shrinkyrn

I thought this was hilarious because I turned 62 on a Thursday and I retired on Friday. I couldn't wait to be able to retire. I'm not financially in good shape or anything I just needed to retire after 41 years. I have a bad back, bad legs and just wanted to be able to kick back and enjoy life, instead of working. No body had to "force" me...and I wasn't making any mistakes....I just thought there is more to life....and there is!!!

Kayla, I just retired after 41 years of Psych/Addictions nursing. I worked inpatient (childrens, geriatric, acute and chronic), outpatient, did ER evals of psychiatric and substance abuse patients. I was hurt in all those years, in all those areas, maybe 3 times. You have to develop good assessment skills, and ALWAYS be aware of your surroundings, you also have to develop good crisis intervention skills. There is training available for managing out of control patients, but one must learn to intervene when you see escalation start, that takes time and learning patterns of the illness. Since many of the sickest patients are frequent flyers, you get to know who you can expect to act out, some people will be a surprise, though. The kids are the worst, in my opinion. I worked with them when I first started. If your passion is psych nursing, learn as much as you can, don't deny yourself, takes a special kind of person to work with the Mentally Ill. Good Luck to you!!

As an Addictions Nurse who saw nurses referred in for "treatment" and having to enter the Impaired Nurses State Program due to DUI or being positive for ANY substance....(and you know pot is in your system for about a month), I don't believe it's worth the risk...the program for impaired nurses is a stringent program....just seems like a PIA to have to go thru for a couple tokes on a joint!

Behavioral Health nurse for 40 years....went into it right after graduation and have stayed there all these years.....Have worked all areas of psych...I'm the most sane well adjusted person I know....really!!.....probably because I have actually used the coping skills I teach to patients/clients....LOL

I question the use of Suboxone in a short term detox period. Suboxone is more of a long term medication, since it hangs on the receptor cells longer a taper in detox makes no sense IMHO and experience with suboxone patients. In the outpatient setting, suboxone is tapered on a longer time frame. The suboxone will keep the addict from getting dope sick, and many times that's why they use it on the street in place of other opioids, but the studies have shown that the best results have been long term with counseling, avg. success is around 2 years.

I got my CARN over 10 years ago, it was a very difficult exam. I am so glad that I took it and got my CARN, it has helped me get my current position in an outpatient addictions treatment center....wouldn't want to have to take that test again!

@ demylenated.....Awesome description and understanding of addiction...I have been an RN in the field of psych and addictions for 38 years....(takes deep breath)....I have worked with RN's who lack that knowledge...Kudos to you!!!

http://www.maine.gov/dhhs/osa/irc/pubs/DrugFactSheets/BathsaltsFactSheetOct2011.pdf this is a good fact sheet explains about bath salts. I work in outpatient D&A, we have had a lot of people come through who were using bath salts, called "salts" by our clients. this is really bad stuff and very addictive. Clients I have talked to have had a difficult time staying away from the stuff.

Don't go into nursing , especially psych nursing to work through your own issues of codependency or depression. Empathy is a wonderful thing, identifying with patient issues will cause you a whole lot of problems. Agree with Meriwhen...Psych patients also have medical issues and tend to not always be compliant with managing medical issues which can create a huge problems. Not to mention a paranoid patient, who won't let you treat his/her medical issue....A psychotic patient with medical issues can try the patience of a saint. And if you go into addictions nursing, you're not going to wave a magic wand and they are never going to use substances again.....Detoxing someone sometimes means you give shots, clean up vomit and bm, and monitor a very serious medical condition....take vitals signs...recognize when you are being manipulated... And as a nurse YOU aren't always the one doing the 1:1's "Cerebral" Stuff.....You may be the ONLY RN for 18 patients, with counselors talking to the patients, you are passing meds, doing charting, taking orders off, admitting people, assessing people and coping with the Medical hand on stuff!!! You want to just talk to people, use your BS in psych.

I first got certified when I worked inpatient dual diagnosis rehab....I have moved into an outpatient Drug & Alcohol setting an am the Addictions Nurse..The pay is nowhere near hospital pay, but the job is much less stressful and so much better for me. I love what I now do..

When I had a request for time off denied because there "was no one to cover" I used my answering machine to screen calls and from that point forward staffing became a management problem not my problem everywhere I worked. I no longer work in a hospital so that is not a problem for me now, but I rarely ever volunteered for overtime when I worked the hospital. I had no problem letting the answering machine pick up the call, no problem saying no and no problem, when they did beg me to come in, negotiating for overtime plus another day off. We take enough abuse...no lunch sometimes, no bathroom break, taking verbal flack from everyone....etc etc.........Set limits, define boundaries!!!

What's the ammonia level?? confusion could be related to hepatic encephalopathy, I don't know what you are smelling but look up "fetor hepaticus"......

I would like to recommend Dr. Kevin T. McCauley's DVD Pleasure Unwoven....It gives hypothesis for both Disease and Choice and goes on to scientifically prove that indeed Addiction is a Disease......It is not a boring presentation, in fact it is one of the most well put together DVD's on brain function/dysfunction that I have ever seen....I use it with my clients...who are able to understand it and therefore the concepts.

Ron White, "you can't fix stupid!"

I have concerns about giving so much in 1 injection....it's 4.2 ml.....the drug rep I talked to said, well it's in water not in an oil suspension so it shouldn't be any big deal.....I wouldn't want 4.2ml injected in my rear end.....according to the literature between 53% and 65% of recipients had ISR (injection site reactions) that's a pretty high percentage IMHO....

