Ultra Violet

Our facility uses DAP notes. I find it takes some getting used to after writing narrative notes in med surge. Being new to psych, I have a question about charting. Is it appropriate to quote a patient's expletives if it is of some meaning. For example, a patient who is harrassing/threatening another patient and calls them a certain expletive. I'm thinking back on a note I wrote last evening and am hoping I did the right thing. I also stated in my note this patient felt afraid of the patient that swore at her due to the behavior of the aggressive pt and what we did about it/room change, ensured her safety and safety of unit, etc. I don't know why I'm doubting what I wrote now. I just don't feel I got a lot of training with regard to charting in psych (other than mental status exam). Thanks.

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Thanks for the feedback. The person wasn't in last night so it wasn't addressed. Like I said, I admit I made the error and apologized for it, but I believe it is unprofessional always to address an issue in front of patients and other staff members, and it did have to do with tone of voice and facial expression as well. I'm going to let it go, but I just didn't want to set up a situation whereby she continues to do this type of thing. I tend to not confront people on issues when I should. Thanks again.

Hi, just wanted a couple of opinions about this. I started a new job about 2 months ago. I was the medication nurse last week. One night I brought a client out into the community area to take a med that the pt has to sit for 10 minutes in front of staff then show staff before they leave that the med is gone. So I explained this to the pt who was sitting right behind staff. My error was in assuming that the nurse very close to me and pt while I was explaining heard me. So I guess I started to walk away when she said (in front of pt and other staff members) -- did you just give pt such and such a med? I think I responded yes, and I explained to him that he needed to show you b/f he left. She said "You need to make sure that you let me know. All I heard was my name." So anyway this was not a huge deal, but it has been bothering me that she didn't call me aside to correct me rather than say it in front of pts and other staff. I'm mad at myself that I didn't talk to her about it that night. It was suggested to me that I still should confront her about it in a nice way tonight. I welcome her and others feedback. I just feel bothered about how she did it (esp. in front of pts). What do you think?

Hi there, I start my new job on a locked dual diagnosis floor on Monday. I will have two weeks of classroom and then orientation on the floor. I am very excited but also nervous about starting over again, meeting new people, etc. I am mostly excited though about starting in the field that I am so passionate about -- addictions. I absolutely love my part-time job that I work at an outpatient clinic too. I love getting to support people in their recovery. I am also starting the UMASS online BSN program this week and hope I didn't take on too much at once, but I believe if I got through nursing school, I can get through anything...

Brookejean - I graduated from LM/RC evening/weekend program in December 07. Most weeks we had classes on two evenings (5 or 5:30 pm to 9:30 or 10 pm). Then every other weekend clinicals which involved research Friday night 5 - 9 pm or so and full day Saturday/Sunday starting at 6 or 7 am. In my opinion, it is a very rigorous program. It can be very stressful. If you work full-time, plan to take time off around exams. It is a great program. The instructors are very good. There will be labs that you have to fit in on your own time as well to pass off on skills especially in the first and second nursing class. Let me know if I can try to answer a ? for you. Best of luck to you!

Gerry, I e-mailed one of the instructors on the first nursing course since I'm trying to make a decision whether to start in Sept. or January 09 - I'm going to be starting a new job too. She said expect to spend about 18 hours per week at least during the first part of the semester - reading, writing, lectures, etc. Did you find this to be the case with everything added together? Did you find these classes to be overwhelming? I have only been out of nursing school 8 months myself. This couldn't be as bad as nursing school, or could it???

I'm also starting in September and am worried about managing a new job, the family, etc. I just got accepted last week so it's a rush finishing up all the financial aid stuff. I need to make a decision quick about whether to start in Sept. or wait until January. I e-mailed one of the instructors for Professional Issues, the first nursing class, and she said expect to spend about 18 hours a week especially during the first part of the semester!!! She said there is a lot of reading, viewing lectures and course materials, preparing written responses to discussion topics and other assignments, as well as a 2-hr live classroom each week. I did not hear that amount of time per week from 1-2 other students. What are you guys hearing?

Hi there, I just got accepted for September as well. Do you mind if I jump in on this thread and ask about how many per hours you spend per week studying/homework? I've never taken on-line classes before, and I'm not sure what to expect. Is it mostly reading and writing papers? I'm enrolled for the 1st nursing class. Thanks so much for your help.

Hi there, I didn't even know there was a Massachusetts forum until today! I just got accepted into the UMASS program as well for fall 2008. I am starting a new job, God willing, on Sept. 8, and I am wondering if I will be taking on too much enrolling for September as well. I am taking the first class, Professional Issues in nursing? I have a lot of support at home. I will be working about 40 hrs a week. I believe if I made it through nursing school while working and raising a family, I can do this! Oh, I'm starting the new job in psych, which is my passion (substance abuse).

