DesertKat

No, nothing legal. I wouldn't have a leg to stand on even if I did want to sue. I guess I just want them to recognize exactly how tenuous their position was and how easily it could have lead to a major lawsuit. I think they seriously need to rethink their position on staffing and refusing to hire agency nurses. I doubt I could have a major effect, but what happened doesn't make sense on any level- staffing, morale or legally. I doubt I can do anything other then eventually walk away once I have a solid employment offer. Heck, I'd even go back to teaching highschool if I can't find anything better (I live in a small city without many options).

Oh, I am looking and trying to maintain my professionalism. My staff and the doctors I work with are being very supportive, which is a huge blessing. I was relieved to walk away from the management position and my husband is as well- maybe we can actually see each other while awake again! I just hate to think of anyone else going through this in the future. And as a manager I also wonder what the heck they were thinking anyway. I've sent home nurses for less and with Joint I wonder how that interview would have gone with me crying the entire time!

Forgot the part where I couldn't reach my husband because he is Air Force and they were in the middle of an exercise. Time management has nothing to do with being assigned every shift that another nurse turned down or finding my name penciled into the schedule for a double without even being called about it. Or being scheduled to charge for 54 hours a week because I'm the nurse they don't have to pay overtime on. I don't have deficiencies I need to "work on", thanks. What I did have was a situation in which I was expected to conduct two full time jobs at the same time.

So in January I was promoted to nurse manager so all sorts if long hours and steep learning curves insued- which I expected. What I did not expect was that once I became salaried, I also became the hospital lackey. I had to take all the overtime and extra shifts that came up (since they didn't have to actually pay me the overtime) and there were a lot because we had nurses dropping like flies. So here I was with a full schedule charging and I was still responsible for all the duties of a nurse manager on top of it. Next thing I know, my husband and I find out that I was pregnant. I didn't get any slack in hours, in fact the situation got worse and when I told them I couldn't do it, I was basically told to suck it up because that was my job as nurse manager. This week I had a miscarriage and was actually told that I had to suck it up and come in anyway. And in my state, I actually did! So there I am, sobbing and ubable to function when guess who joins the play- Joint. At which point I was told by my boss to suck it up and get onto the floor. The risk manager and hr ladies were there and were actually pressuring me to get onto the floor, too. The only reason I left was because my nurses got together and worked up a way for me to leave and the night nurse stayed for my shift. Now, fast forward a bit and today I find out that my boss told the nurses that I was just bleeding a bit and I was being hysterical and preventing everyone from doing their jobs. I may be a psych nurse, but I damn well can recognize a miscarriage when I see one. I am so ****** beyond reason that I have to fight every day not to walk out in the middle of my shift. I hate it because my patients are suffering and so is the rest of my team. I quit as nurse manager, but I have no idea if there is any recourse I have against the hospital. I can't imagine anyone else having to go through what I just did. I am currently job hunting, but I still want to protect my team of nurses as I best able.

I was just out of school. The orientation I got was one day of orientation to the facility itself and then the one week following other rns. There was little rhyme or reason to it and then I was tossed out on my own. The only thing that saved me was I used to be a highschool teacher and classroom management was already ingrained. Needless to say it wasn't the smoothest transition.

Depends on the facility. I was a new grad and got one week and then became charge nurse, so there you go. The main difference is that I have found that nurses new to the psych field tend to forget that they are now treating the mind. They tend to document very well on the physical interventions but without a single word about what is going on pschiatrically with the patients.

Yes. And no. There were days when I really helped people and there were days when all I did was be a glorified unit secretary. There are so many elements to the psych setting that, frankly, you could land in a really great place or a really horrid one. But as with all things, you can only do what you can do. In the end, I chose to leave the psych setting because the culture of the hospital I was working at was at intrinsic odds to my personal ethics. I learned quite a bit during my time as a psych nurse and will always be grateful. If you feel drawn to psych, by all means pursue it. But do it with eyes wide open- advice I would now give regardless of the field your looking into. Talk to the nurses, see how happy they seem- even when towing the company line you can still tell how they feel about their jobs. Look to the patients and see how content they seem about being there. Good luck.

Yeah well, remember the phrase "nurses eat their young"? Sadly its often true. I can't advise you more then saying that you are going to have to be your own best advocate. Unfortunately in nursing you only seem to get what you demand.