I am an RN, although not a dialysis nurse. My husband is a dialysis patient. The unit he goes to was taken over by DaVita about 2 yrs ago. The nurses, techs and even the unit secretary are caring wonderful people overall. There are times when they do or say things that my husband doesn't like, usually that is resolved. My husband has had a myriad of medical problems and the staff have been supportive....some policies changed when DaVita took over....some good, some bad...We are all dealt our lot in life and we only go this way once, having a positive attitude as both a patient and a nurse can do a whole lot to make life liveable. People are not always going to follow directions, as patients you can do what you choose as long as you recognize that their may be consequences that you will need to deal with.....I work in the field of Addictions, many of my patients/clients do NOT follow directions. As a family member I often feel very alone in dealing with a chronically ill individual, the staff at the dialysis unit have always been helpful. If he is having a particular problem, they will listen to me and keep me posted on his status, if necessary....I am so thankful for the dialysis nurses at my husband's facility............Thanks to all dialysis nurses....Happy Nurses Week!!!

@ jackstem.....that may well be true....but, I needed to provide some reference information. My clients all learn that it is important to understand H.O.W. it works....Honesty, Open-mindedness, Willingness......Maybe some posters will accept the Open-mindedness and Willingness to try to understand the disease process....wanted to provide the opportunity for growth.

It's a disease....Check out Dr. Ohlms and definition of Disease. Read Healing the Addicted Brain by Harold C. Urschel, III, MD. Read the first 164 pages of the AA Big Book, go to healthybodyhealthymind.com and look for Hope for the Alcoholic:Scientific Breakthroughs (episode 1702)...my

It took me a LONG time, worked psych, dual diagnosis, got certified as CARN, I now work in an Addictions private office as the Addictions nurse...I wear many hats, do some counseling, I ran a Suboxone program for a while, am working on a Dual Disorders program right now, we are working on a program for clients who need medication enhanced treatment i.e. Vivitrol, Campral, Suboxone....etc.. It is rewarding and utilizes my Certification and my skills....but the pay is NOT what you'd make in a hospital by any means....that's not what I'm in it for....more money would be nice but.....

I have been a CARN for almost 10 years now...best thing I ever did....I now work in an outpatient office as the Addictions Nurse....LOVE it!!

Not sure where you got your information. My diploma education prepared me to function in ANY hospital. I've never been sorry that I attended a diploma program. In fact I did not work at the hospital I attended for nursing school after I graduated and neither did most of my class of 30 +++ We went to other facilities to get the experiences we needed to get a superior clinical education!!!!

To all: Sorry! :smackingf Just a real sensitive area. I had to justify so much, I went looking for another job right after that and within a year, I was OUTTA there!!!

I'm really not sure what you are implicating here, but I'm certainly not appreciative of how you worded what you said:nono: :flamesonb I'm not going to explain to you what transpired and didn't ask for a comment when I said that as a reason I don't miss the job I left. I sense a judgemental response from you and you really don't have a right to judge my reasons. If you smell a fish the smell is present where you are. Leave judgement unto the Lord!

I recently left hospital nursing for outpatient! I worked psych inpt. 1. I don't miss being the ONLY RN for up to 18 pts. (Mental health workers were the rest of the staff):trout: 2. I don't miss NEVER being able to leave the floor.:angryfire 3. I don't miss non-nursing immediate bosses who didn't understand :trout: 4. I don't miss getting suspended for saying "NO" I don't have the help and can't!!!!-(it was easier for them to suspend me than give me help):trout: 5. I don't miss working 12 1/2 hours:selfbonk: 6. I don't miss being told I can't have time off, because there is no RN to cover me. 7. I don't miss 3-4 admissions a day, of which I had to do the entire admit (Only RN remember) 8. I don't miss being so stressed out daily that I thougt my name was be-otch!! :flamesonb I do miss my friends, fortunately, I keep in touch. :biere: :cheers: :icon_hug:

When I worked night shift on the acute psych unit even nights were busy with psychotic individuals, pacing the halls and not very redirectable because their meds hadn't kicked in yet. I've worked units where manic folks were up and about. Most of the units I've worked at night were units where we did get admits during the night and needed the necessary skills to diffuse crisis admits. I've worked intensive psych units where we had folks in seclusion during the night who needed the appropriate seclusion care. I've worked geri units where the patients had sundowners!! and were screamers who woke up the rest of the unit, and perhaps the unit above or below. Don't be fooled into believing that nights in psych is a cake walk!! You have paperwork that people push off on nights because the "patients sleep".:zzzzz Nothing made me madder than a hornet,:angryfire than to hear that after a rough night with psychotic, disorganized patients or intoxicated admits!!(Yeah, you'll get those, too, even tho' you will tell the ER or doc on call that you are ill equipped to handle a detoxing pt, (who if they go into DT's is a medical emergency)!!!! and what's even more important, they can't sign in voluntarily if they are intoxicated:nono: Probably the least eventful unit I worked on at night was child/adolescent. Guess it depends on the type of unit. When I did ER evals for psych and detox and coordinated admissions to the psych units, there were admits to psych more nights a week than not. Could be I worked big city hospitals a majority of the time, but even at the rural hospitals I worked, the RN didn't have time to play solitaire. Not enuf credit is given to night shift for doing the best you can with what you have, and I haven't worked nights in years. Hope you find what you're looking for but, if you like psych and want to really learn how to deal with people in crisis nights can give you that. Best bet to find out exactly what type of unit it is and if they accept admits at night and how much paperwork ie. chart audits, QA studies, Treatment plan revisions, reconciling MARs, cleaning fridges, which med passes, VS, treatments, discharge preps, etc. etc. etc. you will be responsible for and how many pt.s does the unit hold on the average, will you have to float to other areas of the hospital in times of low census, what are the credentials of the coworkers (do they have a psych background) Will you ever have to work alone in times of low census, (these may sound somewhat petty or improbable, but the are important)!!! Good luck.....................Shrinky:bugeyes: