docpsychrn

Hi there! I've been a psych nurse for over 23 years...I love psychiatric nursing! I too worried about my medical skills but I took a 2 year break to work on a step down unit/med surg to get my skills back up to par. I have no problems with drawing blood, starting IV's or giving IM's. As for the harder skills like chest tubes, trachs, traction etc...psych will never take those kind of patients because of their medical status. If you could work PRN medical unit while working psych, this would allow you to gain skill in medical yet keep your job in psych. Also, be the first one that is willing to float to medical when your unit is overstaffed. As for being a psych nurse, it's what you make it. The main thing is to listen and observe. It takes many years to learn the many aspects of mental health and when a patient is in crisis etc. Always remember safety is the most important part of your job. Whether it's your safety or the patients safety. Never feel bad if you call for help and always have someone with you when you have to talk to a patient and you feel it's going to upset that pt. If you are lucky, you have electronic charting if not, most of your time your nose is stuck in the chart charting everything by hand and revising treatment plans etc. Don't ignore your patients as this is a critical time in their illness. Set a specific time that you can talk to them so that they know upfront you are not going to sit there for the next 8 hrs. This is most useful with your borderlines. Never show your fear. You can be scared to death...just don't show it. YOU are the one in control, they aren't. YOU are the one that decides what the game plan is going to be and YOU offer that pt the choices he has vs him going off and hurting someone. I wish you all the best and if you love it, stick around it gets better!!! Take care!!

I am so sorry you are having to go through this!!! I too had a very similar situation! But I ended up quitting because I just couldn't take it another night and knowing my license was at risk every shift I worked! I too think you should have a job lined up before you quit but if that isn't feasible, quit! I quit before I had another job but I had to. I had bullying going on and no one would do anything about it on top of very low staffing and very dangerous situations. If you haven't done so already, go to your supervisor and ask her for an immediate transfer to somewhere in your hospital. If that doesn't work, then go to her/his supervisor. If that doesn't work then you go to Human Resources to tell them that no one is helping you transfer out and you have done your year as your supervisor instructed you to do. This way you have followed the chain of command. I know from experience, they hate it when nurses go to Human Resources or administration when their problems aren't being addressed on the lower levels! They actually panic and then they move! They pretty well do anything it is that you are wanting! So try that and then let us know how it goes...good luck to ya!!!

I just wanted to share with you all that this recruiter kept e-mailing and calling and I sent him a very stern e-mail telling him to stop contacting me! I even gave him the excuse that I had taken another assignment with a different company (I hadnt). He sent one more e-mail stating "When did you plan on telling me this?" and I haven't heard from him again!! YAY!!! I am so glad that's over!! But here's the kicker...I got an awesome job in Springfield MO and I am so looking forward to working there! My extended family is all around that area and this allows me to be close to my daughters as well as my other family!! So, things were looking bad and now they are looking good! Thanks for all your advice and direction in my questions!!! You all are the BEST!!!

I don't want to at all! I have stayed on this site during this whole process to see how you all do this traveling nurse career and I have learned so much! So, knowing this, I have found other nurses that have worked in this state and hated it and I have had other agencies tell me that they pulled their contracts because their nurses would never go back to this area. I just hate to think that I will blacklisted from ever working in Corrections again because I declined the position! I did verbally agree to take the position but then e-mailed him my decline of the positioni the next day. Now he is calling me or e-mailing me everyday....

My recruiter just called me and told me that if I don't accept his first assignment for me and show up for work next week, that I will be blacklisted in the State where I am suppose to go and that I will never be able to work in corrections again!!! I NEVER signed anything and he said it was a verbal agreement. I told him that I could not make it there in his time frame because I don't have my requirements met ie physical etc. He said he could get me through without all that. He sent me an e-mail yesterday basically threatening me with being blacklisted if I didn't follow through on this assignment even though I hadn't even received the information packet etc yet!!! So, what do you suggest that I do? Take a horrible assignment that other agencies have told me they no longer deal with or hop in my car and drive 20 hours to work for this correctional facililty that I know is a very difficult place to work and other nurses have vowed never to return??? I feel horrible!! He offered me the position late one day and I declined early the next and now I am having to deal with him calling and e-mailing day after day...

