darrell

I know that ACT, too, TerpGal02. My own MI guru work with an ACT team. Acceptance and Commitment Therapy is different, although it does play well with MI. Here is a link to the synopsis. ACT | Association for Contextual Behavioral Science It differs from the CBT thing by focusing on changing our relay ship to thoughts and suffering, rather than trying to change the thoughts themselves. I love this because it is such simple sense: thoughts of anxiety may arise, but I do not have to guide my behaviors by them. Defusing from the mental stories allows a more objective perspective on our own mental activity, leading to acceptance of thoughts in the same way I accept that some days are rainy and some sunny. DBT and MI are usually better known, and MI is awesome, of course. I am glad you posted and hope we can exchange tips and knowledge! D

I work in community mental health for New York State. We are undergoing a lot of changes and restructuring right now, and our clinic has been riding out the process pretty well. Part of that seems to be that we are willing to try new things to help folks fit back into the community. I provide case management and primary therapy in addition to nursing support. Much of my focus is on behaviors, helping people achieve concrete changes that bring observable improvements to their lives. I use mindfulness approaches a lot for this, including Dialectical Behavior Therapy (DBT), Motivational Interviewing, and Acceptance and Commitment Therapy (ACT, pronounced like the word.) I would love to connect with other nurses who are using or interested in these or similar approaches. There is a slowly growing special interest group linked below, and also a Facebook Group. The Association for Contextual Behavioral Science (ACBS) is also supportive of any projects to capture this field in book form, a potential opportunity for professional growth. Looking forward to meeting others of like mind! http://contextualscience.org/act_related_nursing_sig https://www.facebook.com/groups/ACTRN/

I work for New York State in communi mental health and I provide primary psychotherapy and substance abuse counseling. I have a BS in counseling studies and an MA in H&W focusing on coaching behavioral change. I use Acceptance and Commitment Therapy (ACT, pronounced like the word), Dialectical Behavior Therapy (DBT), and Motivational Interviewing. My focus is mostly on the behavioral change coaching. ACT-Related Nursing (ACT-RN) | Association for Contextual Behavioral Science

It is one line in the progress note. And it is her right to to take her pills however she chooses. If you had interfered, you would have something to agonize over...:).

Thanks for the chuckle, Sue, although I also empathize with your heartache (headache)! I am reminded of one snafu in which I showed up an hour late for an interview. We never did find out whether it was my mistake or HR's, but I got a second shot at the interview, and was incredibly lucky enough to be gifted with the job despite the embarassing bungle. I can't guarantee that it was my carefully crafted resume and my suit that turned the tide, but I imagine they did not hurt my chances! I am 54 and I know cultures change over the generations. I wonder if the formal job interview is becoming an anachronism? Is grammatical correctness on its way out as younger people move into hiring positions? This story would have had me shaking my head thirty years ago, but it seems just a sign of the times to me now-is that just a misperception on my part?

There are many special interest groups (SIGs) within the*Acceptance and Commitment Therapy (ACT)*Community, but not one for nurses. I am trying to see just how much interest there is in setting up a SIG for nurses interested in ACT and behavioral change coaching. My hope is that folks on the general lists getting this might forward it along to nurses they know, creating a bit of a viral momentum. My name Darrell King. I work as a psychiatric RN for the State of New York in a community setting, and my focus is on coaching behavioral change. I am involved in bringing the use of ACT into the Nursing setting for the purpose of assisting clients with behavioral change in areas from diabetic diets to medication compliance to managing psychotic symptoms. I see this tool as something useful to nurses whether they work in the home or the hospital, a way to make healing in this area available even on a nurse's limited schedule. I think we can benefit from establishing a nursing SIG focused on behavioral change, which can have many functions. One of these is the online discussion list, wherein members exchange ideas, thoughts, problems, and suggestions in pursuit of growth and problem-solving. If you have such an interest, please send me your name and email at [email protected] and I will notify you when the list is set up. Or, visit http://contextualpsychology.org and investigate for yourself, and drop me a line if you join the association! Thank you! D Darrell G King, RN Rochester, NY, US [email protected]

Early car drivers were likely criticized for their contraptions, phone users for gossiping on party lines, etc. Change scares people. D

In at 50 and doing great in psych. Some issues with schedules at home, but working on that! Keep up with the continuous improvement and have a comprehensive self-care plan! I have a daily workout with Yoga and a meditation regime.

