hpcat

If you're interested, give it a try. I've been doing it for 3 years and love it. You will learn to recognize when patients are escalating and how to bring them down. A good rappor with your staff is essential, as mine have actually prevented me from being attacked a couple of times. It's so rewarding to watch patients who are paranoid, delusional, agitated, suicidal etc. become clearer, calmer and stable with your help.

Just an FYI, psychiatric nursing shifts are typically 8 hours instead of 12. That's because the patients are really rough on the staff. Don't assume psychiatric nurising is easier, in fact it can be much more difficult. Some of my coworkers left psych to go to medical positions because they couldn't handle it.

If you work inpatient in a state psychiatric hospital or short-term acute hospital unit or facility, you need CPI. Typically the hospital will give you the training in a class. I have worked for the state and short-term acute, you need CPI to protect yourself, your staff and your patients.

Try to present yourself with confidence, they will want to know if you can maintain your cool in an emergency.

For this type patient, you need to know crisis prevention & intervention (aka self defense for psych nurses), you need to be able to medicate with PRN and/or stat meds, over objection if necessary, and you need to be able to use seclusion and/or restraints. Violent psychiatric patients are not to be taken lightly, you can get very seriously hurt. Not telling you to leave, but I would, pregnant or not. Your facility is not prepared for this level of agitation/aggression.

I was taught in school to aspirate. But sometimes circumstances make it less than ideal. When medicating an agitated, adrenaline fueled psych patient who's being restrained by a half dozen staff, you need to consider the safety of the patient and staff.

I strongly believe that psych nursing has a huge "social work" component to it - the pt's social problems are the prime reason they become ill and the biggest barrier to getting well. The medical aspect to psych can be much lighter than any other kind of nursing but the therapeutic, communicative component is HUGE and is the difference in my opinion between a good or bad psych nurse. I find psych much tougher than other disciplines because of the emotional and psychological toll it can take on nurses, it can be frustrating to see pts relapse over and over, or languish in long term facilities, or constantly try to hurt themselves or others. The healing takes a long time and a lot of effort, with many relapses along the way. As a psych nurse, I can honestly say, if you want to do this cuz you think it's easy, it's not, you need to find another speciality.

I also started in psych which is the specialty I wanted, first a 13 week contract at a state facility, now at a small acute psych facility that used to have a prestigi0us rep but now on the wane and awaiting takeover from a hospital network. I work nights, so I savor opportunities to interact with pts since most sleep thru my shift. There are people there who have been doing this too long but never had any other job and do many petty lying things to make others look bad and themselves look good. They rarely spend time with pts unless they have to get some work done. There's a lot of paranoia about the takeover, and some of my coworkers have more boundary issues than the patients. I have a preceptor who does nothng but give negative feedback and nitpicks, yet I see her make huge mistakes.The other day my preceptor told me I am too social with the patients, I need to be more medical (FYI she does not socialize with the patients, she's kind of cold). She saw me talking to a detox patient who was anxious about 1) coming off meds, 2) wants to quit smoking and 3) is anxious about discharge and fixing the mistakes he made when he relapsed. Call me silly, but I think it IS A MEDICAL ISSUE to talk to an anxious patient - DON'T WE MEDICATE FOR ANXIETY???? She said I sound like I want to be a social worker. Get a patient with unstable VS and she's in her glory. Get a patient who wants to talk she she sends them off. Another FYI - when I was interviewed, the nurse administrator wanted someone who WOULD INTERACT with patients, I guess the preceptor didn't get the memo. Not for nothing, although I love psych patients, I am done with psych nurses who don't interact with the patients. Yes. the pts can sometimes be dangerous and unpredictable, but if you're too scared then switch to another specialty! I have learned to keep myself safe AND enjoy a positive therapeutic relationship with even the most dangerous patients. You can't help them if you don't talk with them!