I am seeking out my FIRST travel assignment in psych and there are very little positions open in any agency. I thought about doing corrections but had some serious doubts when I took an offer with Supplemental. I was very disappointed with their offer and had this gut feeling that something wasn't right. I have read over 10 pages of the pages in travel nursing to see how you guys are doing it and the pros and cons etc but I am still having difficulty finding an agency that I can't "trust" to tell me the real truth about what they offer and what will actually take place. I have a hard time believing that bringing home $250 is worth taking my first travel assignment only to find out that I am working in a facility that is less than desirable and many other travel nurses have already said they would never work there again! Any suggestions would greatly be appreciated. Thanks~

All of your responses are great but how do you negotiate higher pay when they TELL you what you are going to make? I mean they have it all right there and throw it at you as if you are suppose to be thankful...I am don't get me wrong but I just have this gut feeling that something isn't right about this assignment! I have had other agencies tell me their nurses won't even go back to the facility that I am going to! I'm just really leery about this whole thing...and he pushed, pushed, pushed so much that I have ONE day to get to North Carolina, find my way around and be at work the next morning at 7am!!! I live 16 hrs away!!!

Hello fellow travelers!!! I need your help...this morning I accepted a first time travel assignment in North Carolina. The recruiter from Supplemental explained the pay etc but it was so confusing that I could tell he was getting upset trying to explain it to me. He is telling me that I am going to bring home less than 1100 a week and that includes my housing stipend. I don't understand how that is more than what I am making at my full time job? I thought travel nursing paid better than your average full time position in a hospital? I am worried I made a big mistake taking the offer! I can always change my mind but would need to inform him sometime today. I am not trying to find other people's take home pay but I have been a psych nurse for over 25 yrs and the pay they are offering me is less than I made 20 yrs ago!!! Also, has anyone worked in the Virgin Islands??? They too are offering me a position....Thanks!!

i was offered a position at a local hospital a few weeks ago. i put in my notice to my current job and prepared to work for the new job. the doctor that did my physical decided that i was not medically cleared to do the new job and they rescinded my offer. first of all, what are my rights here? the issue at hand is my numerous hernia repairs through the years. i have worked for the old hospital for 2 years after the last hernia repair and have never been written up for any work performance issues. is this discrimination? i got notes from my attending physicians clearing me but the doctor at the new job disregarded any information from my attending. what do i do? how do i approach this? can i use my short term disability through the hospital that i worked for? by the way....this was simply a transfer from one hospital to another sister hospital.....so i am still in the system.

The meds were cancelled out 2x because each time they didn't want the medication so I just closed the door back. I didn't even look at the medication. Im just standing in the med room and because they wanted something harder (I start with the lower amount of meds) they refused the tramadol. It's just so upsetting to me! I can't even remember the last time I saw that pocket or how many were in it! We don't use a lot of pain medicine so I rarely even pulled that med up on the pyxis. Anyways, thanks for all your help and I will let you know what happens.

That is what scares me...the staff nurses never count the pyxis. It hadn't been counted since Sept of last year. So that means that hundreds of meds have been pulled since that time with no count ever made but now they are asking me where the meds went just because I had 2 pts that didn't want that particular med. Again, I never waste or return a narcotic or controlled substance without a witness. When it comes to Tylenol etc, I just leave it in there and move on to the next med. We pass meds on so many adult pts that want so many prn's and then emergency meds etc that the pxyis is our savior with determing who has had what meds for when we chart our prn's. We scan everything we give and it automatically goes right into our charts. So, it it's not scanned, it's not given (or that's the way it's suppose to be). I've seen a lot of mistakes made with this system but I have never given a med and not scanned it. So, I am really upset that I am being questioned as to why meds are missing when I have never had a med error or anything since I have worked with this employer. I have made 3 med errors my whole career. I just don't know what to do....what to say...what they are going to do regardless of what I say to them...

The medication was not a controlled substance. Tramadol. It is in with all the other meds like Tylenol, Motrin, pepto and naproxen. There has never been any counting of these meds since I have been employed there. The supervisor would even go in and pull a motrin for herself or others and then push, cancel withdrawal once she got the medicine. So, meds were taken out of there all the time for different reasons. Again, I have never pulled anything out meds other than for patients or emergency reasons only if they had an order.

