pattyjo

I have a "Do what you love" philosophy on this, so if psych nursing is calling your name, go for it. I've worked in different areas through my career, usually briefly, but always end up back in psych. Now, having said that, I need to respectfully disagree with those who say med surg and psych are totally different and you don't need med surg skills if you are going into psych. You will have patients who have bipolar disorder and type 2 diabetes; major depression and high blood pressure; and yes, schizophrenia and pregnancy. Not only that, the newer medications are effective in helping to manage symptoms, but they also carry a risk of metabolic d/o, seizures, thyroid and cardiac dysfunction. Some increase the risk for various other disorders, like agranulocytosis. If you are going to work with persons who have substance abuse issues, you most certainly will run into co-occurring liver disease, neuropathies, GI problems. You are a nurse: your role will be to assess, advocate, educate, keep your patient safe, help them return to a higher level of functioning. If you are concerned about losing your skills (I'm guessing you mean the tasks like starting IVs, dropping NG tubes etc) then maybe consider a casual position on a med surg unit. Or take a refresher course if the situation dictates. It sounds like you are thinking this through, and that is a good thing! Good wishes to you as you continue on, and make the decision that makes the most sense to you.

Relapse prevention, coping skills, discussion on any local support groups which could be used after discharge (provide meeting times, phone numbers etc).

Could you create a clinical scenario or maybe find one on line? Sometimes the text book publishers include these in their online resources. Perhaps your students could work in teams and then come together for a discussion. Good luck with this; I had something similar happen recently and I'm trying to find a replacement experience as well.

If interested, here is the page for DSM V which is due out in 2013. I believe right now APA is looking for comments from interested parties on the changes being made. http://www.dsm5.org/Pages/Default.aspx

Anything written by Kay Redfield Jamison, PhD. She is a psychologist who was diagnosed with bipolar d/o in her 20s. An Unquiet Mind (autobiography) and Night Falls Fast (about suicide) are especially valuable, but anything she writes is worth reading. Crazy by Pete Earley about his experience with his young son's illness and the mental health system in general. (The title refers to the system, not his son!) Addictive Thinking by Dr. Abraham Twerski helped me understand a lot about this. He has written much about substance abuse and is known internationally for his work. Agree with jahra regarding APNA; think about joining. Good luck in your new job!

I couldn't agree more, Eric, I recommend this excellent book to my students. It is heartbreaking and extremely valuable. Patty

>>Finally, if I were to venture a guess on another potential drug class of Some of the second-generation antipsychotics, such as Abilify, have apparently increased the risk of hyperglycemia in the elderly population. While no definite correlation has been specified due to the tendency of the population to be at high risk for diabetes anyway, a plausible relationship has been noted (www.fda.gov/medwatch/safety/2004/safety04.htm). True, plus further studies have prompted a black box warning on these meds due to unexpected cardiac-related deaths and deaths from infection. Also addresses the "off label" issue since none of these are approved for use in agitation with dementia. (Someone correct me if that has been updated) http://www.fda.gov/cder/drug/advisory/antipsychotics.htm Patty

You can also check out universities in your area; they often have qualified interpreters on staff. My only concern with using hospital lists for non-English speaking patients (including those who are Deaf as was mentioned) is when the information is something like consents or other legal documentation, or specific teaching. I think then you need to have an interpreter specifically qualified in the needed language to be absolutely certain the information is conveyed accurately. We had someone once who said she knew sign language; turned out she knew the alphabet and numbers 1-10! For routine things like baths, meal times etc, someone on staff would probably be sufficient. Patty

As odd as this sounds, it isn't something that just popped up. I remember sending an article about this to my son several years ago. Couldn't find that one, but here's a link to medscape, an article from a few years ago. This one was also referenced on CDC website. (You may have to register for medscape, but it's free and a good site to have anyway.) http://www.medscape.com/viewarticle/463678 Patty

Just a message to all of you who work in hospice care: Last week, my MIL died 13 months after being diagnosed with pancreatic cancer. At that time, she was told she had "6-8 months" Clearly those docs didn't know who they were dealing with!! In the time she had, she enjoyed her family, her faith, bingo and travelling. She crocheted baby blankets for moms who didn't have much, and she worked on accepting her fate. She spent the last 3 weeks of her life here with us and did well until about 5 days prior to her death. We had a nurse from hospice come; she opened the case, got us oxygen, a bed, meds if needed and assigned us "our" nurse. We never got to meet her because my MIL died that night. Her sister came downstairs as my husband and I were getting ready for work, and found that she had peacefully slept away. Why am I telling you this, when it's clear we didn't have that much contact with hospice? Because the "on call" nurse came right to our house, she took the burden of calling our doctor and the coroner from us and let us sit and grieve together. She looked at pictures of our family, listened to some really silly stories, got the priest and a nun (both volunteers with hospice) and was so abundantly kind to my husband's aunt that it took my breath away. She helped us with funeral home calls and she stayed with us until we were ready to let her go. Before she walked into our house, she was a stranger; she became a gift to us. I hope you are all proud of the work you do; I am so very grateful Patty

