WillyNilly

The staffing is unstable. If someone codes on the unit it pulls both nurses in the room which then leaves the aides on the floor alone. If there is a companion case who covers the case while someone takes a break? The age age group can be more physically demanding and at times more violent towards staff and others due to disease processes. Please be aware before doing it. Good luck!

Follow the advice the others have given. Previously I have told others "If you can not speak to me in a professional manner, please don't speak to me right now" There was one incident where I saw him cursing and ranting and he was coming towards me. As soon as I saw him in my face I burst into laughter and said "you're kidding, right?"

Some insurance companies offer this type of job, however more and more of them are downsizing and asking them to become case managers and work in the field as travel or home care nurses. Is there a reason you would like to leave? What about gaining med surg experience?

Would you consider a social work aspect of psych? It would offer the counseling and not as much of the physical interactions that you may be seeking. You would also be able to make a decent earning, work in a hospital setting, counsel/interact with patients/family and have flexible hours.

The acuity we are dealing with is getting higher. Our goal is to use techniques to calm prior to reaching this level however it can happen. Only you know your body and it's limitations. Would you qualify for a replacement now while you are still in good health and be able to replace the other prior to changing careers? have you explored other areas of nursing as well? Honestly, I am on my feet 13+hours a day at work. It is constant movement and patient interaction as they move to keep a calm milieu. It is not always sit and coffee talk. Hope this helps

Every person has a bed alarm at night. No exception. Explain it is for safety reasons, most are agreeable. Slipper socks on everyone as soon as they walk in the door. Orthostatic vitals daily. During the day, most are pulled to a common room to encourage socialization and to keep eyes on everyone. Staff members must be with them at all times. If high risk for falls, follow them to the bathroom and back. We walk a lot with our patients. Station the computers outside a cluster of rooms at night and answer those lights in person. With everyone clustering, charting is getting done and patients are getting quick care. We can place mats on the floors, restraint free alarms on people, bed alarms, nonskid socks, every 15minute checks, hourly rounds (toileting, etc), utilize quiet areas, activities, etc.

It is dispensing without a license. I will not be cited for it. Some have asked me for Mylanta or Tylenol and I refuse. They get upset but I tell them "The store is down the street. If you would like to take a break to get something, let me know". I will not be reprimanded for a simple thing.

If she was a threat to self or others, verbal redirection was ineffective, altering the environment did not work and redirection did not work you are with in your means to use a medication. Just be aware of physical holds can be considered restraints per CMS guidelines. Anything that prevents free movement is a restraint. Also, be aware that the Ativan you gave could disinhibit and make more prone to falls or inappropriate behavior. Take a deep breath, write down what happened as if you were charting for when you have a meeting for reference, and for your own protection get insurance!

This may sound dumb BUT never put your mouth on inflatable equipment at work. You can use almost empty oxygen tanks to inflate the rest of the way. Have seen others mouth chair pads to beach balls, etc.

Before starting a group, do a potty round and snacks/coffee/drink pass. Fill a tray with drinks and misc snacks. Ask each if they need to use the potty, if not ask about a snack. Tag team the snacks and potty with another person. Thennnn proceed. You will have more attention if everyone has peed and are fed. Large print word searches can be printed free from google as well as coloring pages. Plenty of crayons or markers in fat sizes for easy grasp. Plenty of playing cards. Beach balls or balloons to toss the ball for exercise. Daily reminiscing or current events while they wake up. Trivia cards such as old trivial pursuit cards are fun too. Movies such as older ones or themed around holidays -A wonderful life, etc. Music therapy. Some use internet radios for multiple channels with a portable speaker.....sing along if you know the words! Orrrrr use soothing lullaby style to do chair yogas. A lot of this can be done with or without her there. When she is there, she may be able to do craft items or focus groups with more 1:1 attention. Hope this helps.

4530 is heavy with busy work too-4520 is cake compared to that one. Easy but repetitive to mind numbing.

Who wouldn't want to walk around comfy in their undies if given a choice? 10:1 if it is asked it would be met with a "Because I want to!" or with a "Because I like it" or another oldie "Don't you want to see it?" A 1:1 for naked? Cheese! There are places that have staff for that? Can you continually chase behind saying "Breakfast is here. Put your pants on." "Would you like coffee? Put your pants on" "Heres your meds. Put your pants on" "Name and DOB? Put your pants on" Realistically? No. If the backwards shirts or suspender pants don't work annnnnd When it disrupts the safety of the milieu, the PRNs would need to be assessed when other interventions have been exhausted and care has been discussed with the physician.

Are we talking underwear or full on birthday? Is it psychosis or dementia? Can this person follow commands or limits? If redirection, environment altered, and unable to follow commands has a PRN been utilized? Has the dr been notified of behavior? For dementia or alzheimers there are certain clothing articles that are made and can be used with permission from family. They are similar to leotards or a button down shirt may be worn.

Badge is on a retractable clip. Keys are clipped on a hook with a short lanyard to the inside of my pocket so they are never left behind and no one can easily take them. When going in to an emergency situation, my badge is secured away prior to entering the room so it does not get grabbed-same with keys.

It will also open up questions "ooh so you are married? Tell me about your husband!" Plan your response of "Policy states we aren't allowed to discuss personal items" or " well it's been so long I don't count the years anymore" My fake is 2.99 from Amazon and just for fun