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Have been a nurse for 30 some odd years, experience in OB, OR, and now Psychiatry

morghan's Latest Activity

  1. morghan

    a new twist on mandatory OT

    Thanks to Jenny for the response... that does make lots of sense to have the off-going RN make assignments hmmmm wonder why the boss didn't think of that one.. and no, the nurses stay the entire shift, they do not leave 30" early. morghan
  2. morghan

    Showing up at work smelling of alcohol

    Great comments Molly,,, I was going to state most of those but u beat me to the punch!.. I did an intervetion on a contract CNA in our hocpital, we smelled alchol on this breath... called the supervising agency, and he left to straight to provide a sample, as we say
  3. morghan

    tips for dealing with dementia

    Hello to my colleagues in Geriatric care out there... this is such a great thread and am so glad to be able to participate. I am a Nurse Case Manager on a 26 bed acute care GeriPsychiatric Unit in the midwest. We happen to have a great group of team members (Key element Team!!!). Care delivery to memory impaired individuals, who often present with a variety of co-morbidities common to the aging population is a challenging but very rewarding field. I believe that all persons are worthy of human dignity, respect and compassion. Can you imagine what it would be like to hear the news of someone's death (mother, husband, etc, as described above) as new information every time! How horrible that would be. I find that judicious use of low dose antipsychotics and low doses of mood stabilizers povide better relief of restless wandering and late afternoon agitated behaviors. I agree that entering that person's reality is the way to interact with these persons, for it is often impossible for them to be in ours. I recently joined the NGNA, and they have a great journal that comes with your dues, and super meetings. Also, APNA's convention in Dallas in going to have an entire Gero track for those involved in this specialized care delivery model. Thanks for letting me share. Morghan
  4. morghan

    a new twist on mandatory OT

    The Management on our unit must really be getting heat from on high about the OT (short staffing, so nurses have to chart sometime!!) ... to eliminate the nurses being to long in report, the "Charge Nurse" has to now come in 30 minutes early to get report and make assignments:confused: She has to be done with report in 20 minutes, and have assignments made... anybody out there know if staff can be forced to come in 30 minutes early every day of their shift??? Would appreciate feedback for my colleagues... thanks
  5. morghan

    patient falls in psych.

    Our hospital uses a fall assessment tool which is fairly pondorous and minimally predictive... this is the key element prediction. Not who may fall but who is really going to fall. I did lots of searching too about this since I work on Geropsych and we have lots of frail elderly clients. I found a book by a lady named Morse... Janice I think, and she has done a bunch of research on fall prediction, and has developed a tool to assess which patients will fall. You can purchase her book off the web, and use her Morse Fall scale which is a quick and dirty little 6 point item test. Good Luck Morghan
  6. morghan

    How do we COMBAT workplace violence???

    I agree with karaLea and ounce or prn is worth a pound of cure... or something along those lines.Our hospital had a serious assault on two of the security staff, after the patient had barricaded himself in the room (old building, didn't have the newer doors) One officer required chest tubes for his pneumo he got with the broken ribs.... other 7 staples to the head.. but this guy had been slowly esclating all night and no one addressed it... so there u have it.... kinda like when you first learn to use the computer, that old rule of "save early, save often " rather applies here, if the patient has demonstrated behaviors which endanger the safety of self/others then interventions need to be initiated... early meds... allow time to ventilate... i don't know if you have secred somking rooms or not, if the patient can be in control...if not, then staff need to assisst him/her with that decision.... well i'm getting to tired to make any sense nite all
  7. morghan

    a minute for Alex

    I will keep your friend and her little girl in my prayers; she is so fortunate to be alive, and with today's wonderful surgical techniques, should have a good outcome, too. {{{{{{{{{{{{{{{alex)))))))))))))))))))))))
  8. morghan

