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

I just feel like venting! i am a psych nurse who acts as liaison for inpt psych,when we have indigent clients we assess them for acuity,if they meet criteria we admit them or petition them to the state hospital, but when we have substance abusers who are not in withdrawal,who have been medically assessed,we are not allowed to tell them we cannot admit them for inpatient because they have no insurance,that is an EMTALA violation...why? they know they have no insurance,we obtain funds from mental health when we can,and we never let anyone go who is a danger to themselves or others...why do we have to make something up to tell them they cannot be accepted inpatient for detox or whatever rather than admit it is a funding issue? we often medicate people so they can get to a rehab the next day which has funding,but we are not allowed to tell them why we do this...i don't understand why we are not allowed to be honest or why it is a violation because we are providing services and ensuring safety,please explain this

i did not have the support of my partner but i went ahead anyway,it's tough when the person you lives with does not support you and actively argues against your chosen field,and like you i was 33 when i went back,but once i graduated and it was clear i wanted to be in this field i got the support i wanted,basically it's your life,not theirs,and while you can have input on some subjects,how you spend the hours of your life in work has to be your choice,not theirs...would you choose a career for her ?...good luck

Speak to HR,this is clearly a violation of same job,same pay and violates common HR practices and sets the institution up for a law suit they cannot win

one of the problems with psych nursing is that an act of kindness must always be considered in terms of boundaries,there would be no problem bringing cookies to a med surg unit or an ortho unit are we really so different that we can't just accept cookies without overthinking it ? go for it !

I think your capacity to empathize with others and feel is a great asset to you as a psych nurse,it is people who can no longer feel the tragedy of such situations that are at risk,i would want someone who feels strongly the way you do to care for me should i have a psychotic break,i am sorry you felt bad and hope you feel better now,i agree with these other posts that it is a part of psych nursing and that it is the equivalent of a medical code,thankyou for being there.

I love Psych nursing because our clients are often wise and powerful,they exert a lot of power back on the health care system and they are independant and often fierce against tremendous odds.I have learned so much from my homeless mentally ill clients about life and every day i learn more from them about how resilient and courageous people can be even when they are without the simplest things.Our clients speak the truth and hold nothing back. I consider it an honor and a privelege to work with our patients and feel sorry for everyone else who does not get to share with these incredible people...there are a lot of things that are wrong in the health care profession but the chance to work with these people is so rewarding...i don't understand why evryone is not knocking on our doors wishing to be psych nurses!after 14 years i am still excited going to a job where i never know what will happen next!

From what you are describing this person is not schizoid,but schizotypal,a schizoid personality would not be expressing strong feelings of dislike or hatred towards others as they generally aresimply indifferent to either praise or criticism.Ashizotypal personality would be expressing the kind of odd beliefs you have described here,"chlorine in the gene pool " etc. There is no real treatment for personality disorders in the sense that they are able to perceive the world as you do,they can have cognitive behavioral therapy which challenges their world view by asking them to find support for their thoughts and also to provide alternate scenarios for their beliefs,but generally they retain their delusions,even when they know on some level that those around them do not share their beliefs.Personality disorderd people are provocative and draw people into their sphere by challenging them with assertions that are not consistent with what others see.You were wise to not challenge this person as you would only be drawn in and really unless you have to engage a personality disorder distance is the best defence.People who enagage personality disordered individuals often find themselves drawn into a whirlwind of controversy and argument and they are generally perplexed as to how it has happened.It is far more likely this person has a garden variety personality disorder than either a true schizoid or schiztoypal personality,but neither personality is well suited to the nursing profession.Personality disorders are developed in response to very toxic environments experienced by the individuals in childhood,with a genetic component that predisposes them to certain traits,and are thought to cost the country millionsof dollars yearly in lawsuits and employee conflicts.Avoid this individual and good luck...i am sure as you observe their interactions over the next few months you will see a lot of activity around this person and you don't want to be involved..

This is a very frightening post,we all know some nurse out there who is dangerous...how many of them are there ?

I am an older nurse myself,i meant no disrespect to those of us who have been there and fought the hard fight,that is why i said "ONE of the reasons" and not "the only reason"

I have terrible problems with foot paim but i brought a pair of Spiras,you can find them online or in the Hammcher Schlemmer catalog,i had never tried them but they are awesome!!!i spend 12 hours a day on my feet and they don't hurt at all,they range from 87-120$ a pair,but it was worth it,and my coworkers are all buying them now and i haven't heard any complaints:yeah: