We do it at our state psych facility if need be. In your case, the patient could be pinked slipped and removed from your facility. I have seen it done.in fact, before I became a psych RN, we had a LTC pt come through our ED to be transferred to another facility....a psych facility......I had to remain with this pt all night as his 1:1. So it can be done. Best of luck to you. Keep us posted as to the outcome, developments.

Great posts I have been reading.......As I stated in an earlier post, I work on one of THE most violent units in the hospital, and since that posting, it has become worse..........unbelievable. :uhoh3:The thing that comes to hurt us as staff is that because of the population of patients we have, THEY have more rights (because they are under age 18) and are more protected.......and they know it! My staff, currently, are very leery, worried, concerned,etc., in anything and all they do due to this. We are currently under the microscope AGAIN because the number of our seclusions and restraints have gone sky high........vice it being looked at as to WHAT is REALLY:eek: going on, it seems what is staff doing wrong (well, they are NOT perfect, but at the moment, they are totally doing the best they can overall) ...........I had a discussion the other day with our staff psychiatrist that I am totally convinced that it is the programming that is being used. We have been trying to say this ever since it was instituted; however, the "powers-to-be" totally disagree...............I am totally realistic that it does truly take time for a patient to come around and finally be in compliance, but under the programming we had when I first started, it was FAR more effective (even for the most impaired of the patients in their executive functioning) than what we are using now. Even the patients make comments about it. They know and know how to totally manipulate, especially with this current programming. :mad:The other thing that is so frustrating is that our staff are highly educated (most have their bachelor's degrees); however are treated less than............mostly by the therapists (a couple in particular), because staff do not have a master's degree et al. However, it is OUR staff who are working with the patients day in and day out 7-days a week and holidays/weekends, whereas the therapists see them for their once a week ONE hour group or sometimes for individual therapy depending upon the patient. They do NOT see the day in/day out actions of these patients and only see/know what the patient does when they have that short period of face-to-face. But yet, overall, our staff are not respected to actually be totally listened to. Every once in awihle, they get lucky. Heck, one therapist is totally "terrified" to come onto our unit. The only time this therapist comes onto the unit is for therapy group(s) and if it is at any other time, it is for a VERY short period of time. :uhoh3:Another thing is that our nurses'/tech station is totally exposed and we have complained a multitude of times to have it enclosed (like on the other units), but the powers-to-be won't allow us to have an enclosed place when we have made suggestions/recommendations as to how it could be done:mad:; however, when we tried to have a boundary set around the nurses'/tech station, we were told to remove it in that it was too "restrictive" or something like that.................so here we are supposed to be teaching patients about boundaries, respect and limit setting, safety, et al, but yet nothing for us to be protected. I have been sitting at the computer doing my charting and getting hit, attacked, et al, because patients climb up over the countertop or barge into the station. I feel that there is very little to nothing done for our safety except for what we are taught when dealing with the patients out in the milieu. Also, we get bullied by patient's family members (one, who got upset, because patient ended up in a physical hold with the intent to seclude, actually called the local police on me and they actually showed up at the unit). Long story on that one of which I won't go into here, but we deal with violence (verbally and physically) on all fronts like I have never seen before........even moreso than in the ED, et al.......... That all said, I would not leave psych nursing for anything (except maybe to go to a Trauma/Level 1 ER here)........... :redbeathe

Yes, it is true from what the predictions are, once the economy stabilizes, that "baby boomers" will plan to retire and there will be a return to the major nursing shortage; however, the real question comes into play as to WHEN? For now, it is not very helpful for the newly graduated RNs or those about to graduate soon. Travel Nursing companies rarely take (the reputable ones at least) new RNs without a minimum of ONE year experience in a specific specialty area. Some staffing agencies, similar to travel nursing companies, might, but it depends and where. THere are companies like CNS who do the annual immunizations (influenza et al) who will hire temporarily RNs for that period of time (generally Oct-Dec) and some have been hired on full time. I know this doesn't pay, but volunteering at various clinics that service the homeless, et al..........that is a fantastic way to also get your foot into the door and also meet your various state RN board requirements to maintain your RN license. In some ways, I agree with lsvalliant's post of about the international RNs. I have seen where they have been getting hired but yet an American citizen RN has not been hired. I have had patient's complain with having a non-American RN attend to them due to not being able to understand them. I have seen some that are not very competent but there are also some very dynamic and awesome ones out there as well. I do feel priority is taking care of our own first and foremost; however, I see this in other areas (especially the tourist industry, i.e., ski resorts where VISA employees get priority over citizens due to their VISA criteria............the defense is that an American can get a job anywhere/any place else but the VISA employee cannot.............you get the picture)...........At any rate..........it will be a matter of time and jobs will be opening back up. Nursing is a cyclic profession.............we went through something similar back in the 80's (if memory serves me correctly) and it was very difficult for a newly graduated RN to find a job and took multiple applications/interviews to get on somewhere...............then we went into the huge nursing shortage................now, due to the economy, we still have the shortage, but to due cut backs, et al..........jobs are very hard to come by. The shortages in are specialty areas of which several years of experience in that specialty is required. Even very experienced RNs are having a hard time finding jobs. At any rate, all in due time...........where there is a will there is a way. I have heard that NV is in dire need of RNs.........just a thought! Best of luck to all of you new RNs.................I wish you all well! :-)

JulesA writer is so right. Yeup, tell that to my staff too who have also had countless injuries due to our patients (again, I have one of the most violent units in our state psych facility). There are times, staff just didn't approach the patient in the right way. As with a caged/cornered animal, patients at times have the same reactions............and as a result, that is when staff get hurt. Vice just waiting it out for a bit, geting the rest of the patients out of the milieu, having enough staff (or campus police) to assist, etc. No matter, though, being is psych is very dangerous overall; however one of THE most rewarding specialty areas IMHO. And nursing HAS become a more dangerous profession to the point that the ANA, APNA and ENA have been addressing this more aggressively than ever on all levels............between later-to-lateral violence to violence inflicted upon nurses by either patients or relatives, etc. The reason it is not on the "Top 10" listing of the most dangerous professions is that there had not been that awareness made until relatively recently. At any rate, psych nursing is fantastic and I, too, cannot imagine doing anything else (except ER since I am also in EMS).

