MADHAT6

Nothing left to do but smile,smile,smile

As you get more experience you will be able to bargain for better hours and jobs,know your worth,you may not be able to make your current employer give you good /better hours,but job hunt and parlay your experience into the hours you want,make it a condition of being hired ! and good luck it may take time but you will succeed !:wink2:

Once you go psych Med Surg you won't like !

Determine the secondary gain from these violent attention seeking behaviors and assist the client to find other ways of fulfilling that need,is the client deliberately provoking to acheive the type of destabilized environment she is used to,or to recreate the comfortably hostile environment she grew up with,is she replaying old patterns,trying to acheive control by disruption,these are some questions i would ask in order to assist the client to regain control opf her behavior,there is a great book "Mind over Mood" you might find helpful,good luck dealing with these clients,it is difficult and you are wise to seek advice,but you will find once you identify the behaviors associated with this personality,that many people share their traits...i still have to seek advice after 20 years

I'm just thankful i still have a job!

i love my bipolar patients and the things they say like "why the hell can't i be in the damn religious program !" or "i have been fired from over 200 jobs for my excellence,now tell me do you think that is right!?" or "why shouldn't i borrow money from my sister so i can sue her !!!" they keep life wonderfully fresh and it is a privelege to work with them and hear their perspectives.

I have worked detox and rehab units and the thing to remember is that people in recovery have developed coping skills that appear highly manipulative,they can be extremely demanding and assertive and are often not like the grateful clients you find in a hospital medical/surgical setting.You have to have very good personal boundaries and be aware that the clients are often suffering physically as they detox but emotionally as well as they are being forced to come to terms with their own pain and the pain they have caused others.They can become aggressive and inappropriate at times in a way that you rarely see in a medical hospital.you may also find yourself administering medications to large numbers of people,i had 28 clients on varying detox protocols,they vary significantly from drug to drug,and this requires concentration and patience as people in withdrawal may come to the med window and yell at you. It can be very rewarding to work with these clients but you have to know yourself well and be able to separate your own personal issues from theirs and not be too crestfallen when a large number relapse...people have lots of different reasons for ending up in rehab,many of them having nothing to do with actually getting clean,but there is a lot to learn in this milieu and i would not trade the 3 years i worked with this population for anything...good luck with your choices

try working in a skilled facility,the pay is good and you would be amazed at the types of patients you get to work with,pts with central lines,tpn,on chemo,trac pts,you get to do ostomy care,wound care,iv pts,psych pts,its really amazing and hospitals love you when you have this type of experience .good luck!!!

WOW!Have you read your own description of how you feel? you sound like you know you need a break...read your own letter to us and treat it as if it was coming from a stranger then take your own advice,sounds like you need to work in a caring supportive environment for a while,even soldiers get leave ! thanks for what you are doing for all of us ! you have done more than your share !

Your facility sounds terribly understaffed,i cannot understand why you are assigned 10 patients who are children with this level of acuity,no wonder you and your physician have been injured,you are working in the equivalent of a psychiatric picu and you would never have 10 patients there... i don't think its the fact that it is psych nursing that is burning you out,it is the staffing,you should contact your state board of nursing to find out what realistic staffing ratios are for this age and population,then pat yourself on the back for lasting this long,i have been a psych nurse 15 years and have never heard of such a terrible nurse to patient ratio on an inpatient peds psych unit,it is a lawsuit waiting to happen

Its never good to criticize your last employer,its better to say it wasn't a good fit or didn't meet your needs,wasn't what you were looking for etc

I have read that Ruth Bader-Ginsberg made her reputation by taking on discrimination cases against men...unfortunately what you describe i have seen happen to men and women by clinical instructors who have too much power, it may be a case of male discrimination but it may also be a case of nursing instructor playing God,i was treated better in boot camp in the army than in nursing school !

i hope this does not sound mean but if you are not even in nursing and yet you are already worried about the stress level is it the right choice ?

i am wondering why we can't be truthful,but we have been told to avoid stating why we are not keeping them after medically stabilizing them,i have been truthful and have been,shall we say,redirected ?

EMTALA requires us to provide medical screenings and prevent negative consequences,so yes,if they are without medical symptoms and have no insurance and we have no indigent beds or money from the state/county and if our local inpt rehab has no indigent beds the we would not have to admit them