Psychopath

Sometimes a gut feeling or an intuition may just be what saves the day. Trust also in your clinical risk assessment and judgement, if you don't think you can, always good to double check with another member of your team like you've done.

Haha.. I think a bit of 'crazy' is in the dna of the psych nurse. :) Well psych nurses often find some aspect of this profession stimulating hence they do have a fascination in working where we do. Maybe we'll all end up together one day into a purpose built retirement village specifically built for psych nurses... Complete with straight jackets, glass syringes and fountains of drinkable CPZ to remind us of the good old days! :)

I'm guessing the drug of choice you signed out as PRN was an accountable one. Every facility should have a protocol and policy dealing with the handling, administration and storage of these types of medications. You did the right thing in reporting the incident. Not only does it mean that you have legally documented a required aspect of your practice, but most importantly you are highlight safety concerns for your patients under your care. When reporting, it is important that you are supported through this by your manager. It is about raising awareness of the potential for situations like this to reoccur and to reduce the rate of the same situation to occur again and what strategies that can be put in place to manage standards of health care expected by your national body regulating nursing. Different people have different reasons for not reporting these types of incidents. In fact the majority of medication 'errors' are often undocumented or not formally recognised. One can speculate reasons for this: eg fear of disciplinary action, having to do extra paperwork, we've always done it this way etc. but remember the risks of an an adverse reaction to occur in which that particular dropped medication may be at a later date found and taken by that client may have potentiated the IMI that he had or worse may have been contraindicated if taken concurrently. Thus it is important that safety concerns are always addressed in appropriate, prompt and non judgemental way whether its addressed by your manager in a staff meeting etc. no one wants to tattle on their colleagues, so its good that it is clarified to your manager and it can be addressed. Besides the CYA principle is always a good one to follow! everybody no matter what their role is, is responsible for their own actions.

Good points there rncash89 re: nurses coping mechanisms. A macabre sense of humour is a fine thing to have! Helps us regulate and balance our own mental health when we're dealing with potential stressful situations eg cutting.

Congrats on passing your finals!! Double congrats for choosing psych nursing! For new nurses starting out in this field, I always tell them to keep an open mind, be willing to learn and absorb as much knowledge as you can! As more awareness of mental health becomes accessible to the public, there will be a greater focus on treatment, care, pratices etc. to support new funding into the system. Make sure you get an induction from your nurse unit manager or delegate! Be mindful of policies, procedures and legal aspects particular to this pratice. e.g. legal classification of your patient/client Be aware of occupational safety requirements for your hospital and emergency procedures. Ask about the model of care that you pratice in your ward/hospital. All patients deserve and should have the same respect and provision of whether or not they are a someone with a mental illness or one with a physical illness. You'll meet great psych nurses and you'll meet other who may not be as good. I'd stay out of area politics intially until you get a feel for the ward culture and dynamics of the place. Listen to experienced nurses and watch and learn what they do, how they interact with patients, and identify what is it about their practice that you feel that you can adapt to. If there are times when you feel you are doing nothing but sitting around and watching patients.. remember that one of the important skills of psych nursing is observation - you are constantly assessing their interactions, signs and symptoms of illness, behaviour, response to treatment etc then you can formulate a plan of care and act on it. Be professional in your interactions with people, be honest and don't be afraid to ask lots of questions! Not only does this show that you are keen to learn, but its also important that others don't assume that you already know about some important things about your service. Psych nursing is no different in terms of professionalism and the value of caring that you are expected to provide in any area of nursing. Learning is an ongoing aspect to all fields of nursing. You may be suprised that even the most senior nurse can learn a few things from a freshly minted nurse! Take things slowly, theres a lot to absorb when you first start.. you are not expected to be an expert clinican. As you progress in your career, keep an interest in new developments in psychiatry/nursing/psychology etc to keep you up to date with current pratices and issues. You may asked to join a program for new grad nurses and/or forum, inservice and courses in the near future, so keep an eye for those. Don't be afraid to identify yourself to everyone (from other health professionals, patients, families and other staff etc) and communicate anything that you feel is relevant. Remember there have been many many other nurses that have been in the same situation as you and many more will be after you. Everyone is a newbie at some stage! Identify staff that you feel comfortable with and can act as a potential mentor/buddy that can ease you into psych nursing. Even as a new nurse you'll have an innate sense of what is the right and wrong thing to do. If you see a fellow nurse do a particular procedure/therapy/or an aspect of nursing care that you may not understand, don't hesistate to ask them about it e.g. ff you're not familiar with some technical aspects of psych nursing e.g. PRN medication administration then obtain help from another nurse. Make sure your documentation is contemporaneous, to the point and identify key aspects of how you interacted with the patient you are allocated to. Document their mental state/risks/concerns etc in notes and read through histories, reports etc. Even in psych nursing there are sub-specialities that you can go into e.g. working in areas with specific catergories e.g. age groups, diagnostic focus, treatment focus e.g. acute, rehab etc, different settings - hospital, community, forensic, inaptient/patient etc. You don't have to stay locked in on particular place or setting for the rest of your life! So once you get some experience, you have the opportunity to move on to other specialties if you wish. Most of all, look after yourself at the end of the day!! I always say to my fellow nurses, you can't look after other people if you haven't looked after yourself first. i.e. make sure you have that cup of coffee and breakfast first thing and don't forget your lunch break! :) and Enjoy psych nursing!

I just finished doing the 2 year accelerated program this year.. as I did the EN course already.. best way to do it I think.. get paid for the 1st year and work as an EN on your days off uni.. I can't say that I really studied.. bought like 3 textbooks during my time here.. downloaded the rest of the notes off the web..but hey I passed! 2nd year is pretty much full on for some people..4 days at uni ..if i recall.. 3rd years a breeze.. well since theres like hardly any exams.. just assignments and workbooks and clinicals.. you only go to uni like a day or so. Yea.. i agree that the teachers are pretty good over here.. although there are some which if I ever find their car in the staff parking area....ahem.. anyway summer school isn't that bad.. for the accelerated program.. its only 4 weeks.. (2 week clinical, 2 week uni)..just project stuff.. It is good to have a car when you goto uni.. although they do have shuttle buses between campus..for clinicals its really handy. Just remember... the greatest thing about UTS is the fact for EN's you do not have to do a bridging course for 6 months before you start the course! Only 2 years and you're set! I think that keep me going.. well also the amounts of good looking girls on campus! (being male and all..) The only drawback I can see for doing uni based nursing.. is not getting paid on your clinicals and doing rougly the same nursing duties as you would normally be paid to do! Other then that.. relax and take it easy.. and enjoy your time (esp @ the Uni bar!! :)