I started in my later 40's. At 52, I am in psych and loving it - and still in school to advance my professional education. I do take care of myself - fitness, Yoga, meditation, rest, diet - but your age is not a factor in my eyes. Regarding whether you will like nursing, I feel you'll have a good idea before you even graduate. Facing the same question, though, I did some times as a volunteer EMT and then as a patient care tech in a hospital and a rehab facility while I was in school. Practical experience plus testing the waters... Doing this will mean stepping outside your comfort zone. And your wife's. That decision you will have to make yourself, but realize there is work involved. Nursing school is not regular college and requires commitment and hard studying at times. Review the choice now but, once it is made, don't waste time on second guessing yourself. It just adds useless stress to the path. D

Skimming replies, the part about learning from past mistakes and experience seems the most productive advice. Being new, you likely had no idea that you could refuse the assignment right at report if it was unsafe. This is facility-independent, although it could easily result in being fired. Still, your license would be safe. Please note that if you had pulled the shift off, you would likely have found yourself facing similar situations more frequently. It's about the money, after all... I liked the part where you had the presence of mind to prioritize even under pressure. Well done. D

I agree with the spirit of your opinion, but I'll add that there is no privacy. Posting online, including this response, makes the information public. I avoid details about work except the most generic especially because of HIPPA. I will, however, continue to feel free to post opinions. It will take some parts of the business community time to catch up, but the trend is obvious. I can find most addresses on Google Earth and zoom in to ground level and see the place as though I were standing outside it. I can find information on many people with their names and general locations - more or less according to whether I want to pay membership sites. Privacy still applies to what we think, but not so much to everything else. I really figure it's not worth stressing over anymore. D

Cultural bias does not always equal bigotry. That being said, however, I think somebody probably had to review her response a few times after this. It seems like one of those knee-jerk responses that could have been better phrased! Were it me (I'm a male, but I have never been able to generate any intellectual support for gender discrimination), I'd probably avoid appearing to be on crusade but otherwise just move forward with quality nursing care. There are bound to be rough spots in any inter-cultural interactions. I may disagree with what was said, but I wouldn't go out of my way to make the NM's or doctor's lifde hell over it. It's far from the most ridiculous stuff I've run into. It's tiring, I admit. My time on the floor is supposed to be about helping people heal - I'd rather not spend it in social maneuvering. Still, maybe this is a case of nursing care being needed by staff...:). D

Yes. Reincarnation and many other beliefs have filtering into various Buddhist traditions on top of the core teachings of Buddha, which center entirely around this life and how it is lived: he advised not wasting time on speculations about the afterlife. Regarding how to die, though, I believe he advised that every event in life be experienced mindfully and with aware serenity or detachment. It would be advantageous for you to explore the Buddhist tradition involved and depend upon its community for answers. BuddhaNet - Worldwide Buddhist Information and Education Network Death and Dying in the Tibetan Buddhist Tradition Death and Dying Buddhist View on Death and Rebirth A Buddhist Guide to Death, Dying and Suffering. Buddhism and Death D

I do work in psych. I agree. Most especially about the staff behavior - I've seen more situations escalated by clumsy interpersonal skills than through psychoses. I think some folks are so uncomfortable with the reality of violence or altered mental status that they are distracted from considering the impact of their behaviors. D

I am 52, work full time, have had my RN for a couple of years and am attending school for my BS with 16 credits this semester. I suggest that you will only know for sure when you have done it, so it is probably time to tune them out. D

