psychnurse37

"Understaffing" will always be a problem because there is a big difference in how you look at staffing, and who is looking. Administration is looking at it from a monitary standpoint. They have to show a profit (even if "nonprofit") in order to pay salaries, buy new equipment, compete with others. The nurse is looking at it for job satisfaction, safety, etc. The patient/family is looking at it from a comfort viewpoint. The "productivity" experts will always say a unit is overstaffed, because that's their job. I think acuity needs to be factored in somehow, because sometimes we can work with less staff and get things done, and other times we need so many more in order to just make it to the end of the shift without an error or death. As for burnout, the best thing I ever learned was" You have to take care of the caregiver if you are going to keep on giving care." We need to take care of ourselves" practice what we preach: RELAX, take time to do something fun. This might mean a long bath, a hot shower, a walk in the park, a golf/tennis match, reading a great book, playing with the kids, a romatic interlude, a movie, cooking, going out to eat, gettig a good nights sleep, etc. It will be different for different folks. Just unwind, leave your work problems at work and your home/personal problems at home. Take care of yourself, take care of your peers, take pride in what you do, or find something you can do that will make you a better person: get more education, take time off to regroup, become an optimist, look on the bright side, use humor to laugh. Volunteer, work with youth in the community or at church. Visit a nursing home or veterns hospital. Good luck nurses, do what you can to prevent burnout, we need all the nurses we have and more. You chose nursing for a reason, now fulfill that purpose, make your career something you can be proud of. Take care of yourself! Take care of others!

Lts has changed in 10 years, even more in 20, 30 and so on. Some of the changes have been for the better, some for the worse. We used to give back rubs. We used to reuse equipment after it was steralized. We used to not have sonograms or ultrasounds and know the sex of a baby before it was born. Hospital stays were longer. People were admitted for tests that are done as outpatient now. All surgeries were inpatient. There were wards instead of private or semiprivate rooms. Nurses wore WHITE and had caps. Now, I'm not saying all was great back then, but all isn't great now either. At least nurses are paid a little better, even if we work harder and care for sicker patients. I'm still glad I'm a nurse after 38 years!

I have dealt with many patients who hallucinate, even some who were hearing or sight impaired. The "voices" are real to them, sometimes coming from in their head and other times coming from somewhere outside their head. Some are friendly voices, others are threatening or demanding. Sometimes they can recognize the person "talking to them" and sometimes it is a stranger. Some even got upset when the medication made the voices go away, they enjoyed the "companionship". For this deaf patient, the voices may be "thoughts" which is how some patients described the voices. Many of our hearing patients use a Walkman radio to drown out the voices. Others can just say "go away" and the voices will leave for awhile. I am usually amazed when they so freely describe the voices. I thing I would deny them if I was hallucinating, but they usually talk about them. The hardest voices to deal with are the "command hallucinations" they seldom respond to medication quickly. These patients must be monitored for impulsive behavior, because the voices often tell them to hurt themself or to hurt someone else. When your patient comes back to the ER, just spend time with her and tell her with "signing" that the medication will help if she keeps taking it. Good luck. I praise all of you nurses who are dealing with the psych patients in any field besides the psych unit. Thank you for caring for them and trying to understand their needs. They are a special population, often misunderstood, but usually very needy!

I suggest you are truthful in your letter of resignation. Accenctuate the positive experiences you had while employed but add something about concern for daughter and husband's health due to exposures. I am a director and have read a lot of resignations and appreciate the ones who are truthful. Then when you do apply somewhere, write the reason you left your previous job (ie concern for infant and exposures to infectious substances.) You may not want to write you had panic attacks, because that is your business and you are seeking help. And anyway, who hasn't questioned the possibility of bringing home some "bug" from work? Just take care of yourself and your baby. There are a lot of fields in nursing with less potential for contact with blood or other body fluids.