Best of luck to you. Everybody posted some really great advice and so very true. Depending upon your facility, as long as proper traning is given to you all and good policy and procedures in place, yes, psych is a very violent career area; however, since you already know that when you go in to it (or hopefully realize that there is that risk), be smart when around patients (expect the unexpected; never EVER let your guard down, know you WILL be manipulated (especially when starting out.........and especially if dealing with Borderlines, but not limited to Borderlines); never EVER have your back turned on any patient, don't get yourself into a situation of which you cannot get out of/escape (patient's rooms, etc), remember that when a patient has a violent outburst/physical aggression, it is nothing to do with YOU personally but something transpired that possibly brought up past memories/trauma, et al; remember that with most patients that it will be a fight or flight and generally it will be a fight (especially in dealing with pediatric/adolescent population of which are trauma survivors with PTSD and RAD (oops Reactive Attachment Disorder)..........the list is endless, so I think you get the point:lol2:) From my own personal observations, staff who get hurt generally got themselves into that position/corner for many reasons........it is rare that is NOT the case. As Dave posted, don't listen to the naysayers. You have come to the right forum to get some fantastic advice.......psych nursing is one of the most rewarding career fields you can be in on so many levels. Those patients (and their families) truly do need us:heartbeat, especially when there still is that general perception/misunderstanding out there about mental/psychiatric illnesses because it does affect behavior:confused:. I have had the opportunity, by being in the career specialty, to educate people on so many levels. I also work in EMS and my supervisor has oft said (he does ER, fire, and air ambulance too) he does not understand how I can "do it"...........yes, it is NOT for everybody...........you are not going to cure your patients..............however, there is a service that you can provide to your patients like no other:nurse:..........on so many different levels. I am on one of the absolute most violent units in our entire state hosp facility............we average of late 10-20 holds/seclusions...........I have a fantastic staff:yeah:.................of whom truly do not get paid nearly enough for that they endure day in and day out..............they do it because they truly do care about our patients.........I knew early on in my career as a RN that I was going to do either one of two things once I got my Med-Surg experience done (felt it was wise to go that route for and very thankful for doing so even though I HATE Med-Surg)........and that was either ER/EMS or Psych.............I am both (full-time is psych)...............by being in this career specialty area has also assisted me in non-nursing situations every day......more understanding of people as a whole, et al................:redbeathe At any rate, welcome to the "family"...................may it also be your passion! :redbeathe:clown:

I, too, have to agree with Elkpark. When I read that new grad's post, I shuttered. Having worked psych for quite awhile, in a major psych hospital, and on one of the most violent and active units of the hospital........and being an experienced RN (med-surg, et al) and also currently still working EMS (medic/RN), that reading from the newly grad RN.............I am still somewhat shuttering.........I would seriously question that facility as well..........not to say anything against the newly graduated RN...........but to put somebody into that position in the first place as a newbie.............regardless...........Our facility puts all of our NEOs through an extensive orientation, and then orient them additionally on the units once nearly through the classroom portion (be they RNs/LPNs or psych techs. At our facility, due to the fact the jobs are very scare for newly graduated RNs, we have TONS of newly graduated RNs.........one of the differences is that many were either psych techs or LPNs working our facility prior to becoming RNs to they had a "leg up" overall. However, in some cases, some new RNs were hired right off the street, and it's been scary.............it's one thing to have to deal with psychiatric issues, but one really does need to be relatively strong in med-surg skills in that patients with psychiatric illness, due to medications or just poor individual care, will have medical issues. And one needs to be alert and able to discern between what is an actual medical issue or patient is simply being somatic. I have seen serious issues to where a patient, with a history of being very somatic, did not get the proper assessment for a possible medical issue and had a VERY serious medical issue as a result. I personally would not advocate (and I am no doubt going to get some angry respones on this) going into psych straight out of nursing school unless have already had experience working in psych as a psych tech or LPN, et al. Just saying...............Best of luck to you, AngeloRN. I do wish you well.............

I belong to the American Psychiatric Nurses Association and we get the journal with it. It is more of a research-centered based sort of "technical" magazine. Unless you are into statistics, et al, it is a "heavy hitter".........I have not checked out the other one mentioned though.....JPN.............However, I think I will in that it sounds to be more down to "earth" with regards to day-to-day issues within psychiatric/mental health nursing. It's great to know of the various research that has been done in various areas of psychiatrist/mental health field, but my eyes start to cross when it comes to all of the stats and mumbo-jumbo.............

