TopazStone

It happens to me a lot and as the only scheduled nurse, I can't avoid caring for them. I do inform my supervisor and reassure the person that everything is confidential and will remain so. I do have the option of trading sites with another nurse but ...

Thank you for writing this post. I am pretty sure I am reaching burnout levels as a psych nurse. I can still feel empathy for the patients who are in a psychotic break and I have a soft spot for the young adults who are entering the system for the f...

Spiders, heights and creepy old dolls. I guess when I was around 3, I bounced down to my grandma's basement where she had been trying to clean up some old dolls so they were all sitting out (some with missing limbs and mildew over their eyes). My mo...

Sheesh-- I've been saying for ages now that the poor girl seems to be Bipolar and they should leave her alone. Can you imagine having your psychotic break publicized like this? It is unfortunate but I'm sure the media had access to a police scanner a...

Good heavens! I work at a psych crisis facility and have been complaining about the ten to 16 patients I've had to manage. Of course, our tech is not able to complete VS or blood sugars and I am the only medical staff available on my shift (free stan...

This is one of my worst fears. It seems that psych is the bottom of the feeding chain everywhere as far as safety, staffing and funding are concerned. I worked nights on an in-patient unit and at change of shift, I had three patients. One of the med-...

Another method to block the manipulation is to use a single cell phone/ pager for the manager on-call. This gets rotated to the person on-call and is the only number provided for CNA (heck-- and nurse) contact. No exceptions, substitutions or refunds...

Now that the Summer is upon us, I have had an increase in missed visits. Either the patient calls to D/C or they just plain aren't home! The salary nurses have a weekly quota and visits are scheduled the week before. The missed visits do not count...

As far as working with visible body piercing, remember we work with the elderly (for the most part). There are clear "holders" you can purchase to keep the hole open when you can't wear the jewelry. For safety, I would NEVER wear anything that a pa...

Wow, it sounds as if your neighbor has a lot of stress in her life! Sometimes when people refuse to address their feelings, they are turned inward and show up later as physical problems. Angina is a common reaction to stress. Also, I see a lot of ...

OK, here's the psych nurse input. Thyroid levels need checked-- possibly hyperthyroidism. With the use of Zoloft, could she have had an anxiety attack? I frequently have pts who c/o the symptoms that I think are cardiac related. The absence of ches...

We are mainly Medicaid. We manage meds and long term physical problems because the patients are constantly hospitalized if we don't assist (ie, check BS, apply skin treatments) and we do some social work as well. No, we don't decide when to D/C. I...

I love how they keep saying that better bennies and salaries will drive up the cost of health care. If you pay well and appreciate your employees-- how much better will staff retention be? The cost of training new nurses and using agency to cover c...

We just had an inservice from a wound care nurse. Some supply companies are hiring them and they will come and do consults and F/U. They even call the doc to ask for treatments. Check around to see if you can find one in your area. They will give...

Hoolahan, Take a deep breath and let it go. It seems that many people in the system want to find somwhere to lay blame, and it is not usually on the patient. Most of our patients are sent to us for noncompliance issues. We try to call prior to the...

I have to take a notebook into the home with me to jot notes. You don't want your delusional, paranoid and agitated patient to see you document that they are "paranoid, delusional and agitated" lol. Our notes are due weekly and we are going to "off...

Check the DSM-IVR for the specific criteria that a child should meet for a diagnosis of ADHD. There are several different types as well: Impulsivity dominant, inattention dominant and hyperactivity dominant. As with any psych disorder, it should o...

Had a pt come in for psych eval after cutting her arm and getting sutures. I walk into the room and there is the >300# pt digging her fingers into her fatty tissue after puling out her own stitches. Tried not to gag and calmly said "Oh dear, tha...

Gotta say, I was impressed. Our managers sat at lunch with us and told something that they appreciate about each and every nurse, plus the goodie bag. Wow! I do feel warm fuzzies tonight!

Hmmm, guess I have been lucky. I can't remenber last year's gift, but the year before we got the clipboards that open up to hold papers, files, pens, etc. and a little daily planner (not the one with the company logo). The admin at that time also l...

I have been asked to do an informal poll on what other agencies include in their summaries on the 485. We are in the process of reorganizing our paperwork and want to set up a form for case managers to complete rather than write an endless narrative...

O.K. everyone-- yes it is the 487:imbar . I just tend to flip it and keep writing LOL. We work with mainly with the chronic mentally ill Medicaid patient. Every 60 days, we send a summary to the physician that addresses VS range, physical status, ...

I have the Cardiology II. If you want good sound transmission, pull out the diaphragm and ::gasp:: cut a few inches of tubing off. You want it long enough that the patient can't grab a hold of you when agitated, but a shorter tube makes the sound ...

Barneyridge, Sorry I can't cite the resource-- someone had forwarded the info to me ages ago. The docs at the crisis center I worked at were not receptive to trying this. I had to rely on the old tried and true . . . when our fave BPD came in from t...

I don't know. . . Thinking back to "fisacal ed" (with my inherited grace), there were times I prayed for execution :chuckle