I am about to leave a job at a psychiatric facility (my decision, got a job offer:yeah:). This was my first job out of school. The facility got a great rating from JCHAO. I had a contract position weekends double shifts and have floated to many wards there and find their ancient MAR books scary as hell. Lack of consistency in formatting/punctuation that mean you have to reread the order for clarity, many many handwritten changes that are often sloppy or unreadable, orders d/c and changed several times, pages out of order or in the wrong patient's section, even white out! I worked 2 days in a new ward. A patient had been having some behaviors when I arrived that the psych aides said were different for him, more disoriented and confused than usual, making strange vocalizations. Priority bloodwork done on my shift was wnl. MD and psychiatrist gave no new orders. Pt continued to deteriorate thru the next day. I called the MD because he was unsteady on his feet and appeared to be tensing up and moaning, he is noncommunicative and I believed he may be in pain. MD had him lie down and take Tylenol. Pt came to dayroom later and seemed a little better, still tensing a bit though. After dinner he was more unsteady. Tensing took on the look of a mild seizure. Called MD, he said pt has hx of sz disorder and is on sz meds but he could not change them as he is weekend coverage, weekday regular MD would have to change. He ordered close obs for fall prevention and for regular ward dr to see pt in AM. Pt was taken to bed, seizure activity made him flail arms and legs, then get up and walk the hall, where he would nearly fall down and had to be helped back to bed. I called MD again, he stood by pt bed for about 10 minutes shaking his head, then ordered 1 mg Ativan IM. Gave med, pt seemed ok for about 20 minutes then starting trying to get out of bed again after seizure activity continuing. MD finally agreed to send him to hospital. Upon reviewing the MAR for his sz meds, it seems his Depakote was d/c by someone who drew a penline thru that entry in the MAR at end of September. No new order in its place. Of course whoever did it didnt sign their name or initial. He is also on Phenobarbitol. No one had been giving him Depakote since end of September, including me. I can't access computer due to my contract status, so I did not know it was still an active med. I can only go by the MAR. No other nurse since end of September has signed out the med. The Depakote is in his drawer, but I have seen d/c meds in other carts on other floors that didn't belong there (as well as meds missing that were ordered but not obtained by other nurses and therefore not given but thats another story). Complete mess, hoping I don't become the fall guy cuz it's easy to blame the person leaving. FYI if you're wondering why it took so long to send pt to hospital, it's cuz they dont like sending pts to the hospital on weekends, drives me crazy, I had another patient with a bowel obstruction that I had to fight to send. I hope this is not an indication of what nursing is like elsewhere.

I used to work for a case management dept of a hospital (nonnursing position) and saw what happened when families had to face loved ones whose health was declining and/or they could not be placed safely back home and needed LT care. #1 problem is denial. Many family members want to believe the pt will get better with time, or that the family can meet their needs at home (even though explained that pt needs 24/7 care) or that a "better" doctor or hospital can help. We had families virtually turn the hospital upside down trying to find a way to save their loved one when nothing more could be done than what we were doing. Anger was another problem. Frustrated people feeling helpless will lash out at anyone, nothing personal. We had one mother suing virtually everyone who came into contact with her son -he had extensive brain damage from meningitis and his long term prognosis was poor. She was clearly grieving the loss of her son's health. No one could talk sense to her, and as a result she created more problems for herself because healthcare providers were afraid of getting sued. She ended up limiting her son's options to a scant few. Re-familiarize the stages of grieving. People grieve loss of life, health, function, independence, family role, etc. I think it's a huge part of nursing - for both patients and families.

Don't overlook the value of anything you've done, even for a short period, that is healthcare related. I did some volunteer work with emotionally disturbed children, did flu clinics, had a non-nursing job at a hospital, trained adults adjusting to disabilities for office work in a vocational rehab program and was an aide in an adult home while I was in college years ago. Everything I could put in the resume that might help. I have gotten my foot in a couple of doors thanks to it, and now I'm getting some experience. Focus on things from your past experience that sounds like something a nurse might do or a quality a nurse might have.

I had a major neck injury at age 35 but fortunately my then employer gave me long term disability insurance. I couldn't work or drive even for a year and a half. Short term disability and saved personal/sick time runs out fast - I was so happy to have that protection. You may not be permanently disabled but you could have an illness or injury that puts you out of commission for a long period.

My daughter's nurse practitioner has bipolar disorder. She also has 2 MSNs (nurse practioner) in behavioral and peds, and is considered an expert on children with ADHD. You can do this.

Must be a "frenemy"

you can douse a room with buckets of blood and diarrhea, one ill-placed loogy can send me retching...

I don't think it's all that gloomy. New grads are going to have it tough of course, no one wants inexperienced nurses cuz it takes too much time and $ to train you. I'm starting to hear of more nurses retiring which will open up some spaces. I'm finding it takes longer to find a job but there are jobs, maybe not all med/surg but good starting positions. Once you get some experience, your opportunities start opening up. Don't count on hospital nursing, like previous poster said it's trending toward home care and outpatient services as well. People are healthier and living longer now, there will probably be more wellcare and geriatric, more people who have chronic illnesses rather than acute, more people trying to stay in their homes instead of going into nursing homes. There's always going to be a place for nurses but I think it's going to be very different in the future. The question is, why are you considering petroleum engineering if you want to go into nursing? You need to decide if nursing really is for you. Don't waste any more time and energy on a career you may not want. If you really love nursing, you should pursue it and not let what-ifs dissuade you.

Good reminder - if you want to live in NYC you have to pay city taxes in addition to regular state and federal. Well to New York!

I'm doing Molloy in the fall, but my hospital want to certify me themselves, I'm taking it cuz basically it looks good on a resume.