I have been in psych/mental health nursing for awhile now, having come from Med-Surg, ER, L&D (and still working EMS as medic/RN). I was working, till about a month ago, day shift. I am on one of the most violent and active units of our entire psych hospital. Currently we have over 20 patients. When I worked days, I was the ONLY RN on duty except one day/week then I was doubled up with another day shift RN assigned to our unit. Our make up is, (if I could digress for a second here), 3 day shift RNs and 2 night shift RNs assigned to our unit. We all work 12-hour shifts and have one shift that is our 8-hour to get in our 80-hour pay period. Our shift time is 0600-1830 hrs/1800-0630 hrs. Day Shift has rotating shifts with working every other weekend. Night shift has more set shift. Ok, that said. When I was working days, as mentioned above, I was essentially on by myself (the otehr two day shift nurses were doubled up most of the time.....of which a lot of the times, one of them would get pulled to another unit). We do our CofS at 0600 hrs (RN-to-RN), then at 0630 hrs Day Shift RN will do CofS with day shift Psych Techs. Once get them going for the day, then review emails, check staffing assignments, do med watch (if not doing own meds.....usually there is an LPN assigned to the unit....and on our unit, the LPN also serves as the unit clerk). Staff meeting is generally at 0900 hrs. Once a week, we have patient staffing and that is at 0930 hours where the entire treatment team and those affiliated with the patient meet to review specific patients staffed for that particular day (each patient is staffed monthly). On our unit, we have an enormous amount of seclusions and physical holds/restraints of which can get up to as high as 20/day. Day Shift RNs chart on DOS, 1:1's daily, do any PIRS for seclusions and restraints, RN data notes, as applicable. IF there is time, RNs do RN groups of various sorts. I had about three different groups I did........not as regularly as I would have liked to have been able to do, but with how our unit is, I was busy doing charting most of the time. It was RARE if I ever got a lunch break at all. Essentially never. No coverage essentially. At 1430, another CofS with afternoon shift psych techs.....get back to the unit a bit before 1500 hrs...........get patients ready for their various scheduled groups........and this time period is THE most hectic time period/most chaotic until 1530 hours. That transition period.................and most challenging especially when therapists do NOT show up on time and patients are anxiously awaiting..............that is one of the time periods we have seclusions/retraints increased..........On our unit, due to the design/set up of our type of unit, we do it ALL: housekeeping/cleaning (except once a week, housekeeping comes in and does the "deep" cleaning), laundry for patients, meals (hospital kitchen sends over meals, but we are responsible for cleaning up/washing everything to be sent back to the kitchen) .....we do it ALL. We also have several DOS/1:1's and a lot of time we barely have enough staff to adequately cover our unit. If we have a seclusion (and we have multiples), it really taxes our staff immensely. Another CofS at 1800 hours between the RNs (one going off and the other coming on). Throughout the day, we are constantly monitoring patients, caring for any who have medical conditions/illnesses, etc. This is just the tip of the iceberg for Day Shift. Night Shift is a bit less hectic and less stressful. The most stressful time period is from the time the NS RN comes on at 1800 hours till patients go to bed around 2000-2100 hrs. During that time, there are still on-going groups/activities for the patients, on-going cleaning, laundry, et al that didn't get done during the day shift. NS RN has charting on all of the 1:1s/DOS's as well, any data notes, as necessary, then (only on our unit) it is the NS RN who does all the RN weekly charting and treatment assessment notes (TANs- monthlys) in that Day Shift simply does not have the time. On other units, that are far less hectic than ours, they divide up the Weekly's and TANs amongst the RNs and shifts. We have enough to keep us busy throughout the night although we do have more down-time during the night shift compared to day shift overall and it is a bit less stressful overall. I have found that I am far MORE busier working psych than I ever was during Med Surg et al (and before switching to night shift, far MORE stressed out). It is a different type of work overall...........and everything is relative.............I would suggest having a strong Med-Surg background before coming to work in Psych though.....in that have to be on top of your game with being able to do thorough assessments on patients and being able to differentiate between somebody who is being somatic or one who truly is having a bona fide medical issue. I have know of cases of patients who have died as a result of not getting adequate and thorough assessments because of their reputation of being very somatic.........you know the old crying wolf "syndrome"..............There are so many of the psych meds that cause medical issues and some mimic other things..............I know there's been an age old argument about there's not that necessary "need" to have med-surg before coming to psych..........I had kinda thought that once, too..........but since then I have seen the light..........and see the results of such..............so..........just saying.............Psych is truly rewarding..........psych is NOT for everybody........it takes a special person to be able to do this type of job.........and have that compassion and understanding of our patients........even the Borderlines................At any rate, I gave you a somewhat idea/overview of what we do.............but there is a LOT more we do do on a daily basis.................Best of luck to you in your decision...............

I am on one of the most violent and active units in our psych hospital. People who get hurt are those who generally are not using approved verbal or physical SIT procedures. As the charge nurse, I have watched staff many times approach a patient who is being violent and how they approach them. Sometimes, when patients are going "off", they are in "animal mode".........and to be able to work with a violent patient is also similar as to how to approach an animal (understanding animal behavior). Sorry for the comparison there but those who have worked psych know exactly what I am talking about.......First and foremost (and somethign I also learned in Martial Arts and also taught my students when I was teaching Martial Arts).....avoid the situation as much as possible.....don't get yourself into a bad situation (i.e., ALWAYS be vigilant and expect the unexpected)........secondly, if the situation arises you cannot totally avoid it, that is when Verbal SIT comes in. Being able to know how to use the right THERAPEUTIC sentence starters and avoid the "fighting words".........remaining in control, but firm and matter of fact (but not making "threats" such as "if you don't calm down, you will end up in restraints/seclusion", "you are going to lose your home visit because I will knock down your level", etc. Remain out of power struggles/plays.......... Thirdly, IF it comes to the point of having to use Physical SIT, then if it becomes to the point YOUR life is in danger, etc., as our campus police have told us, you do whatever you can to protect YOUR life. In RARE instances, has that actually happened...........we have received oustanding physical and verbal SIT training at our facility. That is one of the major benefits we have, by working in major psychiatric facilities, is that we get that training, whereas in hospitals/EDs, they do not get that same training..............I also work EMS as a medic/RN. And I have worked Med Surg et al. Believe it or not, Forensic units are actually the safest of all the units as a whole, and the most violent units are the adolescent and pediatric units. I LOVE working psych and outside of wanting to work ER, I have no desire to work anything else.......been there, done that! I have been with psych for a few years...........it is one of the most stressful specialty areas, and most misunderstood on many levels, but it is also one of the most rewarding.

I work on one of the most violent and busy units of our entire psych hospital. I switched to night shift recently to get a break from day shift (of which we average 10-15 PIRS/day and it's become much more active since), and it has become way too stressful. However, it does extend over to night shift (since our shift starts at 1800 hours-0630 hrs). It is nothing unusual to walk onto the unit, and it is utter chaos. On night shift, on our unit only, the RNs do all of the RN weekly notes and the Treatment Assessment Notes (TANs) of which keeps one busy enough along with some other things. Granted it is not nearly as busy as Day Shift (of which will usually have two RNs on (unless one gets pulled to another unit), but we (night shift) are on by ourselves (currently have over 20 patients). When I worked days, the way my shift was set up, I was on alone MOST of the time. At any rate, if I am doing my job correctly (during night shift), I will have some down time around after 0300 hrs, IF I am lucky. Generally I do NOT get a break. On day shift, I NEVER EVER got a break. Nobody to relieve me, etc. The other NS RN who is counter to my shift doesn't do nearly as much as I do in the way of charting (i.e., it is required that per shift all DOS and 1:1's be charted on in addition to any of whom may be on home visits). I do all of that. Just a habit I got into. In my down time, since I am working on my Masters and my Psych/Mental Health RN certification, I do some studying. I will, just for a break, check out my personal emails, et al. Facebook is essentially blocked (although we all know the "back door" to be able to access Facebook except for the games of which are totally blocked).

