cherilee

Ok calling all experienced psych nurses: This is the third pt at least ive seen that appears to be in benzo withdrawal even after the taper is DONE. Seems no doctors think that people could be physiologically withdrawing from say xanax, ativan, clonopin.......even though they were previously on these drugs for YEARS. So I have seen pt number three this week: was on xanax for three yrs prior to this admission (as well as other drugs). His pupils are dilated , his BP and hr are climbing all the time. He is having tremors. But the docs say NO WAY is he still in withdrawal. SO has anyone seen people still withdrawing after detox from benzos?? Im convinced they can and they do keep having symptoms of WD . what do you think??? ( He finished ativan taper a few days ago)thanks:nurse:

believe it or not you are a hot commodity for this field. You have psych experience, Most sick people have psychiatric issues ie depression, losses, substance abuse, you name it. Your med surge experience is invaluable in this field. most psych pts have medical issues as well. Just get your foot in the door by perdiem, or start in geri psych. Most cities are hurting for nurses . If LA is anything like Boston, you wont have a problem. good luck:yeah:

Hi everyone, I have been working in psych for eight months now. Sometimes I really love it, and other times I dont. It has been really interesting, never ever boring. Anyway, I was wondering what some seasoned psych nurses do to help suicidal patients. What do you say to help their perspective, or give them hope? Today I met a very young man , early twenties , who cam e in suicidal, and I found myself during the assessment not too sure what to say to him. I know Im not "curing" anyone in a day, but I really want to help not hurt a young person so vulnerable. Usually with depression I try to encourage groups, listen, point out when they are proactive,etc. I stopped to think today, if someone is this depressed, with a fresh suicide attempt, what do you say that could help?? Thanks in advance:nurse:

Im getting conflicting info on levels... anyone know what a true lith level is when its toxic? over 1.2? Also, what symptoms do you see? have u seen any patients with true lithium toxicity? What did it look like clinically? thanks in advance

sounds like you were maybe missing info on your application somewhere? call the test center that you took the test at. Good luck!

If it gets better, shortly, grrreat If not, dont sweat it, take what youve learned, go somewhere else. dont accept anything less than a supportive work environment, TRUST ME there are enough jobs out there for nurses, you dont have to settle

You are being WAY too hard on yourself. Yous ound very concscientous and you are more than likely doing fine. In a perfect world, we check bands every single time we walk in a room. Like the previous person said, You had been medicating the patient all day long. Give me a break. You knew the patient. As a new nurse, try to shake the smaller things off. You come across as more confident that way. Fake it until you actually can really do it on the inside. Unless a manager brings up something as a major concern , just keep your head up and keep learning. You will be amazed Lisa

Im sort of a bleeding heart when it comes to patients. My question: Im thinking the other day, boy I feel so bad for this pt [borderline) because he is so distraught, acting out, crying, etc. Someone was surprised I felt "bad" for him. Are these people really suffering, or Is their behavior sometimes an ACT? maybe my perception is off. They seem to suffer greatly any thoughts?

I agree with you one hundred percent. Skills come eventually. By far, the greatest Issue I had as a new grad and at my last jobwas lack of support. Entered a job in LTC and lacked some basic skills, even though I had been working in a community hospital for a year already. I was overwhelmed with anxiety when my preceptor became "annoyed" any time I wasnt proficient at a skill. In turn, I performed worse. Granted, in hind sight, I wish I could have been less sensitive. But STILL,to be in a new job, you need support. I wish Nursing school prepared me to be tougher on the inside. And it did, to a degree. I think to be a successful nurse you really have to have a thick skin, not freak every time someone isnt that nice. But how do you teach that? I also think people in the experienced world have a responsibility to the less experienced nurses. They need to act a s resources and help rather than put other nurses down. Ultimately, nursing school certainly gave me the foundation to think critically in situations. I am working and supporting myself and my son, so I consider myself successful.I also passed nclex on the first try. You must be a good teacher, because your perception of whats important is right on, IMO. Lisa

dont be too hard o n yourself. I had been doing that for a year, and still do it sometimes. It is POINTLESS. Trust me, everyone makes mistakes at times . EVERYONE. If the patient wasnt harmed, and you learned from it, move on. You become a stronger nurse with every lesson. A good nurse doesnt get fired because of one mistake. Let it go:nuke:

coping with someone elses depression can be difficult. Dealing with your own is hard too. My ex husband went through some pretty bad depressions.He would lash out at me, get migraines, refuse to participate in fun things, etc. Then I realized I had my OWN stuff to deal with. Unfortunately, our marriage ended. I had to focus on myself and what I needed to feel ok good luck take care

thanks, needed tohear that . I cant let one mistake blow me over. How is your job going?

Hi everyone, Just started a new job in Psych and love it... But I got so nervous after realizing I transcribed an order WRONG!! today, I documented on the wrong sheet! I hat e making stupid mistakes. The manager was nice about it, but I need to avoid these mistakes!! I have a year experience in med surg. any words?? I dont want it to continue.. Thanks ps, I work with a friend, she got me the job!

Wow! I would say you are in the minority of people who are bored with nursing(on this thread anyway). Here is my suggestion: Find out what you love and do it.