Look into schools on discovernursing.com, there are some online bridge programs for people with a bachelor's in something else, I can't recall the schools offhand but they have you take a couple of extra classes and you can go onto a master's.

I agree, the cost of education is pricey, good luck with that tuition reimbursement. Maybe it will cover if you go to a state school and stretch out over time, but, uh, everyone else is competing with you for those slots cuz they're trying to save a buck too. Private college - $300+ a credit? Not counting fees and books and etc? You're gonna be paying a lot out of pocket.

I think it's great to encourage RNs to get their BSN. I have an ADN plus a BA in social sciences, I plan on getting a MSN. However, we're in a time period when the employers can call the shots since there's a lot of unemployed nurses. Watch things turn around and they'll gladly take ADNs again... About 3 years ago I saw that a local hospital insisted all new hires have a BSN or be working on one. A couple of months went by and suddenly they were fine with ADNs. I think they set their requirements too high for the job market at the time. Now of course they want BSNs or students near their BSN grad date. I'm hearing more about nurses retiring where I work, and I'm hearing of more new grads finding positions. Things will turn around.My advice is get a job where you can, work and get experience, and continue your education as soon as you can manage it.

I think it depends on the position, try several travel nursing companies. Many travel nursing jobs look for very skilled people, yes, but there are also temp assignments cuz they don't have the budget for new positions, need people to cover employees going on vacation, etc. This particular job I got was good for a new grad cuz skills you used in clinical, like meds and knowledge of mental illnesses in this case, were fine, I did not need to know how to start an IV or intensive med/surg experience cuz they don't really use it, and the rare times they do there is always someone to around to help. The shifts I'm working are heinous, one of the reasons I think I got the job is no one in their right mind wants double shifts on the weekends (day and evening). If you're super flexible it helps. Sell yourself as best as you can, especially if there are any skills you are really good at . I did tons of foleys during clinicals, which comes in handy for psych cuz urinary retention can be a side effect of the meds. I also had some geriatric experience from 20 years ago, including dementia, and have done foster care/adoption volunteer work on the side - foster kids often have serious trauma issues. In my opinion, it's not that relevant to adult psychiatric but I think it helped. Make a list of stuff you can use to sell yourself. Someone also suggested to me that as we get closer to flu season, see if the local clinics, senior centers or county needs help with flu clinics. Also I was on the verge of doing voluntary work for a nonprofit clinic just to keep up my skills. You can also try contactng your school to see if they can recommend any community health work you can volunteer for or work part time or temp. There are community health screenings for blood pressure and diabetes, often with seniors. ACLS is a nice thing, everyone perked up when they heard I had it. Don't know why, the crash cart at work has almost nothing in it - someone codes you call 911. I'm also going to take an IV certification course in october. Kind of useless since most hospitals want to certify you themselves, but it looks nice on a resume. This is extreme, but a friend of a friend is going with her mid-wife professor to Honduras for a week to do maternity plus any first aid/med surg they need in a clinic. Might try asking your school if they know of any programs if you're interested. If you're interested in working in the NYC area, look up Westchester hospitals on the internet, I don't know why but I keep hearing of people finding jobs in Westchester. Some of the hospitals there still have new grad programs too (Hudson Valley Hospital Center is one). I hope this helps, I know it's frustrating but keep plugging, I met someone who graduated in 2009 and just got a job. I really think things are starting to open up more. Good luck!

yes they are called supplemental health care, so far I've had good results and service from them, they are nationwide. Good luck!

Update! A travel nursing position came thru for me for a local state psychiatric hospital - ironic cuz that's what I wanted to specialize in. It's only 32 hrs a week (2 weekend double shifts, yikes!) for 13 weeks but the pay is great and they even gave me orientation. I also may be able to develop it into a full time job, they said they've hired other travel RNs from my agency. Try to get a travel nursing job near home... I also have a second interview on Tuesday for a local foster care/adoption agency/residential treatment for children, they have a waiver program where they need RNs or LPNs to do respite for foster kids who are medically fragile or emotionally disturbed, in the child's home and they will choose an assignment near my house. It's maybe 15-30 hrs a month. I'm hoping I can do this second job during the week, it's not many hours but good peds/psych experience. Definitely the jobs that have come thru are the oddball ones. I highly recommend trying anything you can find, I didn't think I would get the travel nursing job as a grad RN but according to my agency I'm the second new grad they hired at this facility. I'm perfectly happy to take two part time jobs, I will be making a nice paycheck for a while and grab experience at the same time. Hang in there, the jobs are definitely turning up.

It used to be that if you had an ADN plus any other bachelor's or master's it would be acceptable as a BSN, or so I was told by a couple of nursing school instructors. I find now they are actually wanted the nursing bachelors or masters. My BA is in social sciences so it seems to be helping me with any nursing job with a social services edge (like nonprofit and psych) but I'm already thinking on getting a BSN anyway.