response from a psych nurse of 37 + years: JCAHO has a goal of ZERO restraints and seclusions and most hospitals are trying to meet this goal. We have made tremendous progress since I first became a psych nurse in 1968. We seldom have to resort to seclusion and/or restraints because of the meds available and the education to staff on early recognition and early interventon to prevent acting out or assaultive/aggressive behaviors. In the old days it was like tag team wrestling. Now we use any alternative that we can to prevent physical intervention. Very seldom do staff get injured, there are programs taught that help you learn to protect yourself from harm and how to therapeutically deal with aggression. Psych nursing isn't for everyone, but then again, no specialty is for everyone. Only a few choose psych and stay, but at my facility, many of the nurses have been there since we opened 18 years ago. Many of the psych techs also have stayed for years. We have little turnover, and are probably more like a family than most other areas of the hospital because we do care for others and know how to interact and relate to people. we listen to each other and use each other as a sounding board. "We know when to hold them and when to fold them" and we know when to back off and get help (sometimes in the form of a prn) I agree that some med surg experience prior to psych nursing is good, although I have hired nurses just out of school. The main pre-requisites for working in psych are: 1. A desire to make a difference in the lives of those with a mental illness, 2. Being able to listen with your eyes as well as with your ears, 3. Great communication skills (which includes listening skills), 4. Caring for someone as you would want someone to care for you or a loved one, 5. Being able to deal with people of all ages, religions, races, alternative life styles, IQ's, illnesses (including medical problems), 6. Being able to manage your own emotions and not over-react or take things personnaly, 7. being able to act professional with patients, family members, co-workers and doctors, and perhaps the most important 7. being able to leave your work at work and not take it home (in other words, have a means to relax and reduce the stress in your life. I may have left a few of the pre-requisite out, but you get the idea. I love psych nursing and can not think of any other field I would care to work in. Psych patients are everywhere... in every firld of nursing. They are in the ER, having babies, in OP clinics, on med surg floors, etc. We have patients from age 5 to 99. Each unit is different, each shift is different, some days are fun and some days aren't. No one can predict what will happen from minute to minute, a new admit can change the melieu, a staff member can make any situation better or worse, families can help or hinder to healing process. We get to know our patients because the recidivism rate is high in psychiatry. We get them stable and send them back to the same environment that was unhealthy to start with, they can't afford or think they don't need the medication, there are few resources for the indigent, they have burned a lot of "bridges" with family/friends due to past mental problems, there is still a horrible stigma associated with the mental patient I wish you well in your nursing and hope you give psych nursing a chance. When you interview, ask to talk with some of the nurses or techs on the unit so you can find out how they like it there and maybe get a feeling for how you think you would fit in.

Psych nurses do wipe butts! We have many patients unable to care for themselves: seriously mentally ill patients, Alzheimers patients, unco-operative patients, 5 year old ADD/ADHD or "crack baby" unpotty trained children, overdoses, etc. In fact, when I interview prospective employees, I always mention that changing diapers (depends or pull ups) is a minor part of the job, but required if they are going to treat the patient as they want to be cared for (who wants to stay in wet or dirty pants or diapers?) I had one person walk out at that part of the interview saying "I don't change diapers on adults". I'm the DON and once had to ask a PhD (program director) to help me change a diaper. We all "do windows" at our facility! Nurses have to be prepared to care for any and everything.

if you need input from a psych nurse with 37 years experience, let me know

Alabama starting wage lower than most places. "They" say it's because cost of living is lower???!!!! Anyway, new grads start at 15.50 per hour in my area. larger cities offer more PRN rate is $25 per hour for 8 or more years experience ther is $2 per hour shift diff, $2 per hour for charge nurse they do have a weekend schedule where they offer $30 if work Fri, Sat, Sun full time we do have excellant benefits, and that's worth a lot of money there are specialty units where staff gets extra hospitals here are stingy about sharing salaries with other hospitals, which makes it hard for us to encourage HR to be more competitive we're worth a lot more, and this represents a lot more than several years ago I often tell new grads they'll never get rich being a nurse, but what other job has so many "perks"? (long hours, too many patients, not enough help, little support from administration, onary doctors.. but great peers to work with, ability to make a difference in someones life, opportunity to be there when a new discovery or new drug is discovered to treat/cure a disease.)

