FutureRNMichael

Hello hello! I used to post on allnurses years back when I first considered nursing. Now I have an offer and plan on (finally) making the jump to be an RN. I've worked as a Psych Tech/CNA since I graduated high school about 5 years ago. I work for a large government agency, DHS, which has recently began offering the current staff a chance to enter a 1.5 year program to obtain a 2 year RN degree. They pay for all of your RN program but you must work for them about 2 years afterwards. The good is... I will only have to take out loans on the pre-reqs. I have a guaranteed job right away at a decent salary w/ great benefits. Many friends have tried for several years to get into an RN program here in the Portland metro area - the programs here are stuffed full for years in advance. This program provides a direct entry. The bad is... I'm stuck in Psych for awhile (I like Psych but not great for acquiring RN medical skills). I'm a little concerned about graduating then being stuck in Psych nursing for my first two + years post graduation. I'd like to explore many areas of nursing, ICU/ER/NICU/Surgery especially, so will this two years in Psych set me back much? How hard will it be, logistically, to go back to school for a BSN then Masters? Not for sure I will have to motivation to do this but it is a thought. Lastly, would you consider this program a good deal? Should I go for it? Thanks for your time! :bowingpur

i heard pcc accepted 40 or 50 people this year from 900 applicants... not the greatest ratio.

Thank you both for sharing. It is nice to hear the reasons why a person might cut. I have been interested in a young lady from school who cuts and it really saddens me to see her do that to herself. She is such a bright, beautiful women. I doubt she knows but I have seen cuts on her arms/wrists. Either way, maybe it is best not to become more than friends when she is working through this particular problem... I don't know?

Most likely place to recieve the type of training mentioned in this thread is by a employer before starting in your position. If you ever work in Psych, you will go through a course by the employer consisting of containing a patient, keeping other patients, yourself and other staff safe. I have worked in Psych for several years now, with the most chronically ill indviduals in my state and have never been attacked to the point where I felt in serious danger. If you form a bond and treat patients with respect your almost always likely to be the last person they attack. Most patients will always attack the staff who treats them undignified or direspectful and/or has no rapport with them first and foremost. Just make sure you do not ever find yourself in such a position. Your best bet is to analyze and recognize a person who might be one to cause you harm and keep a safe distance at all times as best possible, never get the patient between you and the exit/door and most of all get the heck away!! Escaping is always best because you are not risking harm to yourself or your job by HAVING to defend yourself. Yes, it is a disgrace to be fired for defending yourself, in most cases. However, some nurses I have know used excessive force to threat they faced and we're fired, rightly so.

Wow, thanks for the links! I've been watching some of the grand rounds tonight, good stuff!!

mom's are always right (i work in a state hospital)

Wow... Deep stuff. Please do post your final copy, if you don't mind sharing with all of us!

Has anyone in Psych Nursing been introduced to this relatively new topic yet? It's a new thing, from what I hear anyway. Talks of changing attitudes amongst psychiatric hospital staff and clients/consumers (their new term for patients) as far as the age's and age's old attitudes go in Psych. Introducing a new kind of enviorment on inpatient units of self/consumer policing units, frequent comunitty meetings to implement this and let clients tell others how they felt when so and so tore up the ward and went into restraints, getting completly rid of restraint rooms, no more forcing people to take meds as it gives them the wrong ideas...etc,etc... I recently attended two seminars on the topic. One small and one large(500 people from all over the west coast). A small-ish acute care ward of 25 or so adult clients in Salem, Oregon has implemented the model and had great success. No restraints and only one or two seclusion's in 1+ years. Only a year or two after the intial implementation of the Sanctuary model. If your interested in more about the topic, you can read: Sanctuary Model by Sandra Bloom or just ask and I can scan/email you copys of the paperwork given out at the seminar. EDIT: Found a few links which might be of interest: (http://www.sanctuaryweb.com/main/Sanctuary%20model.htm) (http://www.sanctuaryweb.com/main/sanctuary_senior_faculty.htm)

I'll throw a few ideas out but I apologize if they are not 'deep' enough to write 10,000 words about. Just some interesting things I've found while in Psych. Dual Diagnosis, How one issue affects the other, how you would approach treating such a patient, what area would you focus on first or would you focus on both first..etc Undiagnosed childhood disorders being mis-diagnosed later in life. Strong aspergers tendency as a child/teen later diagnosed as OCD. Mainly, what have your favorite topics/case studys in mental health been thus far? Find one you really love and write about it!

Thanks for the response. I totally agree!! Anyone else with additional info on this topic?

Looking for some info(For my own personal use) regarding the status of civilally commited patients who commit crimes in the hospital. There is a patient who has assualted several nurses and they are looking into pressing legal charges against this patient. The patient is on a civil commit on a regular adult psych ward within the state hospital system which also runs the forensic program. What are the chances of the charges coming to light and the patient being sent from a adult unit to a forensic wardwithin the same system? What do you, as an RN, feel about a RN pressing charges against a patient? Not to give too much detail but the patient is Borderline and not 'psychotic'. Thus the reason they feel the need to have the patient face up for what they are doing. Any information would be great!

Where do you find the surveys online??