Like one individual posted, nursing (like with a lot of other jobs) has had its ups and downs. In the 80's (If memory serves me correctly), new grads had as difficult time in finding jobs as new grads are facing now. Then for whatever reasons, the nursing "shortage" came about. In some ways, there still is a shortage; however, it is in areas that demand high levels/years of expertise that even the most of experienced of RNs are not getting hired (unless they have that expertise). Once the economy turns back around (and who knows when that truly will happen), as one posted, there will be the "Demand" once again. I know it's not very encouraging at the moment, but if one wants to be a nurse badly enough, one will stick it out and pursue relentlessly. Also, to add to the mix of everything, a lot of facilities are not hiring unless one has their BSN (something of which I totally disagree with, but not going to go into that in this forum), but that is the reality of it. Well wishes to all the newly graduated RNs in hopes you will eventually get something. Keep the faith and continue pursuing..........it will happen..................Cheers!

It was two years ago I had posted inquires about travel agencies for Psych RNs. Thank you for the posts as to agencies. So from what I saw with one of the posts is to remain away from Supplemental? Primarily of the housing issues? Does anybody have any updated information on them? What about Nightengale? I have seen and heard they work primarily with Psych RNs; however, from only ONE source have I heard that they are not a good agency to work with either. His first travel assignment was up in OR for the state hospital up there (and he had not even been an RN a year, too........hmmmmmmm......of which I found interestesting in that MOST travel agencies require a minimum of 1-2 years RN experience). At any rate, he indicated that if it wasn't for the recruiter he worked with, his experience would have been bad. His overall impression and opinion of Nightengale was not good. I do not know what agency he has used since leaving our state hospital to resume travel nursing. At any rate, I am in serious hunt for a GOOD and RELIABLE travel agency that works with Psych RNs in that I really do need to get away from the current position I am working at our state hospital. I have been there for 3 years and just want to get away from the hospital "politics" et al and a change of pace but yet remain in psych nursing of which I love. Additionally, it would be great to know of a GOOD and RELIABLE agency that has 4 week assignments as well since my husband will not be traveling with me of which is the only reason as to why I have not pursued more seriously travel nursing up to this point. How long are the assignments in HI? (at Tripler.......of which interests me in that I am also an Army Veteran......one of our staff psych doctors left our facility to take a governmental position with them and has been working with our vets with TBIs...............). Speaking of Veterans...........The VA has a travel RN option now as well. Has anybody checked into that route, and if so, experiences.........or does anybody know much about this VA travel opportunity? At any rate, I DO need to make a change, and yet remain in psych/mental health nursing, and jobs around here where I live just do not exist unless I remain at the state hospital. And I do need a change........the unit I am currently core RN on is extremely stressful of all of the units then add to that the administrative issues that we RNs have to deal with overall daily......................my only other option would be to go into the Acuity RN Pool and remain benefited and work all of the units, be out of the "politics" of the units, and actually be a NURSE and do what I love doing........Psych Nurse......................what I am doing right now is NOT nursing at all...........and that is not why I became a RN................... I have also thought about going back into the Army Reserves too in that they need psych RNs............just trying to locate a recruiter et al to work with me................fun, fun, fun................ At any rate, would be greatly appreciated with any updated information on Travel Agencies who work with Psych RNs: the pro's, con's, benefits, and so forth..............again, it is very hard to find that specific information on the web sites.................. MANY THANKS C :-)

It's hard to determine if a school has really challenged you or if it is a good school. The reality check of it all is what the student puts into it and gets out of. The posts are very true in that NCLEX-RN is based on ensuring that you are going to be a safe RN at the new RN level. The rest is continually and a constant learning process throughout your entire career. That is why there are preceptors/mentors after one graduates from school and starts his/her first job as an RN. Additionally, each hospital one works in will ensure that each RN new to that hospital, regardless of years of experience (or lack thereof) attends an in-service on equipment, policy/procedures, and so forth........and annually, at an absolute minimum, retraining/refresher inservices. Nursing is such a vast area of practice that NOBODY is a subject matter expert in everything from medications to diseases and disease processes. Your REAL education comes when you graduate, pass the NCLEX-RN and start your first RN job. It is all about you and how YOU perceive things to be and what you want it to be. Nothing, to include nursing schools, is perfect. There's good and bad in ALL nursing schools, even the best of them. It is what the student brings to the "table" and takes away from it. I hope this makes sense. Best of luck to you. A seasoned RN and Medic STILL learning :-)

