NiteNurz79

OK, my boss wants several of us to get our ANCC certification. We work on a small inpatient psych unit in a medium-size rural hospital. I already do more CEU's a year in psych than ANCC requires, so it's not about keeping up in my field. A co-worker says that hospitals benefit when they have ANCC certified nurses on staff - looks good to the inspectors. What's the real story? Is the benefit to the nurses and our patients, or just the CEO? Any ANCC certified nurses out there with an opinion?

Leave psych nursing? And give up 12 hour night shifts, exposure to violent patients and infectious diseases, indifference from doctors and lack of support from hospital management? I'd have to be crazy

Next time she comes in ask her doctor about a psych referral...and look up "Borderline Personality Disorder" to see if it describes you patient. Good luck.

I went back to nights after YEARS on dayshift. I think the great thing about nights (that you only find out once you are there) is the attitude. When you are down to just core staff - few doctors, no managers, minimal staff - everyone seems to pitch in and support each other MUCH more than I ever found on dayshift. When ancillary departments are closed the "McGyver Principle" kicks in...you look at what resources you have there in front of you and find a way to get the job done. Often the anticipation/fear of having to "stay awake all night" is worse than the reality. Evening shift keeps you away from your family more than nights, especially with a working spouse or school-age kids. Sleeping during the day while they are busy at work/school works for most of us. Yes, it is hard to switch your body's internal clock - maybe that's why they pay us a shift differential? Because it's hard? But is IS doable. Approach it with an open mind - you'll find the more experienced hands on the night shift ready with tips and support. After all - we've all been there...some of us have even gone back. :smilecoffeecup:

You sound like you have reason to suspect an imminent threat of harm to the child - "The mother has other "issues", but has already been documented with bizarre harmful behavior regarding this child abd another one a year older." Has anybody hotlined this situation? Does Dad work out of town, that he can't be the one to give all meds for a while? Is there another relative who can "give mom a break" and take the child for a week (to see what happens in another setting)? This isn't an issue like weight that can be corrected later on...brain injury is forever. Support Dad in doing whatever is necessary to protect this child. Risk hurting mom's feelings or making her mad? TOO BAD! The priority is the child. If mom is somehow causing the problem, there must be a payoff. Does she not get attention at home when things go well? Do family/friends go to her aid because she is caring for a sick child but leave if the child looks well? Does she get to play the martyr role at church? Justify staying home? Ask yourself "What would be different for her if the child got better and stayed well?" then look at what she might think she loses if that happens. It's a complicated situation, but just keep putting the child first in all your decisions and you'll get though this.

I work on a psych/substance abuse unit - I don't know the answer to the problem of people with genuine chronic pain developing addictions, but I do know for certain that an increasing number of people who intentionally abuse drugs are learning to take advantage of the current attitudes about pain management. I get patients all the time who use IV oxycontin for the high then demand their "rights" and want opiates prescribed while they are in the hospital. One client actually quoted a line from a pain article to me, saying " I have a right to pain meds and I don't have to prove my pain to anyone. My pain is whatever I say it is!" How exactly do you document medicating a patient like that ( the quote itself is probably right out of a nursing magazine, and it's hard to describe the smirk on her face in medical terms!) It's frustrating....

Our Risk Mgmt folks told us that there is an exemption under HIPPAA that allows us to release information to law enforcement on an individual involved in the commission of a crime (assault and battery, property damage etc.) while here as a patient. Check with your facility's Risk Manager(s).

I've been an RN >25yrs. Spent the first 15 in Med/Surg settings and the last 10+ on an acute care Psych unit. I always recommend that new grads get some med surg experience before settling in on Psych regardless of their level of interest in psych patients and here's why - your mental health clients WILL have medical problems.You can count on that. The question is, will they be able to count on you to identify and intervene in a timely manner? Two weeks ago I came on duty for nightshift and had to ship a patient to ICU - the dayshift (Psych nurse since graduation years ago) missed a developing medical problem that had the patient on a vent within 90min of getting to ICU. Will you recognize an MI, CVA, aspiration pneumonia, pulmonary embolus, acute GI bleed etc. if it happens to your schizophrenic client? What happens if you don't?