There have been a lot of good things that happened around me the past 37 years or so of being a nurse. A lot of them were patient centered, and usually went quietly by, without "thank you letters to administration", but I knew I had made a difference, and that's what counts. Some of the great moments were out of the hospital when I was off duty. Once, I answered an overhead page in Kmart for help on aisle >>> It was a gentleman in a wheel chair, unresponsive/confused when he did respond. Without all the machines at a hospital, it was nearly impossible to tell exactly what was wrong until the ambulance got there, but I could hold his hand, talk to him, make sure his airway was open, comfort his wife, and offer praise to the employees who were trying to help. Several times I have helped friends when they were dealing with the impending death of a parent or child, this was hard because I wasn't the nurse, I was the friend. Other times I felt good about being a nurse was helping someone "die" with dignity. One was my father in law who wanted to die at home and another was someone I called "mother" who was actually the mother of a good friend. We can make the difference in someones life, and sometimes it's our lives we make a difference in because of something we did or didn't do.

I read a lot of the replies and agree, we are in it together to care for patients, whether it is in an office, a hospital, with hospice, teaching, helping the kid down the block, in a war zone or whatever. We really have come a long way since nursing was first a profession. We have choices, and only we can make it better or worse for ourselves and our patients. Sure, we could work retail, but they have their own set of problems (like one writer pointed out about WalMart). There are so many field choices for nurses, you may have to look around until you find the right "fit". Sure, the hospital is in it for the money, cause they'd have to close the doors if there was no profit... no money for raises, supplies, marketing, research, etc. If you look at life, most of the people are in a job for the money (to pay bills, go on vacation, save for retirement, etc) There are two quotes I have believed in for years: 1. "If it's to be, it's up to me" 2. "Whether you think you can or think you can't, you're right" Maybe one of these quotes will help you see nursing from a different perspective. You may even need to take a vacation or work break and regroup. I do wish you success in whatever you choose to do with the rest of your life. I hope you come back to nursing with a different perspective, because we need more nurses every day. We even need nurses who question 'Why we do something', or raise doubts about staffing or other patient care issues. Don't do something just because we always did it that a way, change when change is needed.

Nursing is a stressful job, but some areas or units more so than others. If peds is a dream, go for it. If ER is a dream, go for it. Or combine the two and work in a pediatric Er (yes, there are some in the bigger hospitals) As a psych nurse, I can tell you, your history of depression, anxiety, ADD and OCD could benefit you as a RN on a psych ward, or with child/adolescent mental/behavioral patients. You have personal experience and can empathize with the patients. A lot of my staff feels like we help each other and care for each other in order to make it through the day, and we a very close knit group! Best of luck in your career choices!

You are on the right track by asking others for suggestions. You have to first decide where you see yourself in 5 or 10 years. Do you want to work in a hospital? a doctors office? teaching other nurses (inservice or nursing program)? long term care? hospice? school nurse? Public health nurse?traveling nurse? What field- peds? geriatric? dialysis? psych? med surg? ER? ICU? ???????????? What about working at a larger hospital, there may be more options there. Apply somewhere and tour the units with openings, but go in with an open mind and try to "feel" how it would be to work there. There are so many different fiels of nursing, and we are getting to be as specialized as doctors. Try to broaden your experience if you haven't found your niche. If you are a people person, perhaps that is what you missed in surgery. I work in psych and we get to use our people skills all the time. But, psych isn't for everyone. I guess what I'm trying to say is... explore your options, listen to your heart and compare "apples to apples" (make a list of plusses and minuses for all the options and make a decision based on facts!) You may make a mistake, but you can learn from mistakes and find the job meant for you. Just keep on being the best nurse you can be! Best of luck! (I guess you're from Alabama, and so am I)