Yes. of course. You are not alone. Nursing is tough, and especially when you are new. Don't spend too much time worrying... Regroup and reassess what it is that would make you happy. One setting that is good for you may be not so good for someone else. We are all different. There are many avenues to nursing, home care, psych, hospice, long term care, outpatient, take your pick. I have been through really tough experiences so far, and Im one year in. Im on job 3. Keep in touch with us, good luck , follow your heart:redbeathe

:twocents:pros, you stay busy , money can be good, opportunity to help people and feel good about that, theres a schedule for everyone, there are many different fields of nursing/ many job opportunities, it is a respected profession, opportunities for personal / spiritual growth, you are always learning, you meet alot of different people from all walks, opportunity to develop relationships CONS: You are too busy, burnout rate is high for medical surgical nurses,the schedule can be daunting,you have towork weekends in many jobs, coworkers can be horrible, easy to make errors when under extreme stress, working with understaffed hospitals is difficult, It takes a long time to develop strong skills, It is mentally emotionally and physically draining,\ sometimes you are the secretary,aide, family counselor, pee on, etc . feeling like you are spending minimal time with pts, . Thats my

That sounds like way too many patients. Do you work with another nurse with thirty pts? do you have aides? do you only have to give meds? Elaborate on the whole picture here. If I took that on, I would be setting myself up for some very stressful situations. Don't accept poor orientation. eight days sounds minimal and not conducive to learning strong nursing skills. Do not accept or continue the job just because it is there. There are other jobs that will give new grads an extensive orientation. At the least, ask for more orientation. Time management is something that comes with time, but you need the support and proper amount of time with a preceptor and other nurses as a new grad to develop these skills. Lisa

I am also starting my new psych job next tuesday. Cant wait Lisa

You may have a tough jobat this place... but that is the best way to learn. NO NEW nursing job is easy, though. The learning curve is steep. The first year is all new. So look at it this way, Get your year under your belt.. If you find it is not your niche, You can pursue other avenues. BUT

Long term sub acute? I assume you will have pretty complicated patients. I worked in a long term acute setting, for a short time, and the pts were sicker than the med surg floor I worked on. You will gain good experience there. You will be gaining skills needed for med surg, like IVs, giving insulin, dsg changes, doc orders, etc. I think Its a good opportunity. If you try it and it is not what you hoped, you can transition to a hospital as a new grad. Good luck:yeah:

:nuke:Dont get discouraged; There are alot of different types of nursing jobs out there! I posted a resume on the net and get calls everyday from all different kinds of nurse recruiters, looking to fill , lets see... I got a call for an office type job, looking for someone with an rn background; I got a call for a psych position, I got a call for an icu position, etc. I only have one yr of experience, too. I am leaving med surg myself, its just a bit too much for me, the pace, the patient ratio, the paperwork, etc. I am amazed at what they put on us nurses. We are the secretarys, the therapists, the nurse, the room cleaner, the waitress, the family sounding board, the list is endless:lol2: I just landed a job in psych. I dont know if itll necessarily be "easier" but I am hoping for a bit of a slower pace and more of a nurse patient relationship. So there are certainly many avenues you can go toward, too. You have that license, and guess what? It is PERSONALLY YOURS> You can do with it whatever you like:redbeathe follow your bliss Lisa

Im glad things are going well for you. I am starting my new job on a locked unit in a week and a half. Im pretty nervous myself,keep hearing about people getting beat up and things like that is kind of unnerving. Im glad things are going well for you. I know in nursing school, the psych instructor told us to never be in a situation or space where youcannot quickly exit. I was told that Keeping a matter of fact tone/attitude when someone is escalating is also a good idea. We were taught to help the person use their own internal controls first, if that doesnt work, to set a non punitive type structure for the patient, ie, " You seem annoyed, maybe it would be helpful if you take some time in your room , to gather your thoughts and then we can talk". I have no idea if this stuff works but in theory it sounds good:lol2: anyway, Im interested in hearing more about your job, as I will be in the same type of position very shortly!

Hi Everyone, I will be starting my new job in an acute psych inpatient setting in two weeks. Coming from med surg, what should I expect?? Im excited and nervous. Originally it was supposed to be in the dual diag. unit, but they switched me to the other setting, acute diag.

ND mom, how has it been going since??

I also want to say something. Being a new nurse is very difficult. It is not just you. I have just finished a year on a busy med surg floor, and its been hard. seven patients is a huge assignment for a new nurse. If you feel like you are progressing, learning, and moving forward, and liking it , stay. If not, there are tons of options out there. There is psych nursing, which I am about to try, and am very excited. There is home health care, there is medical coding/office work for RNs, etc. There is hospice, private duty, and if you want to stay in med-surg, there are places with less nurse/pt ratios. THere is rehab nursing, legal nursing, clinic/ambulatory care nursing, the list is endless. Look at your options. If you enjoy nursing, you can certainly find something that fits you. Like the other replier said, follow your bliss. There is no law stating you HAVE to stay at your first job one year, or two months. Your life is PERSONALLY yours. Whatever you want to do, If your husband is a decent man/spouse he will surely support whatever decision you make. Things WILL get better hang inthere