I am still in the MSN program. Length of time would depend on the area of concentration and how many classes you are able to take per semester.There are 4 required courses for any track you would chose (2 research, health policy, health promotion) then continue on depending on the area you are pursuing. There has been a lot of reading, posting on bulleting boards, projects etc., but nothing unmanageable. You do have to be disciplined though; it could be very easy to fall behind. As far as the bridge program, I challenged out of those classes. Check the site or email the director to see if that is still possible. Also, I had to take a statistics course since I had never had one during my BS program. That was probably the worst part of all of this!!! My undergrad degree is in Health Education, but I graduated from a diploma school of nursing before getting that degree. Hope that helps, let me know if you have any other questions. Have you ever taken an online class before? Patty

http://store.health.org/catalog/

Have you tried this one? They have educational materials for adults and adolescents; you just need to scroll through the list. Most are free. I have another similar site, but couldn't attach it here; will do so on a separate post. I have seen those series type videos for adults, our unit doesn't accept adolescents so we have little need for that. http://store.mentalhealth.org/publications/ordering.aspx Patty

Hi Annlet I did a bridge program through Drexel Univ. and then went right into their MSN online program. I challenged the 3 exams for the required bridge classes, but I think there were going to be changes made to that aspect of the program. Try this link, if it doesn't work, just go to drexel.edu, click on distance learning and then nursing, and scroll down to RN MSN bridge. http://www.drexel.com/Fields_of_Study/Nursing.shtml Patty

Just went to CNN.com to look this up; here's the link http://www.cnn.com/2005/HEALTH/conditions/06/29/attention.deficit.drug.ap/index.html It appears that the FDA is going to look at all meds for ADHD; so far the reports aren't conclusive.

Well said as always, Karen. I belong to ANA and my state organization, and to the American Psychiatric Nurses Association. Do I always agree 100% with whatever decisions are made by any of these groups? No, but when do any of us agree totally with any group we join? These groups still give me an opportunity to make my voice heard and to have an impact on nursing and on health care in general. Through these groups, I've worked on mandatory OT legislation, parity in the care and treatment of mental illness, and safe staffing, among others. In addition, my membership has allowed me to meet nurses from all over the country who share a belief that we can make a difference. Decisions are made by people who show up. ANA membership is a hot button topic here. All I can say is in the years I have been a member, no one has ever asked me for a string of credentials, and I am a DIPLOMA grad. I am a committee chair for my state, I'm on my local board and chair a committe there as well. I think I make a difference and I value what I and my colleagues do. I am sorry that anyone has felt less than valued because of ANA's BSN as entry level position, I guess I don't look at it as putting down any specific group, but rather as an attempt to bring everyone to the same page. I think what really bothers me about this is the divisions it causes at a time when we should be working together to improve our ability to deliver quality patient care and to respect what each of us brings to this profession. Patty

Just finished my first semester at Drexel online. I'm in a mixed track; education and psych. Have you ever taken on line classes before? This one was my first. Different, but a good experience. Good luck to you. Patty

St. Barnabas in Gibsonia? Masonic Village in Sewickley?

There is a Kindred facility leasing a floor at The Medical Center in Beaver County. Don't know if they provide what you are looking for. Did you try Cranberry Place? (affiliated with UPMC Passavant/Cranberry.)

Welcome to psych; I wish you well, and stay excited! You could probably get any current basic text that would give you the "facts" and of course, as already mentioned, a med book for review. However, I also find it helpful to read the "real world" experiences of people who have suffered with mental illness. These pop into mind, and I know I have more: Darkness Visible by William Styron (very short, intense book about his depression,excellent. It literally took my breath away) A Brilliant Madness by Patty Duke, who was undiagnosed bipolar for years. An Unquiet Mind, by Kay Redfield Jamison, also diagnosed with bipolar. (Actually, all of her books are worthwhile) She's a professor at Johns Hopkins. The Day the Voices Stopped by Ken Steele who lived with schizophrenia much of his life. I think reading these kinds of books helps us to know these illnesses from the perspective of those who are challenged on a daily basis. Good luck! Patty

You might find some direction here: Bazelon Center for Mental Health Law. http://www.bazelon.org/ What about treatment vs incarceration of women suffering from post partum psychosis who harm their children? A terrible topic I know, but one that seems to generate alot of strong emotion on both sides. Sorry, just re-read your post and realize you are looking at civil law. I don't know if you can find a way to use that topic, since it most often comes up under criminal. Perhaps something on the difficulties parents have in getting treatment for their kids; having to resort to the justice system in order to have them treated? Psychiatric advanced directives? Good luck Patty

MedpsychRN: I remember a situation similar to this at the hospital where I worked a few years ago. This wasn't on my unit, but I do recall it being brought up in conference, and the decision was made to use mitts in addition to 1:1. Is that now considered to be a type of restraint? As an aside, I am interested that you are seeing an increase in this; I haven't seen it at either of the hospitals where I work. Any explanation? Patty

Karen: If you get a chance to attend, let us know what you learn. I have wanted to hear S Gordon speak and always miss her. Did enjoy Bernice Buresh at PSNA, I was especially impressed with her respect for nurses and nursing. Wish I could attend, too long a drive from Pittsburgh though :) Patty

Thank you thank you thank you!

Nancie: I just started an RN-MSN program online through Drexel. I have a BS in another discipline though, so my program is a little different from many of the others I looked at. The cost is a concern ( because I can also say "especially at my age" :chuckle ) but I really want to continue teaching and a master's is required. PM me if you have any questions,and good luck. I think there are going to be more RN-MSN programs popping up in the future. Patty