Well, I am done. I handed in my resignation and notice this morning. I am just tired of the yelling, irrational accusations, abuse and knee-jerk irrational over-reacting. And for anyone thinking I am talking about the patients, ha! I have been jerked around by the DON for the last time and I realized in Friday that I DIDN'T have to take it. I have a RN for pity's sake! I can get a job even if I did really want to stay in psych I can manage to find something else. I hate not having a job lined up before quitting, but I figure this is one time to put faith in a higher power and jump. Hope I land well.

I crate trained a puppy while in school and then adopted another dog that was about 2 years old who also happened to have a lovely case of giardia when I got him. I managed to get through both without too much mayhap, though it is better if you have access to a yard. I second looking at an older dog for adoption, but in truth look for a calm and quiet dog that will be ok spending lots of time alone. Good luck!

It isn't the object of his psychosis that matters, its the result. There are plenty of people who are delusional, actively hallucinating or are extremely paranoid that still function relatively well. If the psychosis develops to the point in which it interferes with his ability to function on a basic level, then it is acute enough for intervention. And that's pretty much the long and short of it. So yes, if someone is obsessed about cars to the point at which they are no longer eating, bathing, walking into streets or any number of actions that can harm themselves then they would meet criteria for acute intervention and stabilization. So, no- the mere presence of psychosis does not require acute intervention. But it *might* require out patient intervention if, and only if, the patient themselves feels that their illness interferes with aspects of their lives. But to have that much insight, they would have a MUCH higher GAF then those who spend time with me as an inpatient.

In short, he doesn't. But he does have to engage himself. A man living on his own and not interacting with the world looses out, but that in and of itself does not need intervention. If he is so involved with his psychosis that he no longer eats, sleeps or cleans himself or his environment, then that requires intervention.

I don't think one population is really better or worse then the other. Speaking as someone who used to be a high school teacher, its all about controlling yourself, picking your battles and learning to accept that kids push boundaries. I find I tend to relate better to adults, but that might be because I had four years of basically having parents hand off responsibility to me because I was a teacher and I went into nursing to get away from that. I guess that is just the long and the short of it- the populations only seem better because of you. With kids, you have to be comfortable telling them "no" and meaning it. If you hand out a consequence you have to, HAVE TO, follow through with it. It might sound weird, but I suggest you get some classroom management skill books- one of the better ones is The First Days by Wong and Wong. You can't apply all of it, but it helped me quite a bit and I fall back on it a lot while nursing- both in the adult unit and with the teens and children on the occasions that I float down there. It won't make you an instant success, but I think it might help somewhat. And yes, teens can be manipulative and act out like crazy and, to me at least, they are harder to talk down from these times of acting out. You have to realize that they haven't developed their brains enough to really process what they have been put through or putting themselves through. Remember that the human brain develops through the early twenties and that you can't always logic them out of their emotions because they haven't developed that capacity as of yet.

----Off topic rant---- The anthropologist in me shudders each time nurses talk about culture because, frankly, few have a real clue. Few nurses have the training and the experience to step out of their own culture to address the true cultural needs of their patients. Mainly because the majority of their patients have the exact same religious and cultural needs as they do. Cultural awareness exceeds simply knowing that those who are of Jewish descent might not appreciate a slab of bacon beside their pancakes. Its learning to assess the fact that people of different cultures have entirely different ways of processing thoughts and feelings then, say, most Americans. America is clueless about culture because of the myth of multiculturalism. Ok, off rant. Annnnd back to our originally scheduled programing.... Anyway, the fact is you have to assess patients for why they are in the hospital in the first place. As you said, talking to the light fixture is weird (of if you are wealthy and from the South, eccentric) but not in and off itself criteria for hospitalization. Where delusions really have to be addressed, as you have stated, is when it radically interferes with their ability to live day to day life or they become a danger to themselves or others. Is turning off the lights for this patient appropriate? I would say, yes. And for this reason. If the patient is so fixated upon this delusion that you cannot bring their attention away from it and it interferes with treatment, then it might be the only solution as harsh as it may seem. Even in my short amount of experience, I have seen patients fight medication and treatment to maintain their delusions and when they have a trigger, say another patient that is feeding into the same sort of religious delusions as themselves, it becomes that much harder to break the psychosis. Once the psychosis is treated, then it is appropriate to help that patient develop a healthier expression of spirituality- even if it is still directed towards the light socket. Its basically a question of Maslow's hierarchy. Treat the most basic needs first then address the needs of spirituality.