Well, out and out assaults, I have never seen(in 6 or so months). I work with some of the sicker people in the state and rarely hear of such happening. If you build their trust and listen to what they have to say, you should be ok. I have seen cases where a Patient has built up to going after a staff person. For instanse, one patient did not want to be discharged-refused to in fact-but the social workers kept working on finding a placement for this Patient. The patient mentioned several times of assualtive behaviors he was going to do if they kept working towards his D/c. And he did end up inadvertently hurting a tech. But the build up was long and drawn out. My point being, there is usually a way to intervene a problem before it happens. If for nothing else, your own sake. Keep your eyes and ears open. You should do great. All in all, techs-whether degreed or not-learn 99.999% of the skills on-job. Just curious, what type of facilitys have you interviewed at? Residential,Private hospital or a state run facility? Best of luck. You will be building great skills for whatever field you decide to go into to. Feel free to PM me, if you want to talk further. EDIT: Found a great thread for you to read through, if you haven't already. Great De-esclating tips: https://allnurses.com/forums/showthread.php?t=8896

I work as an aide-for the state system. I think it varies greatly from place to place. Generally speaking, I think those of us who work in Psych and aren't degreed typically end up doing a lot of the grunt work that needs to be done by someone. Such as various light cleaning after meals,we typically sit on lots of the 1 to 1's with patients, charting on patient behavior/significant differences, mostly are around to keep things in order and help the patients meet their basic needs and be sort of a liason for the patients to the therapists,nurses and social workers. Interview tips --- Be yourself. Best of luck... Would love to hear how it turns out!

Would LOVE to hear replys to this question.

Not to sound rude but take a look around this forum. Make use of the search feature on this site... You should find everything you need to know! If not, come back with questions when your more informed. Good luck!!

"has led to 4 state facilities still open" Just curious, What did you mean with this comment? Are the state run facility's going by the wayside back east or something?

Maybe because I have no prior experience, possibly because I am young - not really immature but I am a young thinker + dealing with several younger patients on the ward at this time. The younger ones happen to be our most troublesome in general. It's been a rough adjustment periond for me in my first Psych job - working with the adult(18-65) population - I am perplexed. Typically in all other jobs I was an efficent learner and always have adjusted by this amount of time(4 months on the job.) in the past. Whether it be nursing home work,gero psych, food service or otherwise. I've also been working nights for the first time but soon to transfer into a day time positon. Which means MUCH more patient interaction, making me want to get to the bottom of this. It's not as if I have had any complaints about my work performance, quite the opposite. I suppose it comes from the feeling inside about how comfortable I feel. I guess it could pertain to being hard on myself during this tenure, I don't know for sure. Any advice or suggestions to possibly ease the transition period would be wonderful. Even sharing your own story upon your start is Psych. Have a wonderful day! :)

Hello there. I am planning on going into AmeriCorps in late summer months from out in Oregon over to the busy,rough and tough NY. Really excited about it, to say the least! Couple of questions: 1- I'm a Certified Nursing Assistant here in Oregon working in Psych as a Tech. How hard would it be to find a job in NY in Psych as a tech? Would I need to transfer over my CNA to NY? Does NY even hire people without degrees in Psychology for tech jobs? I just want a part time job that will allow me to supplement my free time. 2- Is NY really that rough and tough? I've had people tell me I wouldn't be able to make it for a year over in NY so it has be slightly discouraged but still intent on coming there. Thanks a lot!!

Thanks everyone. I too find it odd he diagnosed John with BIF. However in his recollection when I asked, he did perform a Psychological test and did pretty poorly. Thus probably where the diagnoses came from. But, how common is it for someone with depression to have a low level of mental functioning. The two seem to go hand in hand. This could be a single poor judgment case-I don't want to lump all Docs in with his or anything but it's seems like a quick finger to diagnose a child or adolescent with something like this. Concievably could really disrupt a kid's treatment.

A friend of mine who we will call John was hospitalized in his late teens for severe depression. He was seen by an Child/Adolescent Psychiatrist upon his first few days at an acute care hospital. The Doctor was with him, from his recollection, under 3-5 minutes max. He later finds out that the Doctor diagnosed him with the depression but also with Borderline Intellectual Functioning. He is a very succesful person now,educated,with a good job and from what he tells me, which I believe 100%, his IQ range has been in the 150-160 range for quite sometime. Now how can a Doctor diagnose someone in such a short period of time and come up with such a poor diagnoses? I wonder how common this really is(?). I'm sure some people are labeled things they are not, such as this case, and it can have a lasting effect on their own lives,self esteem and careers. I understand diagnosing depression in such a short time but how does one dignose BIF in 2 minutes? Seems like more would have to be made and shown for this to happen. That's my non-professional opinon anyway. :uhoh21:

Hope I didn't butcher the spelling too much.. Anyway, being new to the psych field, Aspergers disease appears to be an interesting,complex diagnosis. I still know very little about it. Interesting to me was seeing it diagnosed in children and adults - or at least by history. I always thought of it to be a disease which only affected children. Being diagnosed in intellectuals and those who have low IQ alike. Any suggested reading material, as I know they're is a lot out there. Any stories regarding those afflicted, would love to hear them. Regards, Michael

You find the complete list of sites avalible at the State Board of Nursing website here in PDF Form(You need Adobe Acrobat): http://www.oregon.gov/OSBN/pdfs/CNA_CMAprograms.pdf Be careful where you pick because nursing homes need people and they will pay for your training/certification/state test so in a way, the ball is in your court.. I am a CNA currently, have worked in Nursing Homes and Adult & Geriatric Psych. If you have any more questions, i'd be happy to help you. Best of luck!

As a new person in the field of Psych, I have found the people diagnosed with borderline pd to be the most interesting. Both in dealing with them and there actions. Most have been in the system for a long time which makes you want to help them get out even more so. I was just curious how you have had success - or not - in dealing with a borderline patient. What was the approach? How much did the Care Plan come into play? Another problem I have come across is staff have trouble enforcing the same rules with these pt's and this leads to many added problems. Any information you great Psych Nurses would like to share, please do!! I woudl love to hear some success stories and how they turned out. :balloons:

Outside Doctor Consult - two sources I believe - is needed to use IM backup's in Oregon.But, if there in the state hospital, they probably have some decision making issuses as it is.