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Home Health- RN

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  1. lol oh so true. There are some wonderful social workers out there, but there are some that have more personality disorders than a stack of DSM's. To the original poster, that silly social worker ruined the group for the other patients, but at least it wasn't a total loss- the BPD patient had an audience, and we all know they love that.
  2. Inthesky, Its usually very disturbing to the person witnessing something like this for the first time, and you just need a little more time to observe the abnormal behaviors. Learning the ropes of a new job is stressful in itself, and it's virtually impossible to accomplish if you aren't accustomed to the totally bizarre events that occur in the psychiatric setting on an almost daily basis. I think employers forget about this sometimes and they rush to get you oriented and on the floor. And they wonder why nurses leave like their hair is on fire. :tinkbll:
  3. LaRN

    Not giving PRN's even though they are ordered?

    Every place I've worked has had at least one nurse like this, they are everywhere, and they are ignorant. In addition to looking at her like she's stupid, tell her "It's a doctor's order. I have to give it". If it's a supervisor telling you not to give it, then let her know that you have to chart why the medication wasn't given when the patient requested it-- because she told you not to. (ouch, she wont like that) Whenever a patient tells me that they were denied their prn medications, I try to talk to the nurse first. If that doesn't work, I give the patient a statement of concern (complaint) form and encourage them to use it. I also include it in my report (patient complaining that he's not getting his prn medications) and I document everything. The only time that I tend to hold back on prn medications is when the patient has been getting them frequently and their agitation is more like the cumulative effects of a drug (groggy and irritated similar to an erratic drunk). They usually need TLC and a quiet atmosphere so they can rest. But if that doesn't work, I inform the doctor of patients symptoms and encourage an alternative measure.
  4. LaRN

    Death at Group home for Developemntally Disabled

    copy/paste the link to your browser to open it. Facilities hire personnel, give them on the job training, but fail to educate them on matters such as patient abuse, job stress, and how to cope with difficult patients. Sometimes just having a meeting to discuss their frustrations and even using a little humor to put things in perspective helps. For instance, our orientation instructor gave us examples of the things that patients will say and do that may anger some employees. She was very animated in describing her own personal experiences and what went on in her mind in response to them. Some of the orientees also shared their stories too, and needless to say, most of this was very funny. She followed this up by invoking our empathy and understanding for these patients by describing some of their struggles and life stories and stressed the fact that nobody would choose to be in their situations. At the end she discussed the legal ramifications of patient abuse and neglect. By knowing and understanding these concepts, the employee internalizes the fact that they would have to be a complete moron to abuse or neglect a patient. Likewise, an employer would have to be a complete moron to not make sure their employees get this.
  5. LaRN

    Such a bad rap

    with proper education and strict adherence to best practices, (never letting your guard down and paying attention to changes in pt's mood and behavior), injuries are rare, and minor if they do occur.
  6. LaRN

    Help, new unorganized behavioral unit!!!!

    This is how the cracks that patients fall into are made, a tragedy waiting to happen. Insist that your aides monitor the pts the way they are supposed to, and do NOT trust them to do so. Follow up behind them. Make your rounds frequently and make them at different times on no set schedule. If you witness events or things that are not safe, correct it as best as you can and put it down on paper with dates and times, make a copy and give it to your supervisor personally. Of course the primary problem needs to be fixed, but until then, you must protect your patients, yourself, and your license.
  7. LaRN

    Fired recently - REALLY need advice!!!

    HIGH FIVE! So true. Many times I've seen supervisors fire good nurses and praise the ones who aren't safe enough to work at a sno cone stand, simply because of a preference or conflict of personality.
  8. LaRN

    so many suicides

    Although it's possible that his problems are related to his home life, it's also very possible that he has severe mental illness. The automatic assumption that bad parenting is to blame can result in caregivers not getting help for these children.
  9. LaRN

    Pregnant and starting as a psych nurse.

    Not sure if your facility is a true psych setting, but in most of them, injuries to unborn children are avoided like the plague. If my supervisor found out a nurse was working while pregnant, her hair would catch on fire.