When I graduated in 1968, I started as a new grad in Mobile Ala for about $4 per hour. Of course, minimum wage was really really low, and we were proud to have a good job as a "new"nurse. Naturally, I make more now, and probably wouldn't do what I do for $11 an hour. I supervise 80+ employees and take call 24/7 (unless I can talk one of the others into taking call for me) I am a psych nurse and would love to continue to care for these misunderstood and feared patients. Caring for the psychotic or depressed or manic or demented patient is so very rewarding. When students rotate through our unit, I remind them that every nurse will use the skills they learned in psych to care for patients in all other fields! I think when I'm too old to work as a nurse, I will volunteer; it's just in my blood. I do think nurses are way underpaid for what we do, and what we're responsible for. We spend more time with the patient than the doctor and have to make judgement calls all the time. The patients we care for are sicker than ever and the meds we give are more powerful and potentually dangerous. I also don't think it is fair that there is such a wide range in saleries from state to state and in the different regions of the country. We all care for patients, but nurses in Alabama, for example, are paid way less than nurses in Ohio, Penn, Florida, New Youk, etc.

I'm not from your area of the country, but I have been a nurse for 37 years and have a few suggesions for you. In fact I have given some of these same suggestions to students who rotate through my hospital. First, make sure you compare "apples to apples". Interview several places and make a list of pro's and con's, salaries, benefits, driving distances, orientation schedules, opportunities for advancement, level of supervision you'd get as a new grad and just how well you felt you would fit into their organization. Next, ask around and get feedback from friends, family, peers, faculty, other medical professionals. Next, visit the potential workplace and just look around, walk the halls. How does it "feel"? Do you feel comfortable there? Is it someplace you'd like to work for a long time? Do patients and staff look happy and satisfied or are staff overworked and uncaring? Are the halls clean? What does the cafeteria look like? Is staff safety a concern? With a lot of careful thought, you will be making a decision that could impact your career. Choose wisely and carefully because there are many good places (and bad places) to work. Every workplace has plusses and minuses, and you have to work where you feel comfortable and at a place that values patient and staff satisfaction. I hope I helped answer a few of your questions, maybe not specifically about which hospital to work in but how to choose the right fit for you. Good luck as you persue a career in Nursing!

I have been a nurse since 1968. Those were the days when women could grow up to be teachers, secretaries, nurses or "mommies". I had been a candy striper for years and read every book on Clara Barton and Florence Nightengale and other books on nursing or medical heros. I was part of "Future Nurses" association in school. I had two younger brothers and a younger sister, so I was always caring for their cuts and sctraches. I can't really remember giving serious thought to anything besides nursing. I chose to go to Nurses Training in indianapolis so that I could be a short distance from home (250 miles) but close to relatives when I got homesick (40 miles). I got a $500 scholarship and that paid for my school! I lived in a dorm with 200 other girls and learned so much from them and from the Diploma program. We were allowed to work on our off time, after we had completed a rotation. We were an important part of the hospital team, which included externs, interns and residents. It was a fantastic 3 years, and I have never regretted the lessons I learned there. I wish the nursing students now could learn some of what we learned the hard way. Those lessons on improvising and thinking outsied the box are very valuable lessons. I would encourage anyone wanting a career in making a difference in peoples' lives to consider nursing. You won't get rich being a nurse, but you can and will change lives. I somehow got to be a psychiatric nurse (probably the only opening at the hospital I applied at) and would never trade that field for any other. I tell the nursing students who come through our hospital that they may never be a psych nurse, but they will always be caring for psych patients or people with emotional or mental problems. They can use their psych skills to help frienda and family members. They can assess others for depression or suicidal thoughts, and then get them help. Besides being a nurse, I also got to be a mommy and now a grandmother. I also do a lot of teaching (new staff, patients) and secretarial work (reports, filing, etc) so I reall was able to grow up to be all the things possible in the old days. Now, women can be anything they want to be, and choose any field a guy can choose. So, we've come a long way since 1968, but I'm not sure all the changes are for the better. I wish some of the young people had the work ethics the older generation has (of course there are exceptions). Anyway, that is why I am a nurse, and proud of it!