mare4322

I am also concerned about the staffing ratio. I am the charge nurse 3 days a week 12 hr shifts of a 26 bed psych unit We are allowed me, a med nurse, and 2 MHTs for a census over 19. When the census drops to 19 they send 1 of the MHTs to another unit or home. On the unit there is Adult Psych, Chemical Dependency, and a Womans Program. We are supposed to keep the men on one end of the unit and the women on the other end. There are 2 nurses stations and a long hall seperating them. One MHT is to stay on the Womens end and the other stays on the mens end. I am housed on the mens end along with the med nurse. We very seldom have a male MHT. Yesterday we discharged 6, admitted 4 new patients and had one transfer from another unit. This all took place from 3p-7p for me and 2 more pts. were admitted after I left. Administration learns who is to be discharged and begins pushing us to get the pts out so they can fill the bed. The admitting office or Care Center as they are called will send patients to us back to back. It gets so overwhelming, yesterday I refused to accept an admission at the time they wanted to send the pt. I was swamped I had just gotten 2 new patients. I was still working on discharges, answering phones, taking off orders, tending to doctors, not to mention pt needs and issues. OUESTION: I've been told by the care center that I can't refuse to take a patient, that whenever they call I am to take report and take the patient. I know I can (since we have 26 beds) refuse to take any patients over 26. And to clarify I am not saying that I won't take the pt. at all, I am just saying "I'm swamped, I can't handle another pt right now. "Give me 20-30 minutes to take care of the patients you just sent me." Please advise.

Hi, I have been working on a CD unit for the past 2 years. Well, I was just told that I'm going to start having to do a group with the patients on medication. We have dual diagosis patients there. To tell you the truth I don't know all the things that I should as a nurse know. I still can't figure out how I passed the boards. Does anyone have any resources that they could share with me? I just don't want to look like a complete idiot in front of my patients. Thanks for any help, mare4322

Thanks Billyhanes, That's a great idea to start a Nurses AA Group. If I do you'll be the first to know. Thanks for your support.

Thanks for the feedback on this thread. I agree that a drunk doctor is no different that a drunk of the street. We are all equal in AA. I do feel however that some of the things we do in our addictions (ie: addicted nurse takes Mr. Wells pain injection herself instead of giving it to Mr. Wells. Or a nurse is feeling withdrawl symptoms and she basically shops the med cart to see what she can use, to get normal. Or the addicted nurse doesn't go about the proper procedure for wasting narcotics, she takes what is going to be wasted. Going to work and using and then trying "care for a group of patients" is a very scary picture to paint for alot of AA folks who may have family in a hospital. And these AA folks are human and don't deserve to be haunted by what I might share. So at AA meetings I share, but I limit what I share. I'd prefer to have some AA meetings where nurses can go to share and start to heal the shame and guilt of what their addiction has done to them and what they have done to their patients. I'm not trying to protect the nurse but to at least give her/him a forum where the shameful things they have done can be brought into the open and get nothing but total understanding because the other nurses have been there. Part of the recovery process, is admitting to what you did. I won't share in an AA meeting some of the things I did as a nurse because I'm not going to risk having someone terrified that their mother whos in the hospital won't be given the care she deserves. Or share that I'm feeling terrible urges to use, and gave into those urges, with one of my patients sitting at the meeting. The fellowship at those meetings was phenominal. And it was all Totally AA, it just happened to be for nurses and we had a pharmasist also who joined us.

This is a stupid question but I need to ask. When you give an IM or other injection, for that matter, if you withdraw to see if it's in a vein and you do get a blood return. You are supposed to stop and take out the syringe and waste the medication mixed with the blood? Then redraw and attempt again. Is this correct? Thanks, mare

Chellet98, Thank you for responding to this thread. I was beginning to think no one would. I think that it's important for nurses to have a meeting strictly for nurses, pharmacists, and doctors. Some of the things I've done in my addiction are things that Joe Public doesn't need to know about. We need to be able to share and be honest in our meetings. mare4322

Years ago when I first got into recovery there was a group call Nurses for Recovery. It was strictly for nurses and we had some pharmacists attend. I have not been working my program to the best of my ability and have a need to rework the steps and devote my life to it. I am still sober or better put I'm dry. I know I have a lot of work to do. I work on a chemical dependency unit. It's really helped me see that I haven't been working my program. My problem is that tonight I went to a womens AA meeting, a few minutes later in walked my 7 female patients. I had no idea that they were going to that particular meeting. I was so uncomfortable. I need a place where I can share and feel safe. I'm fine with them knowing that I'm an alcholic but I am in a vulnerable place and it is inappropriate for me to share what I need to with them there. Anyway, does anyone know of any meetings for Recovering Nurses or Professionals in Texas? So far I can't seem to find any. Thanks for any assist.

I've been working on a chemical dependency unit for 1 1/2 years. We do not do detox, as pts. are detoxed on one of our psych units then transferred to us. On my unit we have Residential Treatment and Partial Hospitalization programs. I am the only nurse for any 24 hr period and I only work from 9a-1p M-F. We have no secretary and we don't get a tech for 7-3. We've had up to 16 pts. at one time. But a tech is not in our numbers. So, I do the answering of phones, escorting pts., write notes on all pts., take off orders, treatment plans, run to medical records, run to admitting, get the UDS's, call the doc's, etc. 3-11 consists of one tech and 11-7 consists of one tech. The techs are by themselves. I work with a counselor who has a full plate too. The medical director of the hospital just recently had a patient on our unit. He was upset because his pt. was discharged from residential and admitted to Partial by a doctor who was on call for him. He asked if the physician had come to see the pt., I said no, he did not. He then wrote in his note in the chart that we had failed to get the patient reassessed. The Medical Director then talks to my boss about it and next thing you know, we, (the counselor and me) are getting pulled into a meeting informing us that we must have a physician order, not a verbal physician order, when the pt. comes to us. Of course nothing was said as far as how we are going to accomplish this. Our charting wasn't correct either. We are supposed to do BIRP charting. Who knew? My boss has done nothing to train us on what we are doing wrong and how to do it right. He just doesn't know and just deligates to us I feel like I don't have any direction and there is truely no one for me to ask. I've asked for PHP policy and procedures book and they act like I'm trying to get ahold of some great secret. I don't think that they have one. Does anyone know where I might find the state regulations on Partial Hospitalization and Residential Treatment Program? I'm so mad at being put in this position.