I would put in a few months in med/surg, and the reason I say that is psych patients will have med/surg issues at some point. It is prudent that a RN be strong in med/surg, realistically, in order to be able to deal with these non-psych issues. Believe it or not, psych patients will and do have other medical issues outside of psychiatric. And especially to be able to discern between what is truly a medical issue vs somatoform. There was an adult psych patient who was very somatic who died as a result of the RNs not being in tune and strong in med/surg issues to be able to know the difference between someone being somatic and truly having a real illness outside of it being psych. I know there's been discussion in this section about having med/surg experience vs it is not really necessary. Having been on both ends, I truly think it very beneficial to have that med/surg experience. It can truly make a difference in the care your patient may need overall. I used to be one who balked about this need to have med-surg experience before all else, but I have since changed my mind to some degree and see the benefits of it. I, too, hated med/surg:crying2: and knew from the "get go" it was not my cup of tea by a long shot. In fact, my background is actually emergency medicine:redbeathe, and with all of my experience, I was getting that song and dance of "you have to have at least 6 mos, preferably 1 year, of med/surg experience before working in the ER":cry::angryfire.....forget the fact I could do more things as a medic than an ER RN for the most part. But that is another story for possibly another time. I still disagree with that thinking from the aspect of having been a medic for several years..................but on the other hand, even though I hated working med/surg, I don't regret it either and feel I have become a stronger and better RN for it overall. I did learn some additional skills and enjoyed learning new things overall.............I also knew I had to "play the game." :bowingpur I work in a state psychiatric hospital, so our patients are very, very, very sick by the time they come to us. We see it all, to include the non-psych medical issues. One has to be on his/her game in determining if one is sick from a virus or on the throes of NMS? Is one having abnormal muscle movements as a result of Tardive Dyskensia, Tics or something completely different? The list is endless. I work mostly with pediatrics at the moment, so it is a given they are going to have non-psychiatric illnesses as a result of being kids. We also have a geriatric unit...............need I go there with regards to the various non-psychaitric issues........... Our state hospital has hired RN's with no med/surg experience, but the bulk of us have come from other hospitals with experience. We do have a lot of nursing students with us who are working as either psych techs while they are going to school or have gotten their LPN through their nursing schooling working towards their RN while working as our med nurses. A lot of them, the LPN's especially, have come on board as RNs with us eventually. We experienced RNs in other fields have been able to mentor them in what they have lacked in med/surg experience while they have worked with us as LPNs. If you can get on with a state hospital, if they are set up like us, that is the way to go. You cannot get any more experience in psych than at the state level for sure. You get it all. Since I am currently working peds, I have also gotten the autism spectrum as well.................and all else possible. It's extremely challenging, difficult, but very rewarding. I was determined to be working in forensics at our hospital, but all I can say is that God had different plans for me, and I don't regret it one iota. Eventually, I will go forensics and/or corrections (considering that the bulk of the prisoner population has some form of psychiatric illness or another). There is no right nor wrong answer as to the discussion of having med/surg experience first before going into psych nursing; however, I am sharing with you all just what my experience has been and my personal thoughts on it. It cannot hurt at all, and truth be told, it will truly make you a better psych RN overall, IMHO. Again, I hated med/surg as well, but I don't regret having to go that route and having to "play the game." I felt I have become a much stronger, skilled and better RN for it for the sake of my patients overall. I am much more in tune to more as a result. I hope that makes sense. Going the med/surg route doesn't mean you will be doomed to have to do it forever. It is just a temporary, doable stepping stone to the next level in your career as an RN. :nuke: Since you know it won't be a forever thing, you can do it! In fact, you may find that it is not so bad afterall, and find something in yourself you never knew you had about you. I know I did.............and again, I feel I have become a stronger person and RN for it. Well that is my worth for whatever it is truly worth.......... Best of luck to you!

He, he, he................that is truly something that you actually read the entire thing. I didn't mean to get on such tangents. But the ole brain got to going, and the fingers became happy fingers on the ole keyboard:typing.........and you know "the rest of the story!" That is a great question about what ANA thinks. I haven't a clue, truth be told. I think they would be unwise to make an official statement as an organization about EC unless it be pro. On a slightly different tangent, I remember in studying NC7, and reading info from ANA (and then delving further into it) the "controversy" of ADN/Diploma programs vs BSN. I was appalled to say the least. To do away with the ADN/Diploma programs would not be wise. IMHO And it's not because I opted to do the ADN program first. It's good to be able to have that choice (or those choices) for personal reasons each individual may have. Great for those who have the time and $$ to attend a BSN producing nursing program, but to make a blanket statement that it is the only way to go and the better RNs are those who have the BSN...................I don't think so!!!!! Chuckles! My Mom used to be a DON, and she said that so many times, the personnel issues she had with the RN's were the BSN's thought themselves above doing some things.......and I hear that even these days from others...........and right out of school wanted managerial positions. She said many times she got called down to the ER to start and IV or some some sort of procedure 'cause the BSN RN there could not do it. At any rate, I really don't want to cross professional boundaries here in discussing the ADN/Diploma program vs BSN too terribly much. I have seen both good and not so good RNs from all the programs, and same goes with the various nursing programs. All I will say is this: If one wants to eventually get into management or move up to APRN/NP status, then BSN is the way to go. If one is just wanting to remain with patient care, of which is what nursing is all about, truth be told, then the ADN/Diploma program is just as good. It is where patient care starts. In some facilities, there are some phenominal ADN/Diploma program RNs who are fantastic managers. It is an individual choice if one wants to go the ADN/Diplomat route or BSN, and should remain that way! That is really neat about the nurse you work with. :yeah:It is always good to hear and know that there are those out there who are truly professional enough to be open-minded enough to overcome their skepticisms, and especially about EC, and that the RNs who have come from the EC program are no different than any other RN who's graduated from other schools. Like with anything else that involves biases and prejudices, it takes time to educate people. Some people are willing to learn and be open minded enough to really think it through and realize........have truly gotten a "reality check." And there are those, no matter what is presented before them in the way of "proof", will never ever change till they are ready to do so. IF EC was such a "below-standard" nursing program then it would not have been in existance for as long as it has been, or it would not have been accredited....much less the awards it has received that so very few other nursing schools have received, sooooooooooooo......hello, duh, here...............it amazes me how some critical key issues have been missed with regards to EC being a viable nursing school. Again, as I mentioned in my previous post, all I keep hearing is "what about your clinicals!?" from those who are "anti" EC (or should I properly state: "uneducated" about EC?) .............and, personally, that my several years of practical direct-patient care as a medic (and I also used to be a nurse's aid), in their "view", is not good enough 'cause it is "not nursing experience." Talk about an insult! As a medic, do we not use critical thinking skills in having to make life or death decisions out in the field?...........and what about the LPNs who are enrolled in EC? Hmmmmmmmmmmmmmm....................... And from what all my Mom shared with me when she was in nursing school, long before the 1960's, it was a different type of schooling back then for sure.........................it was very disciplined to say least.............talk about how much has changed in so many ways since the "good ole days!"........so I am not surprised as to what your co-worker told you about the bedpans (how many student nurses these day even know that there used to be COLD stainless steel bedpans? and had to be cleaned.......compared to the disposable plastic ones now)...........he, he,he.....................Yeup, can you imagine?........he, he,he........ Have a grrrrrrreat day