I am a psych RN and our techs tend to sit back and grin at the nurses when such needs arise...:). I am a bad one to help as I don't mind doing it - I decided when I chose Nursing that I would accept all body fluids as equal. In the spirit of that decision, I suggest that there is nothing "undesirable" about washing bodies or working with body fluids. It is simply your perspective that makes it seem so. D

When I was a tech in acute care, I wore tops with seasonal motifs and had holiday themes my wife put together for me. I brought some smiles to the patients with these, which absolutely justified their use. I dressed to support what worked for them. I work in psych now and wear office casual all day. I try to look professional, but the emphaisis is on the patient, not me, so my primary guidelines are quiet earth tones and a non-uniform appearance. Professional appearance is a worthy second-place goal behind patient care. If cutesy tops are therapeutic, go for it. D

Many folks will say this, I'm sure: break the path down into steps and then break the steps down until the first move is within your ability to reach. Then start walking them. D

You did well and they might wish to rethink policies and procedures. Remember there may be multiple conflicting drives in play with which you are not familiar. For instance, someone may have lectured the direct care staff about linen costs recently, resulting in conflicting priorities It doesn't take much of that to drive the average person to bitterness. For my part, I do not raise the battle flag and charge screaming into battle. Instead, I do just what you did: I take it one opportunity at a time and decide with therapeutic kindness and clinical judgment as my guide. Although the reality of things may differ from the ideals, there is no reason you can't at least try to implement the ideals. D

When I entered Nursing School, I backed out of an eight-year entrepreneurial career in software to work as a tech at a local hospital. I did it to gain experience before graduation and because I wanted to help people. Financially, it was a step down, but it was part of my vision and I went for it. Some things I did to balance the load were to still moonlight occasionally in software by building web sites or doing small programming projects. I also took advantage of the hospital's healthcare plan, which was cheaper than my previous self-employed version. And I cut costs for a couple years. It's not just about salary comparisons. Be creative. D

By now you've had your meeting. I don't have enough time to read through all the posts to see what happened, but I am sure you can either re-enter or start at a new school. The important thing to remember from my perspective is that your experience was completely human and normal. Try to psych reading or work with a school counselor. This will not be the last stressful situation you face. In ten years, when you have saved a couple of lives because of your calm under pressure, you will tell stories of how you learned the value of the skill in nursing school. Nursing school stories are always funnier in retrospect...:). Get up, dust off, and get back in the ring...:). D

Nursing school was an awesome experience. I went in at about 47 or so and thought I was pretty darn good with the ole' academic front! I came out a bit humbled perhaps, but with a strong sense of accomplishment. My worldview was significantly altered and I opened a couple of unexpected personal frontiers. Despite the challenges, I'd do it again. D

I've worked at two hospitals in my area and both require two nurses for insulin. In my current unit, the med nurses commonly handles thirty patients, but there is usually no more than a half-dozen fingersticks at most and most days only a couple. Only two patients have sliding scale coverage. The rationale seems to center around the speed at which Regular insulin works. D

I am having a discussion with a co-worker about the use of c/o or "complains of" vs. "reports". The general idea is that the c/o phrase has negative connotations associated with the concept of complaining. She says there is an effort to move away from this phrase and abbreviation in the industry, but Google is failing me when I try to verify or refute this. Anyone have any leads? Thanks! D

Beautiful. I can afford, say, $100 per month for healthcare. Handle it through a risk pool or whatever. I can not afford $1200 per month for two people's meds (our current real-life estimate) plus a few thousand more for office visits, labs and whatnot. Even if it is deductible. Obviously I can get rid of the cars, drop the cable and Internet, tighten up the meal belts and stop visiting relatives - all of this will save money which can then go into healthcare expenses. Not much good for the economy, I suppose, and certainly not an improvement to my quality of life, but prioritization and all that...:). D