I had two more interviews -- one yesterday in a detox facility and one today that has a locked psych and locked substance abuse floor. Yesterday at the detox as I was in the waiting area, all hell was breaking loose at the facility. They had to call an ambulance, the police, etc. for an out of control patient. I could see the difference from where I work now on a floor in a hospital that gets a lot of medical detoxes/psych patients vs. this detox. Where I work, we woud call a "Team One" and subdue the patient. I think the hospital has more resources. Anyway, the nurse manager was great. There is definately an approximate $4/hr pay cut from med surge, but there would be much more flexibility in scheduling. Then today's interview was with a recruiter first at the locked facility. It went very well. I will be meeting with the NM next week. I actually did a clinical rotation at this facility during school. I think the pay is a bit higher here, and it seems there is more flexibility in scheduling at this facility as well. Someone asked about the interview questions. Today was the first interview that I actually was asked some of those corny questions like: Why nursing? What is making me look at psych nursing? If she spoke to people that I had worked with in the past, what do I think they would say about me? if I had any biases/prejudices -- I forget how she worded that ? There were others. I found just speaking from the heart/telling the truth worked best for me today.

It's been a busy week. I don't know how to explain it other than I just didn't have a good "gut feeling" for this facility, which was really disappointing to me. I don't want to jump from my current position to something worse. The nurse manager took me about 25 minutes later than my appointment because they had me filling out pages and pages of applications -- info that was already on my resume. That didn't matter so much to me, but it put her off schedule, and then I felt rushed toward the end of the interview and didn't get to tour the facility. Anyway, I would take a pay cut of about $5/hr. It's located in Boston so the drive is at least 30 minutes for me without traffic. There is no flexibility at all in terms of choosing which days per week to work and no 12-hr shifts available. That's fine except the way the woman answered me gave me the feeling she is completely inflexible. (Due to the pay cut, I plan to keep my part-time job which I like alot.) Then she proceeded to tell me that because they are a private facility they take on anyone, some of the most dangerous/ assaultive people -- ok fine, it's a psych unit. They are in the process of hiring a nurse educator, but that would not be in place for me. She said you don't get a preceptor like in med-surge, but they bring on an extra nurse for I believe 3-4 weeks. Then at the end she asked if I had school loans to which I replied I did, and she said she could work on either a sign on bonus or loan forgiveness involving a contract. I'm sitting with this a few days. I'm not jumping into anything. On the up side, I have two more interviews set up -- one for next Wednesday and one the following week. I'm just hoping I find my "niche." I've been so up and down lately. I've never been good at waiting things out being an addict in recovery myself. I know there is going to be something for me that I love. I just know it. Right??? ha ha ha

Thanks very much for your replies. My interview is today at 1 pm. I'll let you know how it goes.

Hi there, I am so excited and also anxious that I wanted to share. I love reading these threads everyday. I am a new grad RN, graduated in December, have been working in med/surge for almost 6 months. It was my original intention to get one year med/surge because a lot of people that I respected suggested that. I was originally going to school for substance abuse counseling but switched to nursing for many reasons so I knew that my passion was addictions from the start. I just can't "tough in out" in med/surge for one year. My unit gets a lot of psych as well/medical detoxes, etc. I am so anxious even though I feel and am being told that I'm doing a good job. Sometimes I feel I'm just pushing meds the entire shift. It's like running a race for the entire 8+ hours. Last night I was there 2 hours past documenting and can't get paid for it. People offer to help, but sometimes they are so busy with their own load that the help is not available. Anway, I have an interview on Tuesday. The hospital is at least 30 minutes from my house. I am excited just to have gotten an interview. I am praying that I will find something I love and an excited about starting a new career in psych. I love to learn and read. The things that excite me most involve addictions/recovery, prevention, etc. not dressing changes, rectal tubes (last night!!!), etc. I love comforting my patients and wish I could spend more time with them. My anxiety has gotten so out of hand that it's having an effect on my home life. I start to dread going to work the day before I have to... Sorry this is so long.

That sounds like an awful and unsafe situation. You need to speak to your nurse manager right away that your preceptor is not working out. I work eves. When I was precepted back in February (for six weeks), my preceptor started me out with one patient the first week up to 5 during the orientation period. She showed me how to sign off orders, enter them in the computer, and anything that I wanted her to show me or recheck, all I had to do was ask. Also, I had certain skills that I had to be signed off on. As far as drugs, I would look them up myself, but again, she showed me where the policies are located, etc. etc. Your preceptor is not doing her job. It needs to be addressed right away before it is too late. Best of luck to you. Keep us posted.