Why would one not say that some mental illness is, indeed, incurable? Are there not plenty of physical ailments which are incurable? Therefore, why would we expect any less from mental illness, especially when one considers that the treatment for such an illness is the alteration of the biochemistry of the brain? It is true that any mental illness, like almost all chronic illnesses, may tend to have a large variance in severity and presentation therefore making no two paranoid schizophrenics or people with bipolar the same. And that's just Axis I. One could make a loose argument that Axis II is mental illness and once you get into that, well, there really is no "cure" for a person's intrinsic personality.

The only problem that might really arise is being out of compliance for med times. Something that is, frankly, a bit of a reality for psychiatric nursing at times. But if you are consistently out of compliance and creating med errors, then learning how to be more timely might be good for you. But just interacting with the patients and answering their questions in and of itself isn't a problem. From what you describe, my only concern would be regarding the med time window. Other then that, you appear to be doing what a med nurse is supposed to do- interact with patients, answer questions and assess efficacy of the medications prescribed.

Austin can be a difficult market for nurses- with a major university there and it being a popular city in Texas, there is a lot of competition. One thing you might look at is the surrounding communities. Sometimes it is easier to get a job in the smaller towns that are close to Austin, and with Austin traffic being what it is- the commute is sometimes about the same.

I am not sure what post no 15's point is. A Doctor of Nursing Practice isn't a Doctor of Philosphy, it's true. It also isn't a Doctor of Medicine or a Doctor of Education. It is, however, a DOCTORAL program with the inferred title of DOCTOR once the program is successfully completed. Therefore, once again, medical doctors have subsumed a title which isn't actually specific to them. If they want to become anal about it, they really need to consider revising their titles to something that is actually acurate.

Ok, new nurse and interested in expanding my knowledge of psych nursing and am interested in the American Psychiatric Nurse's Association and the summer conference. If I am careful, I can swing the cost, however I am not sure that the material provided will be with the large amount of money involved in going there. Has anyone been to the conferences? Also, is the APNA cracked up to the membership fee? I mean, in the end, its a tax write off so I am not massively bothered by the cost. I just want to know if the benefits from it are worth the costs. There doesn't seem to be a lot of resources out there for new psych nurses.

Sometimes an object or "privilege" just becomes a hot commodity among patients. We have a facility that also medically detoxes dual diagnosis patients and we stock Gatorade for those patients. But sometimes there is a run on the stuff from the psych patients and everyone suddenly seems to require it for any number of odd reasons. And then as patient population changes something else will gain popularity. Truthfully, I think its just something that they decide, en masse and unconsciously, is valuable. They attach higher value to it because they really don't get that many valuable items or privileges in the institutions we work for. Almost like, by God, I am stuck in here and I can't smoke when I want to smoke, walk were I want to walk or do what I want to do when I want to do it but by God I can have prune juice! Anyway, that's my take based on my experiences.

What a crock. Some one needs to explain to the docs that the only reason they are called Drs is that they have a doctoral degree in medical science. Doctoral degrees have been around far longer and had, for quite a while, much more conveyed dignity and training then that given to medical professionals. If they are going to have a stick up their butts about the title "Dr" then they need to stop stealing the term from liberal arts and just take on the term "Physician" since that is technically more accurate. Sometimes it just go to show you that an "expert" is someone who knows a lot about one subject and next to nothing about anything else.

Sounds like we are getting the short end of the stick- though to be fair the facility is trying to hire on. Just not a lot of nurses really seem interested in going into psych. At least not in this area anyway. Truthfully, I am just biding my time trying to learn as much as I can before I end up back in a larger city. I am hopeful that the experience here will help me get a better job there in a few years.

I looked into going to Austin, but the fact that they make you apply for UT for a year and then MIGHT accept you into the SON was a major turn off. I would suggest looking into the UT Health Sciences Center program as they are a straight two year program. Texas Tech also has an excellent program from what I understand. Personally, with the cost of living in Austin I decided to go to UTHSCSA SON.

Yep. I just renewed mine and got in back in June. All you have to do is go online and cough up the money. No CEs, no hassle.

I do all the charting and most of the duties of a unit secretary as well. It gets pretty hectic when you have more then one doc on the unit. As far as the math goes, well, consensus is that he failed math in grade school- I just have no other logical answer for that one.