A little bit of both.................Yeah, you are most correct with regards to CA and being in EC prior to the 2003 date and accepting EC grads. After you have been an RN and worked for awhile, for the most part, places don't even look from where one graduated. So by that time, and meeting the SBN requirements for that state, generally no problems getting hired. I have a license in two states, and had heard that one of those states did not accept EC graduates. I had absolutely no problems after graduating. When I was first looking to work as an RN right after passing my NCLEX-RN, I did encounter two separate situations where my schooling was questioned. I stood up for the program and my experience. The one, who refused to listen to logic and reality, I opted to not work. Why should I when one is so closed minded and not look at ME and my background and practical experiences and so focused on the school from where I graduated? The RN I interviewed with commented about my background and my "life experiences", but she admitted she had "reservations" about being a graduate of EC. When I was interviewing for a position as a corrections RN, I was asked about EC and also about the CPNE. The interviewers were impressed and amazed as to what was all involved. I didn't get the position in that a part-timer also applied (was for a full-time position), but I was told to reapply in that they were impressed with my interview and my background . One of these days I will, but for now I am very content and happy where I am. It truly does perplex me as to why so much importance is placed on from where one graduates from Nursing School (and only from one school being in scrutiny.......i.e., mostly EC) when I have worked alongside other RNs who have graduated from "traditional" nursing schools and I had some very serious reservations about them and their skills, et al..........AND they were never asked about where they graduated?......Hmmmmmmmmmmmmmm.................... I think it should be high time that it should be made illegal to ask about where one graduated just the same as it is illegal to ask about marital, religious, etc., status during application process and interviews. When one takes and passes the NCLEX-RN and receives his/her license, one IS an RN and qualified to practice. PERIOD!!!!!! The UP side is, a few years ago, when I was attending the National Student Nurses Association annual conference, I enountered a dean of nursing at a very top notch nursing school who actually indicated she wished MORE nursing schools would have a "final exam" like our CPNE. She said that most of her students probably would not pass it. I also had a DON who commented (and she was also an APRN) who said to me one time that she seriously doubted she could have passed our CPNE from what all she heard about it. Hmmmmmmmmmmmmmmmmmmm......................... So, there are those who truly do have the "reality check" about EC, and that it IS a top notch nursing program, and that it doesn't "produce no junk" for the most part. Just like with any other nursing program, some do slide through the program of which has one scratching one's head and saying......."hmmmmmmmmmmmmmmmmmm".............but that is not the school................like with anything else, the reality check of it all is: it is what the INDIVIDUAL brings to the program, puts into the program and gets out of the program. I have some staff working for me who are in nursing school right now and are in the "accelerated" programs. One is an LPN who has failed his NCLEX-RN twice. He is not a dumb person at all..........and doesn't have testing anxiety.................in one of our discussions, the concern is that they are pushing students through the program way too fast. Their clinicals are minimal; their patient experience, prior to becoming LPNs through the program, are next to none; and just not time to really allow for what they are being taught to be absorbed. I know two other LPNs, also in an acclerated nursing program (and how they got their LPN), who have also failed their NCLEX-RN a minimum of twice (one over three times). In, fact, one of my employees stated that in her nursing program (different from the LPN's program but both are accelerated), as a result of so many failed NCLEX-RNs of late, her program is seriously "rethinking" some things within the program for fear of losing their accreditation or something to that affect. Overall, what I am (have been) seeing/hearing with the contention about EC TOTALLY centers on the clinicals, simply put. For whatever reason, and not taking into account that MOST of EC graduates/students are either practicing LPNs, paramedics, medical corpsmen, et al, "they" are so focused on a student MUST have "clinicals"...............as if by going through clinicals, they are going to have more "experience" than one who actively working in a medical/direct-patient care setting. One RN (a travelling nurse) I had worked with during my first job as an RN, was so danged rude to me, because I was an EC graduate. She was disputing about RN's graduating from EC and EC's program (in the negative), and like so many others who are totally clueless, she was so focused on the "clinicals." Well, just so happened, I had several close friends who were in traditional nursing school in the area, and told me of their "clinicals." Their comments (keeping in mind that they came from different nursing schools throughout the area.....from private college to major teaching/medical university) were the same: their "clinicals" were MOSTLY of just observing and not actually doing much of anything. If they got their experiences, it was because they were actively working as CNAs or EMTs. When I told this fellow RN of this, she yelled out "That is Bull S*%#".......loud enough for the entire unit to hear it. I was humiliated and embarassed to say the least. Talk about nurse-nurse hostility. I did not get cocky nor rude to her when talking to her about EC. I simply and politely,and calmly, stated the facts about EC. It just went along with another "snot-nosed" very young RN, at the same hospital, who said I would have been better off if I was a BSN RN vice an AASN..........I found out, that this BSN RN had major issues when she first started out working as an RN and how much "orienting" they had to do with her. Also, her charting was atrocious to say the least................misinformation, misspellings, et al. As well, that the other nurse (the travelling nurse), they had some major problems with her as well at this hospital, as I was told later on by one of my nursing managers. When I worked at that hospital, I did a good job and got good reviews. I left, because Med/Surg was not my cup of tea:bugeyes:, but yet, I wanted to get more experience before moving on to something I wanted to do down the road. Play the "game." One day, when I was getting my hair done, a young gal working next to where I was, struck up a conversation with me. When she found out I was an RN, she told me she was once in nursing school. Her story she shared with me was horrifying. She quit, after two years of being into her 4-year program, and it was due to the hostilities from her clinical instructors towards the students. This is not the first time I have heard of the clinical instructors being very hostile towards nursing students. One of the gals, in our scheduling office, told me of her experiences. I was horrified. Another one, now working as an RN, told me of her experiences, as well, with her instructors and how they, as students, were treated. So, somebody please tell me how "traditional" nursing programs are so superior to EC's program? On the UP side:lol2:, there have been quite a few other RNs who were in my group in my state and graduated from EC (we formed a study group as if we were in "traditional school"......from almost Day One all through the CPNE). For the most part, we have overcome the stigma of being graduates from EC, to the point that one of the gals, when she was hired on at one of the major hospitals in our city, that she was asked to recruit the rest of us to come and work with the hospital in that the DON was so impressed with the quality of EC graduates she has seen thusfar. Eventually, and one can only hope, and especially with all these other "on line" and accelerated nursing programs coming into play, that EC will eventually be recognized truly for the outstanding program it truly is, and that it is NOT an easy program at all. We meet the same standards of practice as any other graduate from a "traditional" program to be safe RN's and, as with anything else, we will learn as time goes on, just the same as any other graduate nurse. :nuke: Sorry for this to be so lengthy:typing, but as an experienced RN and graduate of EC, all I can say is do EC proud and be positive about being a student in EC. There thousands of us who have graduated from EC and actively working as RN's. On the other hand, there are many, in the EC nursing program, who have, in turn, not done EC any justice for many reasons, and those are the ones who are the black mark for EC and the rest of us who graduated from EC. :crying2:I will not get into details in that this is not the place to do so, and I am not one who does that. NO program is perfect! Never has and never will be. It is what one, as the nursing student, puts into it and perseveres and gets out of it. Unfortunately, for the time being, EC is still under "fire" because it does not follow the "traditional" lines. It is the same as ANA wanting to do away with the ADN and Diploma programs in favor of the BSN.....I am a member of ANA, BTW...............however, we must strive and work together to overcome these "prejudices" and show all these "naysayers" that we are truly very good and experienced medical professionals, and are of quality no different than somebody who graduated from a "traditional" program. We meet the same requirements as the SBNs to sit for the NCLEX-RN and that we ALL take the SAME NCLEX-RN...................PERIOD!!!:wink2: Whew! I hope what I wrote was some encouragement and hope for all who are students now within EC. Stay away from those tutorial services, and stay right with EC's program (added side line). Happy holidays to all of you!!! A fellow RN and EC graduate:nurse: Sarmedic 70