Good idea! I will do that this afternoon...we are sort of in a snow storm right now! But excellent idea!

i have a question regarding the legality of being blamed for meds missing from a pyxis machine. there are several nurses in a 24 hour period that pull meds from the units' pyxis machine yet the pharmacy is accusing me or questioning me where several pills have gone missing and why. they gave me 2 examples of meds that i "canceled withdrawal" and then on a sticky asked where the meds were. first of all, if the patient doesn't want the med once i've opened the pyxis, i just push "cancel withdrawal" and shut the drawer. i don't bend down and count the medication that is suppose to be in that particular box before i cancel the med. second of all, can i be fired for something i didn't do despite them saying i need to answer to why there are those pills missing? again, there are numerous nurses that use this same pyxis to pull their meds or to "borrow" meds when their pxyis is low. i hurt in my gut as to why i am even being asked about this just because i had 2 "cancel withdrawals" on this same med! i have never diverted anything and i am extremely careful and cautious to always have a witness to wasting meds if they are controlled substances or even non-narcotic meds just for my peace of mind. what can they do to try and make me the fall guy? how do i protect myself when i did nothing. if i get all upset, they will think i am guilty, if i act low key and like nothing is wrong, they will say i don't care and it's me. i am in a no win situation unless someone can shed some light on what i should do. i received the letter several days ago, no one has called me at home and my boss hasn't called me. pharmacy is the only one that left me the message...please any advice is welcomed here. ive been a nurse for almost 30 years and have never been disciplined for anything...i don't want to lose my career over something like this! thanks fellow nurses!!

st. louis - $34.00/hr + $2.00 for eves + $3.25 nights + $2.00 weekends + $10/hr if working for bonus shifts. i am making the most money i have ever made in my +20 years of nursing. working for it but worth it! i thank god everyday for my job and i work hard to make sure i keep it.

when working at a maximum security forensic hospital for the criminally insane, i had the scare of my life! another nurse and myself entered the hallway where a psychologist had been murdered and a social worker had been held hostage and raped by 3 patients that had gotten into the locked area. this incident had happened many years before. we had to use the bathroom and when we entered we noticed that the hallway was extremely quiet, all the doors to the offices were locked and we made sure we locked the two doors we entered. as i unlocked the bathroom door, i heard a male voice moan loudly! i didn't want to appear crazy so i slowly went to close the bathroom door because i wasn't about to go in there! as i closed the door there was a heavy sigh from this same male voice! as i locked the bathroom the door i asked my fellow nurse if she had heard "that". she looked at me in shock and stated she had! we slammed the door shut, ran down the hall, unlocked one set of doors to get out and then got out the last set of doors to the main hallway! we were so scared that we had to call security to come and check out the hallway where we had been. they checked every office and the bathroom and told us that there was no one anywhere in that hallway. needless to say neither of us ever went down that hallway again unless it was daytime and there were numerous other people in the hall. i know that male voice was the voice of the psychologist that was murdered there as he tried to save the social worker from those 3 insane patients!

could someone tell me what it means when a wound has a bright green drainage to it? it's mostly serosanguenous in nature but i have noticed the increase in the bright green drainage on the dressing. also, if a person has had mrsa in a wound, will that always be positive for mrsa or does it go away? thanks.

i was on the wound vac for almost 9 months and too had problems with having to go off of it and then back on. but my biggest complaint was when i received the bill! i called them and asked them if i had bought the machine because of the huge bill. i am still paying on about $5000 worth of "renting" the machine...not the $700 sponges or other supplies. :angryfire

we just got a new contract in our state. they are taking over the mental health portion of corrections from cms. the company is mental health management and they are out of va. we have never heard of them until recently and i am wondering if any of you have worked for them or currently work for them and how you like them? so far, they have been super nice and they seem to have so much better benefits. but i told my work site that i would check with my fellow nurses to see what you all had to say about them. you can send a private message if you like, i just need some feedback. also, let me know what state you are from and roughly what you make as an rn? thanks. :balloons:

how does a nurse find a job in managed care? i mean what am i looking for when i start looking for a job in this area? what about legal consultant nursing? can we work with lawyers in cases that require our expertise without having to take that course they offer for legal consultants?