    Advice nurse

    Hi --> I don't really know what you mean by "advice nurse"... are you meaning a nurse consultant??? A new role that has been developed at our hospital is called the "Attending Nurse" it's a little like case management, a little UR , patient and family educator, etc. I don't know if that's kinda what you're thinking about... you say you are returning to school.... get your BSN, Master's ??? I bet you'll get lots of good advice and feedback with a little more info... maybe this helped i don't know , but I can certainly relate to the Burn Out issues you spoke of... insane case loads with terrible benefits and hours... my back finally literally gave out, and i too went back to school to, 3 years later I've got a dream job which I love:) weeeeellllllllll ... it's late for sure 'cause I am rambling good luck Morghan in Wichita, Kansas:nurse:
  9. morghan

    new here, just saying HI

    Hello and welcome to you !!! It's great to have a new voice on the boards... i agree about the gel cushion :roll thank God I have a good 'puter chair. Sometimes if I've had a tough day, it helps to come sit awhile and chat with my online colleagues. Me I'm from the heart of the Midwest and work in Psych... there's great boards to post in so look around and make yourself to home Morghan:nurse:
  10. Hi Magaroon! I haven't experienced bi-polar illness, but it appears to me that your insight into your illness is excellent. I would suggest involving your primary therapist or prescriber to help guide you in this matter. If he or she feels you can handle the sometimes stressful Psych realm... then go for it. But there is a caveat to my comment here... you will have to be clear with boundaries with respect of talking about your illness to clients. Otherwise welcome aboard! Morghan from Wichita ks.:)
  11. morghan

    white uniforms vs. colored/printed

    I have almost thirteen years experience in GeriPsych ... I think it matters less what staff wear than it does how they are able to respond to and relate with the elderly population. Patience. understanding and a sense of humor are keys to successful realtions with the older client
  12. morghan

    APNA Conference in Dallas

    Is anyone planning to attend the APNA Convention in Dallas in October??? I'd like to meet up with my peers from the forums if anyone is interested:)
  13. I haven't been in here for awhile... chiefly because I'm in school doing just what you are wanting to do... I am enrolled in the Psych/Mental Health Master's (CNS) at Wichita State University in Wichita, Kansas. It is a great program, and offers an excellent learning enviornment. Advanced practice specialization is the way to go to achieve the greatest autonomy in nursing today. In Kansas, ARNP's have prescriptive authority, and work from protocols. I highly recommend an advanced degree. Good Luck in your endeavors
  14. morghan

    Stupid questions/comments made by doctors!

    This one has to do with a dimwit doc (cardiothoracic surgen, ha!) he had a patient on the table... patient was to have a mediastinoscopy... patient asks, before going to sleep " well doc, anybody die while you do this procedure before?" doc sez,"Oh I'd say 1 out of a 100, but I've done 99 good ones!" DOH!!!???*** what a dumb!!!
  15. morghan

    The Elderly-What do you see?

    This is absolutely wonderful!!!:) :) I work on a Geriatric Psychiatry Unit, and love working with the old old. They have so much wisdom and we can learn so much if we just listen! Thanks, I'm going to print this page and take it to work
  16. morghan

    new restraint regs

    Reply to Moderator Re: restraint issue That's precisely what we have been doing... writing them up each and every time they refuse... but this issue still is a big problem. The problems with deaths in restraints have nothing to do with who writes the order or does a face to face assessment. The problems lie in 1.) really violent/ill psych patients (ie mental health reform) state hospitals closed 2.) substandard care delivery 3.) Shortage of qualified/skilled nursing staff that know how to de-escalate a situation and possibly divert a restraint episode 4) shortage of qualified nurses to monitor these patients while in restraints; now restrained patients are supposed to be 1:1's (try staffing for 7 or 8 1:1's on your 11-7 shift!!; or any other shift for that matter) I don't really know what the answers are, but I do know that more government intervention/interference is worse not better for health care. I really do enjoy the opportunity to comunicate with my colleagues out there... to my colleage in Fla... I'll type that paper in RTF and email it to you:) Hope everyone has a happy Thannksgiving!