Good Info about EC. However, CA does/has hired EC graduates. I know that for a fact. I have friends from CA, who were EC grads and got jobs in CA with no issue. Great advice about those companies who offer "tutorial" services for EC students. EC has warned EC nursing students about these services and for a very good reason. They are VERY costly and are not affiliated with EC. In Utah, a few years ago, there was such tutorial service called the Academy of Nursing. To make a long story short, a lot of EC (or prospective EC students) were royally burned by AON. There were TONS of shennanigans going on and in some terms could be deemed as "robbing" the students. There had been a couple of other such services prior to AON who were nearly the same, but not to the legal extent as AON. EC is NLN accredited and nursing students who graduate from EC are eligible to sit for the NCLEX-RN as any other nursing student. There are TONS of other nursing school services these days that are a bit similar to EC as well as also totally on-line and also accelerated programs. Keep in mind that EC's program was essentially and is essentially designed for those with already extensive practical experience in the medical field and designed for LPNs to bridge to RN as well as medics (civilian and military). Unfortunately, for a period of time, EC kinda slit its own throat in allowing EMT-Basics and Medical Assistants who did not have the extensive medical experience, and there were "issues" that arose as a result. Since then, EC has changed their entrance requirements and stiffened them as a result, supposedly due to the high CPNE failure rate. Who knows? At any rate, EC is and can be a really good program. With regards as to what states do not "accept" grads from EC, double check with grads from that state to get the straight story. There are always "exceptions"......... The main reason why there is this allegedly "resistance" to hire/accept EC students is due to clinicals. It takes "educating" people about EC and the requirements to get into the program first and foremost compared to any other nursing school. You already have to have to have the medical experience in order to get into the program, and most nursing students are still actively working in a medical field while going to school through EC. In this day and age, it's sad that there seems to be so much emphasis as to where a person got their nursing degree with the supposed nursing shortage (as with the contention of ADN vs BSN stuff................the last time I checked.......take the same NCLEX-RN regardless of being ADN, BSN or school graduated). I have conquered the prejudices against EC nursing graduates. Again, great info provided. Happy Thanksgiving :-) Sarmedic70/RN

"NCLEX sounds like a scare crow to some of the would be candidates and the anxiety that goes with it is possible to make one fail it!! Is there a curriculum for The NCLEX ? I have witnessed people strugling to study for the said exam and buying volumes of advertised NCLEX study guides which , ofcourse , are addressing different topics and at the end of it all , they fail the exam as they findout that what they studied never appeared in the exam at all or only a few of the topic they had actually studied!! NCLEX has made some of very good nurses to drop out of the proffession and the presentation should be revised. My sympathies to those who have failed the exam 'n'th times and urge them to continue trying even upto twentyeleven times!! Best of luck.:nurse:" This is true about the study programs/guides for the NCLEX,and it is very overwhelming in that it's hard to determine just what to prepare for. I don't know about anybody else and what worked for them in prepping for the NCLEX, but I concentrated on areas that I was the weakest in, for "just in case", and yes, I didn't get ANY questions in those areas that I can remember. However, had I not done it that way, I feel, it would have been my luck I would have gotten nothing but questions in my areas of weakness. I simply spent time on flash cards, taking practice tests and reviewing the rationales, and comparing my wrong answers with the right ones (especially since I am absolutely a HORRIBLE test taker, and after about 20 questions, my brain starts to shut down, thereby I have to really try harder to concentrate and focuse and BE PATIENT in order to survive through the remaining of the test questions........I have to do this with any type of test I take). At any rate, truth be told, I find it difficult to understand, with all the available resources out there why it seems there is a higher failure rate now compared to before. In fact, from comparisons, it seems the NCLEX has become easier maybe?.......... Well, good luck to those who are in the throes of facing this challenging examination...............hang in there, and you WILL succeed................ :-)

