SlightlyMental_RN

I totally don't get the lack of respect of the "older nurses." I absolutely LOVE the well-seasoned RN on our unit. She knows the history of all the unit policies, is unflappable, and will rescue you when you're drowning and don't know what to do. Something that I remember (and miss) is having an actual charge nurse that has been there for years and knows what she's doing. Putting new grads and other newer-hires as charge is nuts. I hate how hospitals are chasing out the older nurses for the cheaper newer grads.

Ugh. Apparently, I will no longer be nominated for the Nursing Saint of the Year Award, because I totally agree with eh OP. Oh, and I ONLY work with alcohol and drug addicts, so trust me, I see this disheartening junk all the freakin' time. I am as much of a bleeding-heart-liberal as you can imagine, and I fully believe that we should fund government programs. However, there is so much waste and fraud, I really hope that someone finds a way to clean up this mess. That, would make me so very, very happy.

My biggest hit was when I brought chocolate-dipped strawberries.

This is so not cool. As the others have said, this is big time breach of professional nursing ethics.

Oh, you use plenty of skills, so no worries. We still have to do a head to toe assessment q shift on our patients, and we deal w/many medical conditions that are exacerbated by alcoholism and drug use. Just an FYI, though: You won't be able to get an MSN for a NP down the road...you'll need a DNP. (New requirements from AACN effective in 2015.)

I think that's pretty crummy of a rule, that you're a no call no show if you call after 5. Considering I've had nurses actually be no call/no show, that's a bit different than being truly sick, but not realizing it until close to shift start time.

I'm just amazed that a.) The woman was okay with it. and b.) The guy was able to "complete his task." Sorry, but labor is not the most arousing of times.

Ah, yes....I remember being so freaked out at the first times that I encountered MRSA, etc. It's really not that bad, though. I think that the thing to keep in mind, is that you have a healthy immune system, whereas these people got the infections d/t having a compromised immune system. There are many people that are walking around in the community that are MRSA positive. As a previous poster mentioned, you have, no doubt, already been exposed to it. Just wear any PPE that the infection control people put out there for you, and there will usually be a sign telling you what to put on. It will be okay...just wear your PPE and wash your hands well.

Something to think about: When I was in nursing school, an instructor always seemed to be on my case, giving me the hardest patient assignments, and very critical of my written work. At the end of the semester, I found out at our grading conference that she rode me so hard because she thought I was very intelligent, and expected a lot out of me--more than some of the other students. Before that conference, I would have sworn up and down that she hated me. :) I was rather flabbergasted, but she actually liked me and would (after the class was done) talk me up to other students and teachers. I'm telling you this because perhaps that little meeting with your instructor might clear the air and any misconceptions that you have about one another.

Just curious...have you ever thought that perhaps they used this incident as a way to get rid of you, an experienced and most-likely an expensive nurse to pay. I've seen way too many tales of ageism being told on this board, lately.

Although opiates are wonderful for pain relief, I think that it's sad how often people become addicted. And truly, who can blame them from wanting to escape from the pain? Have you tried gently talking to the patients that are messing with their lines? Confrontation does not always have to be a negative thing. I've seen people that have had someone gently call them on their behavior have a light-bulb moment--"Gee, I guess I'm not fooling anyone, after all." Many times, I've been told by my patients (alcohol/drug addicts) that they wish I was their nurse all the time. Why? Because I treat them with kindness, despite their lashing out. I'm also not afraid to use therapeutic touch--too often, society treats people addicted to substances as modern-day lepers. One of my favorite things to do is to tuck them in like you would a small child. Find out their favorite type of juice and how they like it served (no ice, lots of ice, with a straw.) It's truly amazing the response that you might get for these type of small efforts to be kind. I know that in our increasingly high patient-loads, it can be hard to do this, but it pays off for the long-term, as you have a happier, less-grumpy and demanding patient. Give it a shot...you might be surprised.

Until I went to casual, I was a noc/PM rotation. That totally sucked, as it was NOT self-scheduled. My schedule was Fri: noc, Sat: noc, Sun:noc, Mon: off, Tue: PM, Wed:PM Thurs: PM, and start all over again.

A post from bree* in that thread: "Here's the problem..at my clinical rotations, we never did anything more than take vitals, help people move around, clean up, run around like maids, and read glucose/give insulin injections. I have never even done a tube feeding or wound care or anything. My program was a joke :(" I would be way too nervous to go into home health if that's really your background.

I would like to work as a public health nurse part time and teach a class in psych nursing the rest of the time.

I think that my biggest fear is someone killing themselves on my unit. I had someone slash their wrists a year or so ago, and it was pretty scary.

It sounds to me that the nurse that lied is not using her critical thinking skills (by escalating the patient's anxiety/agitation through withholding meds.) Definitely not the smartest of moves.

I think (my opinion) that some of the posts are going a bit off-topic. The OP is a psych nurse talking about her experiences in an acute psych unit--not pain management, etc on a typical floor, LTC, or hospice. I think that that's a completely different issue.

I think your judgment sounds good, Simply Complicated. It will take a little while to get confident in your ability to distinguish the true drug-seekers vs. those that genuinely need to be medicated, but in my opinion, you have some sound reasoning ability. (Again, a bit different in psych vs. the normal floor.) In my unit they get admitted just for detox, but many are dual-diagnosis w/psych issues. Everything you're saying sounds well-thought-out to me, and I'd just take the feedback from the nurses on your floor into consideration, but go with what feels right to you.

I obviously was just giving a quick run-down of some of the things I look for, as I'm responding to this board while running in between the problems of my kids (middle-school age and one at University). And yes, I do make judgments--nursing judgments. Working in chemical dependency detox/psych is also a different cup of tea than working med/surg. I've done both, you see. In my current unit, we're trying to get them away from the pill-popping. We use a lot of non-pharmacological nursing interventions. P.S. I've been told I'm a damn good nurse. Additional P.S. : I think you need a hug. Sorry about all the problems that you're having.

I'm more tight-fisted with the meds, as too many of my patients just love to take any and all drugs, even if not really needed. They honestly just like the whole process of taking a pill. If they say they're puking or having diarrhea, we make them show us. We have patients say, "I'm having a lot of anxiety right now. Can I have XX?" -- VS are not elevated, no shakiness, rapid breathing, pupils normal, or or other signs of agitation -- I don't give it. One of our senior nurses says, if they can ask for an ativan by name, they generally don't need it. You learn to have a practiced eye, working in chemical detox and psych when someone is trying to pull one over on you.

This one would be totally inappropriate (especially in my unit), but it's still kinda funny: http://www.sears.com/shc/s/p_10153_12605_SPM174686892P?sid=IDx20101019x00001a&ci_src=14110944&ci_sku=SPM174686892

It helped me land my current job. Both HR and my now-manager mentioned that it impressed them.

Man, that's harsh.

Oh, please, don't lump us fatties into the "we don't have discipline" pile. I have plenty of discipline, exercise (2-3 time/wk) and eat fairly healthfully. However, I have Polycystic Ovarian disease (affects glucose levels) and a pretty serious case of hypothyroidism (taking .125 mg levothyroxine). I'm not eating fast food often (and if I do, it's the healthy options at Subway), and I don't garbage on sweets. Many of my skinny friends have remarked that I actually eat less food than they do. I'm just cursed with an incredibly slow metabolism (my resting HR is in the 60s even with thyroid hormone.)

FYI: It's the Kreb's cycle. Sorry, I had to point that out, as I'm a biochem geek. But yeah, I understand what you're saying. For me, though, I do think that understanding the "big picture" is extremely helpful.