laurenkst

You've made a very good decision and frankly your RN may get your foot in the door and give you access to information of jobs available for your BS in Psychology. Also: your new perspective may give you a two way view. You will now know what you are suggesting to the nursing staff may not be the best way to go with treatment when you see techniques or modes of treatment that do not work. You will also learn to individualize treatment plans because you realize that one treatment modality will not work for all patients. Good luck with your nursing education but always keep your eye open for opportunities in your original field--which you must have loved or wanted to do enough to invest the time to get your BS--Lauren

Michael: I am a nurse educator at a Psych Hospital in Delaware--A State Facility. Just a word of caution: please make your prior tx hx clear before they hire you. Most State Psychiatric Facilities do a Security Check/Screen before hiring. Fingerprinting and checks/search for any kind of prior offense--criminal hx--are done. So be completely honest in your interview. Although I personally think that a person who is a recovering drug and/or etoh user can be alot of benefit to our patients who are usually diagnosed with a co-depencency of one or the other-- they've been on both sides of the bed--sometimes administration does not see it my way. There are drug/alcohol treatment clinics who hire individuals with prior drug use. They are very effective negotiators in that arena and actually go out on the street to reach the people who need their help the most. They can spot a line from a drug user that I would fall over before I saw it. They will require however a weekly testing to make sure their staff is "clean". If you want to serve a community that is so desperately in need of your assistance--this may be the way to go--------------Good luck in whatever path you choose.--Lauren

I can't for any reason understand why the L&D was used to house a schizophrenic patient. I used to work in a NICU and the L&D was right beside the unit. I don't know whether the patient was having delusions or hallucinations. But if she's already hearing and or seeing things that are not there, I am not sure she could filter out the screams from the mother's before, during and after the delivery. The parents were correct. They were very wise to take their daughter to a more appropriate facility that could handle her needs more effectively. As for the psychiatrist, why couldn't he see the patient so early. Unless he was on call at another facility at that time, or circumstances prevented him from getting to your hospital, he should have been there--asap. If your facility does not have a psych unit, the patient should have been transferred to a facility that does have one-asap and that would have been his respon-sibility. Please cover your __ __S_ ___, no one else will.

I just received an e-mail from the NIMH website on Medications. Please look into the medication information @http://www.nimh.nih.gov/publicat/medicate.cfm. The information is down to earth and relatively easy to understand. It might help you develop a lesson plan for patients--Lauren

Martha: I had 27 years of nursing as a LPN on such specialties as Med/Surg--54 patients, Neurosurgery--32 patients, CICU-10 when full, Neonatal Intensive Care--24 patients, PICU-7 patients and then I became an RN,BSN in 1991, and worked 3 nursing homes, and prison nursing before I finally came to roost in a state run facility for the mentally ill in Delaware. I feel like I've really found my home now. Before I was really stressed with more and more responsibilities being taken from physicians and thrown onto nursing personnel with none of the power to do anything about my positions' problems. Now I can get help when I need it and all of the pressure I operated under before has prepared me for my job responsibilities at this time. If you are really interested in a field, give it a try. What were you really interested in while in nursing school. They usually give you a well-rounded sampling of all the possibilities in your area while you are a student. You might even consider moving to other areas where the job opportunities you like are available. Check the back of your nursing journals for job opportunities. I do not know if you have Advance For Nurses in your area, but they usually list job opportunities by specialty. Good luck, all you can do is give it a try--Lauren

Caroline: I have been in nursing for 40 years--this year. The last 7 have been in the field of Psychiatric Nursing. There are many qualities that the nurses I work with possess. Two of the most important in forming good staff/patient relationships are patience and understanding. Life presents us with opportunities to grow and the experiences that teach us the most aren't usually pleasant ones. If you look at the times you thought that you just couldn't take anymore, you will find that these areas of your life were the ones that presented you with the need to grow your wings--as I call it--if you are going to fly off on your own as a little bird, you have to take chances and you have to learn to look out for yourself. All of this requires patience. Skills aren't learned overnight. You observe others, you watch your patients interact with them, you try something here and something else in another instance and watch for a response. Sometimes it's subtle and you almost miss it. Sometimes it screams at you, but if you watch carefully and patiently you will get your answer. And little by little you will grow as a nurse and fly off in your own direction--whatever that happens to be. That decision will come gradually too. Your will try fields that you think you will like. Some will work, some will not. Anyway, be patient and don't give up. Somewhere, sometime you will find your niche. The second quality is understanding. Please try to remember that your patients have an illness that has affected another organ in the body--the brain. They are above all human beings and deserve to be treated with respect and dignity, just like every other human being wishes to be treated. Sometimes, I have trouble getting this through to other people--even those that I work with. Not only are you an example to patients'--hopefully--of how to talk and interact with other human beings, but please remember God's golden rule. Treat others the way that you would like to be treated. I would not wish mental illness on anyone, but if--heaven forbid-you end up a patient, how would you wish someone to treat you. All the new theories or treatments aside, a patient must be treated as though they matter individually. Remember that anyone, you or I included, can one day end up in the place that our patients are currently in. RememberIng this keeps you well-grounded. We will all end up having traumatic experiences of our own that can trigger depression or PTSD, have a genetic makeup that causes us to be confronted or faced with mental illness, or something triggers a pre-set mechanism that we just weren't aware was there--genetically that is. Just try to remember your focus. Our patients are the reason that we are here. They are our primary focus. Do not become so "burned out" that they don't take first place. NO ONE IS MORE IMPORTANT IN PSYCHIATRIC NURSING THAN THE PATIENT.