Aye, I got "happy fingers"when typing:typing my post..........sorry................the ole thoughts got going, and transferred to the ole fingers and before I ken it, had written a "novel"..................:loveya: :heartbeat:D

I am not sure if there is a right or wrong answer in this question of how many times to take the NCLEX.:argue: In fact, just this past evening, at work, we had this very discussion. We had a great discussion. :yeah:I think, realistically, one needs to look at the overal situation possibly:specs:.................I agree with one writer that there are some who simply are just not good test takers and have testing anxiety thereby will bomb a test, but in pratical application are the ones you may want to care for you or your loved ones. And on the other hand, there are those who are fantastic at test taking and have no issues, but may be test/book smart, but totally lacking in common sense and critical thinking skills and you probably would not want them caring for you. That said, though, I do honestly feel that there should be a limit as to how many times one may be permitted to take the NCLEX....and I feel that 3 (maybe 4) is plenty. :) Even with the newly designed NCLEX exam, that is doable, even for the worst of test takers. :)I am a HORRIBLE test taker and have testing BIG TIME:eek:, and honestly, I felt I was going to fail my NCLEX the first go around; however, much to my surprise, I passed and with the computer cutting off at 75 questions. :jester:Realistically, I credit the nursing program I took in properly preparing me for not only the real world of nursing, but to also prepare us for the NCLEX. We have the highest passing rate of most nursing schools all across the nation. At any rate, one of the discussions we had last night centered on the accelerated nursing programs that are now cropping up. One of my techs indicated during our discussion (and is a nursing student) last evening that there is a concern in her school of the very low passing rate, of late, for the NCLEX of GNs coming out of some of these schools. Maybe it is too fast, and it's not enough time to sink in for them, and to make them successful for passing the NCLEX. She had indicated, as I understood her to say, that one of the accelerated schools, essentially had pretty much a 0% passing rate for the NCLEX. One of our GNs (also an LPN) unfortunately failed his NCLEX recently. Computer cut off at 75, and it sounded pretty promising for him. Much to our surprise, he failed. :imbarSo, in the meantime, he's continuing working as an LPN till he retakes the test. Another LPN, on another unit, has taken it at least 3-4 times and failed each time. Unfortunately, in working with this LPN, I think she is one who really is not cut out in being an RN, I hate to say. I think she is barely cutting it as an LPN. But that is one. Well, actually, two. I have had an LPN working on my unit to fill in, and he's failed his NCLEX once at least. I have some serious reservations about his skills and safety of care from a couple of things I personally witnessed of him and had to talk to him about it. Both have attended one of the accelerated nursing programs in the local area. However, those are just a small number, and hardly a true representation of the whole. However, it was mentioned in our discussion last night that there is some concern over these accelerated programs. :imbar In all honesty, it is what the individual brings into the program overall...........be it an accelerated program, on-line bridging program (for LPNs and medics for example), a 2-year program, 3-year diploma program, or 4-year program. I have seen failures of the NCLEX in all.........................and from all sorts of schools (private, top-notch universities with reputations of being "the best" nursing program, et al). In short, thought and IMHO, I do feel that there does need to be a limit vice no limits in taking the NCLEX. :wink2: And my personal rationale in this is this, even taking into consideration (speaking from my own personal experience(s) in test taking) of being a "bad" test taker, that after a couple of times, at least you "get it" enough to pass. The way the test is set up now,a nd the feed back after a failure, you have a pretty good idea of what areas of weakness(es) that one needs to review and study. The NCLEX is simply designed and set up for SAFE nursing practices simply put.......nothing more and nothing less. And remembering priorities, et al, and safety.....................well...........................And remembering, too, that the test is designed per "text-book" answers and not "real world".............so the more experience one has can be a detriment actually..................I am a medic also, and I had to keep that fact in mind and at the forefront at all times.......I had to "forget" the "real world" aspects of things and remember the "text-book" aspects...........I am also somewhat perplexed how it is that one can fail a test so many times, again IMHO, with all the practice NCLEX exams, study guides, study courses (Kaplan for example), NCLEX prep mandatory classes some nursing schools require and those practice exams make it harder than the actual NCLEX overall.....................but again, that is just my observation and IMHO................. Anyway, I don't think there is a right nor wrong answer in this overall.....look at how the evolution of the NCLEX has been over the years....................in some ways, as we discussed last night and it is again only my own opinion, it's kinda scary if a RN had to take the test "n-teenth" times in order to pass it......................but, in the end, and since that is apparently the way of things now with the new "standard" for the NCLEX, I shall reserve judgement overall on that RN, and see how he/she is in the "real world" and in his/her pratice....are they safe or not, et al.............and if they are not safe then some in-servicing will be necessary/required.................and also I shall leave it up to my SBN to determine, as well, since whether we like it or not, it is THEIR "final answer" as to how many times a GN can take the NCLEX-RN.............from what I understand it, in our state, it is a 45-day wait before being permitted to retake it and apparently unlimited times to take it. No matter what, there are never ever any guarantees as to what sort of RN an individual will be, overall, regardless of how long (many days, as in days of "old") the NCLEX is given, or if it is computerized vice the written exams of the "good ole days", or unlimited amounts of opportunities to take it, et al, the RN took the NCLEX. It IS that individual RN overall, when it all comes out in the wash.........what he/she brings to the profession......and it is up to more experienced RN's to ensure that that newly licensed RN is safe, is properly in-serviced and abides by his/her hospital protocols, et al, and truly take that newly licensed RN under wing, be kind to him/her, encourage him/her, be compassionate to him/her, and remember what it was like when you first became a newly licensed RN and the experiences (good or bad.................especially since there is STILL nurse-to-nurse hostilities abound out there ...........unfortunately...........the adage of "nurses eat their young alive" is still in existence................but all of that is another topic for a different posting site)..................... I know how I am, personally, to either student nurses, LPN's who are student nurses or newly licensed RNs (as well as peer-to-peer RN)........and that is to be the best I can be for them to set them up for SUCCESS and have a good experience and be safe................. Cheers Sarmedic70 :-)