being a psych nurse for over 15 years, i know that i am a "real" nurse. worked in a maximum security forensic hospital and now in the prison system. i can even start iv's...lol there are alot of cms nurses that think i am not a "real" nurse, but i haven't ever seen them try to do my job! i love what i do and i do it well. hooray for psych nurses and to the other nurses that are our sisters/brothers in the medical field!

correction: i accidently wrote a response to bipolar disorder instead of borderline personality disorder! my mistake! i have worked with borderlines for years and i too believe it's an overused diagnosis for many of our mentally ill patients. i would say that over half of the women on my forensic psych ward were diagnosed with borderline personalities. of course they had to have an axis i to keep them in the hospital so they were always able to find something else to put in that area...

i recently had an abdominal hysterectomy and a hernia repair (3 weeks ago). after one week the doctor took the staples out and within 15 minutes after leaving the office i lost a tremendous amount of fluids through my wound area. they took me back in and stitched me up. a few days later i again opened back up and lost a lot of fluid and the doctor put a colostomy bad over my wound so that it would just catch the fluid next time. 2 days ago this same doctor took half of my stitches out and within one day i opened up again losing a lot of fluid and then again tonight i lost some more. now i am not a medical nurse but isn't there something that can be done about this problem? i am so embarrassed to be out in public and all of a sudden have all my clothing completely soaked and dripping on the store floor! can someone explain to me what the possible causes of all this is? why am i losing so much fluid? i have been using kotex across the wound site so that if i do leak, it will hopefully catch most of it. but i have soaked through one of those too! the tape i am using on my abdomen is breaking me out and tearing my skin up as well. any ideas? has anyone heard of something like this happening? i was scared to death the first time it happened because i thought i had completely eviscerated! thanks.

Being as money is a BIG issue when it comes to our education, I would consider the ADN program at a community college and then while working as an RN complete your BSN. Also like someone said, you could always go to work for a hospital and let them pay for you to go and get your RN? You will have to commit to them a few years or pay them back if you don't stay working with them, but they are usually very flexible with your time while you are completing your BSN on them.

oh, one more thing....the treatment that forensic patients receive is outrageous!!!!!!! at least at the hospital i worked at. they would get clothing allowances twice a year in the amount of $600 or more to buy name brand clothes, shoes, bras, coats etc!!! my aides couldn't afford to buy themselves new shoes much less clothes for themselves or family and yet they had to escort a patient to a clothing fair to allow them to buy anything they wanted for "free" from state funds. some of the female patients had so many pairs of name brand tennis shoes that they were kept in a closet on the ward because they couldn't keep them in their rooms. it made me sick to see these murderers, rapists, child molesters, arsonists, cutters, etc dress better than the staff that had to take care of them day after day. how twisted is that??? it really angered me that the dept of mental health couldn't see the damage they were doing by allowing this patients to get what they wanted when they wanted it and not have to pay a dime for any of it. they also got the name brand drugs and a lot of them! they got ativan anytime they wanted it for agitation because we were told that we couldn't make the determination if that patient was truly agitated or not. (had a girl playing cards one day and she snapped her fingers and told me to get her an ativan because she was agitated....that was the last straw for me....i told her no that she was doing just fine and that i had it documented that she was in no way agitated as she was playing cards and laughing when the request was made). the wards have montly birthday parties, parties all the time for various reasons, receive a canteen allowance allowing them to eat their weight in junk food (the women put on 100# or more when i worked with them), allowed to watch movies all weekend, sleep when they wanted to, we had to bring trays to them if they didn't feel like getting up for meal time etc etc etc. catered to is what these patients were getting. i got out before i lost my cool. i had already had 5 concussions, disability in both knees from hitting the concrete day after day for 7 years, broken fingernails, ripped clothing and a human bite on my calf that will show the rest of my life and i have to be tested for hiv every year. i also busted my back after a huge altercation with a psychotic woman that took 10 of us to get her to the floor. i have suffered chronic back pain since that time and it will never go away. not worth it to me and hopefully i will never go back there again to work. talk about ptsd!! i would say that anyone that has pulled a stint in a max forensic hospital has got to have some sort of ptsd from it.:angryfire