Please check the notes on the 3rd page--BPD. There is alot of good advice from nursing experiences in that listing.

Florence Nightingale accomplished alot in spite of her problems in a time that did not support women or acknowledge their revolutionary concepts. On another note: it certainly would explain alot of her other questionable behaviors. Although, I don't know a single soul who hasn't had "their" problems in "their" times.

Sounds like you are dealing with a patient with a Borderline Personality Disorder. There is a reasonably new Therapy called DBT-Dialectical Behavior Therapy where all blame is removed and the patient has limits set by each individual as to what behaviors will and won't be tolerated by you in your relationship. If you go by the old mandated or mandatory rules system you are setting yourself up for manipulation and staff-splitting by the patient. With DBT we don't blame patients for staff-splitting and there are no rights or wrongs when staff members disagree. This prevents the two or more staff members from having to be absolutely correct in the situation. You handle the patient in a manner--when it doesn't break mandatory unit rules--the way you feel comfortable with relating to them. For instance: I might not feel comfortable with a patient touching me in any way--so for me when a patient does touch me i let them know that I do not feel comfortable with the behavior. If they tell me that Mrs. So and So lets them do it. I tell them that that is the limit on touching that she has set, for me I am uncomfortable with touching. That way I do not fall into the practice of judging other nursing staff and they do not judge me. It also prevents the patient from using one staff member against the other. Try to see if there is anything valid in the response from the patient. As much as we try to deny it there is always a kernel of truth somewhere in what the patient is saying--focus on that. And please remember you need to have a staff member treatment team where you support one another, discuss the things that are not working with patients and help people deal with these very difficult patients who will drain you if you are not careful------------Lauren

We have two types of nursing assistants at the facility that I now am a Nurse Educator/Trainer. There are Certified Nursing Assistants that now work at a Psychiatric Hospital and take care of mentally ill patients with medical problems that they have developed and the geriatric mentally ill. There are also nursing assistants who work on the "active side" they work with the patient population which has mental illnesses. You could work as a nursing assistant while pursuing your Nursing Degree and after 6 months help with the expenses of your education or you could go on to pursue your degree in Psychology/Psychiatry. The world is open to you. Explore all the fields you wish. Try a job working with the mentally ill. They are a very challenging population to work with and they require more skills than you'd ever imagine, but it is so rewarding to see a patient get better and know that you're part of the reason that they did. It is an occupation that requires alot of you, but it is really worth it!!!!!!!!!!!!!!!!!!--Lauren:nurse:

Hi Michael: I'm a nurse educator in a State Psychiatriatric Facility. We have a Geriatric Facility where most of our CNA's work. There are other CNA's who have worked on the Geriatric units who are positioned throughout the hospital, but a majority work in a Geriatric Building that handles Psychiatric Patients who have developed physical problems. They are and have been patients for a long time on the active units, but when they developed problems that required them to be more closely observed they were transferred to this division of our Psychiatric Center. The responsibilities of our CNA's focus mainly on keeping the patient safe, providing quality nursing care physically and mentally and teaching the patients coping skills to deal with their mental illnesses and trying to resocialize this particularly ostracized group of individual. Trying to help them function as well as possible in the environment of their choice is an important part of all employees responsibilities at our facility.

I do not understand how a physician could diagnose a child of two as bipolar and why prescribe Risperdal which is one of the Novel Antipsychotics. I'm sorry this must be too early. With such experimental off the label usage the child must be at risk. Are their any studies to validate this use? Is it a off the label use for ADHD? What is god's name is the rationale for giving this medication to a child that is only two? I'd question this asap.

psychiatry can be a very rewarding field. it has it's ups and downs but best all you really feel needed. the problems with financing for medical problems makes staffing--in all areas of nursing now--a major issue. keeping floors staffed enough to be safe is so important. so we need you honey. stick with it and come join us in our fight to provide good, competent, safe nursing care to individuals at the most vulnerable times of their lives--lauren

why in the world did you come into nursing? did you have blinders on when you registered to become a nurse? nursing is nursing, sometimes it requires handling body fluids. i don't care what field you work in you will come in contact with fluids somewhere at some time. even psychiatry has times where patients get nauseous or are incontinent. if you're about to graduate the message should have sunk in by now. for heaven's sake-------------------lauren