Mish56

HUGE problem for us also! Can't wait to see the responses here. We end up putting an awful lot of geriatric patients on constant observation.

Holy Cow!!! Start looking for another job! I work on a 26 bed inpatient unit, normal day shift staffing is 4 nurses, 4 MHW's and one "nurses aide". The weekends we are down to 3 nurses. The MHW's help with charting, the meds are different every shift but we have found to get the 9am med pass done in the 2 allotted hours (plus now we have to scan everything...takes so much time) we have 2 nurses work together but it doesn't always work out. The evening shift the 4 nurses pass their own meds, but we end up pre-pulling them which we are not supposed to be doing, but hey, gotta get those meds out! Let's all move to California where they have legally imposed staffing ratios. I think in psych it's 6:1

Here is a helpful medication brush up. NIMH - Mental Health Medications You may need to brush up on your basic psych dx, such as schizophrenia, schizoaffective, bipolar disorder, major depression. If you are going to be working with duel dx, review you addictions treatment also. A women's unit can be a real challenge! Review borderline personality disorder and PTSD. The abbreviations are getting way out of hand (in nursing and the world) so good luck with that! Welcome, and enjoy!

My hospital went to color coded scrubs about 5 years ago. I spent the 1st 30 years of my career wearing street clothes. I think it makes it harder for the patient to identify their assigned nurse...."I have the blond with the blue scrubs". There are 5 of us..."old or young?"..."I don't know". That being said they do add a nice institutionalized feel we are losing. LOLOLOL So where is your survey??

Wait?? I'm supposed to get a break???

Wow! It is always nice to hear thank you. Hospital stays are so short these days we rarely see people actually get "well". We help stabilize from crisis, then it's on to a IOP or PHP. Thanks for taking the time to jot us a note!

Great article Thunderwolf! I am one of the nurses on my unit that actually enjoys working with people with BPD. The lack of understanding/education about this particular disorder never ceases to amaze me. Knowledge is power, both for the nurse and the patient. Thanks for your words of wisdom!

My thoughts exactly "TOP OF THE HEAP!" (Do I hear Frank Sinatra singing?) I usually DO NOT tell people I'm a psych nurse, but it has nothing to do with "gasps", it has to do with too many hours listening to some strangers life story about themselves, their mother/brother/aunt etc etc etc. Hairdressers, nail techs, airplane pals (those are the worst-can't escape!), people are every where and they all LOVE to talk. About themselves. Ad nauseum.

Lord, I hate this! I am a staff nurse, and intend to stay as one. I want no part of management. Here's my 2 cents. Set the rules (backed by policy of course) and apply them. Equally and firmly! Where I work our non-licensed people can get away with anything, but they can fire a nurse without much effort. Read the policy's and enforce them. This is not rocket science. It sounds like you are being tested by the staff. As you would with any adolescent, be consistent, fair and did I mention consistent? Good luck! Be a great manager, your employee's will never forget a good one!

oh and BTW, sorry for no definitive answer. I'm gonna guess CMHC

So I'm guessing you live in CT (tags of Yale and Fairfield) and as an old ass psych RN I can give you this advice. Regardless of license start school NOW! I believe Fairfield is already stating you must start a doctorate program. Both of your schools require a hefty amount of $$$$, but I've had a few friends that have completed their Masters at Yale with a Stafford loan, pay back 2 years at John's Hopkins. But also call a Navy recuiter, the armed services are desparate for APRN's ! They will even hire me up to age 55! Can you imagine? JUST START!

Sorry your preceptor is such a burn out! What a lovely intro to nursing. I've been doing acute inpatient psych for 32 years. I hate the fact that some of our patients will "never get better". For many....yes, they will have their illness the rest of their days. Does that mean we don't bother?? Lord knows I hope not! We may just be helping someone return to THEIR optimum level of function, even if that includes living with delusions or hallucinations. And sometimes that means we focus on the basics, such as sleep and nutrition (oh I can hear some of you now, "3 hots and a cot"). I can't tell from here if you were "manipulated" or not, but these are things you will learn as you go. And if that's the worst thing that happens in your day, your still a heck of a lot better off than some of our patients. Hang in there!

"He is condescending, asks for help but then refuses our care and says we are incompetent." 1st I would remind this man that he is being spoken to with respect and you will except nothing less in return. 2): If he wants to dictate care, I would remind him he is practicing medicine without a license. 3). remind him he sought care, you did not go grab him off the street. 4) You or your docs need to be in communication with his PCP or psychiatrist. My concern would be, why is he using multiple ER's for his health care?? He is only in pain when his doctor's office is closed? If he's gonna keep coming in you need to have a partnership with his other care providers! My patients always say they are allergic to all neuroleptics! His allergy to all opiates leads me to think of 2 things. Either he has had previous addiction to them and is actually trying to avoid relapse, or he is simply trying to lay down a really good challenge ie: "I'm in pain and let's see if you can treat me" without a traditional approach. He says he has a sibling and wife, does he allow you to contact them? I'm sure they would be an excellent source of history. He sounds like a complex patient so the more info you have the better equipped you will be to deal with him. From the glimpse of him you have given us, it sounds like he may be more manic than anything (demanding and hostile, ? maybe grandiose). Sounds like a nightmare either way. GOOD LUCK!! You'll need it! I wish I could let some of my patient walk out the door!

I can only hope you are joking! The ramifications of a hyper-sexual Bipolar? The rape or incest victim? The depressed pt. who has lost all interest...might be effecting marriage or relationship? Hello!? Ignoring a patient's sexual health or lack thereof is like saying "I will take care of this patient, except for their left arm, I'm too busy for that part of the patient" On another note; whats worse on an inpatient psych unit than walking in on 2 patients having sex? Walking in on 2 co-workers having sex. Only happened twice (that I know of) and Lord knows, that was 2 times too many:lol2:!

WHAT???? Are we talking acute inpatient here? On my unit the patients are seen daily by their attending, on the weekends they are seen daily by one of our consistent building attendings, who have received a "hand off" on Friday! I have no idea at all about what the law requires, but good care dictates such a practice. I think the law gets involved when there is billing involved (Medicare/Medicaid). Certainly if it was a long term facility (do those exist anywhere???), being seen every few days would seem reasonable, but NOT in acute care!