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HangInThere BSN, RN

Psychiatric Nurse on Acute Care Hospital Unit
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HangInThere has 5 years experience as a BSN, RN and specializes in Psychiatric Nurse on Acute Care Hospital Unit.

There is always something new to learn. Tell me all about it, please.

HangInThere's Latest Activity

  1. HangInThere

    Are We Too PC?

    When someone I work with whispers something to me, chances is are it's not kind and not PC. I don't tolerate it.
  2. HangInThere

    Who is in Charge Here?

    Please share every possible intervention to increase safety and reduce those all-to-familiar unit wide meltdowns. For aggressive patients with borderline personality disorder, I have made a written list with them at the start of my shift. We review it to check off their demands as they are met. I've seen these patients verbally assault every staff member, one by one, who passes through the unit - from dietician to supply clerk.
  3. HangInThere

    Who is in Charge Here?

    Okay, I see where you guys are coming from. So there were some things I omitted from my OP. For instance, the patient was built like a tank. And, he had attempted to strangle me during an earlier stay on our unit.
  4. HangInThere

    Responding to psych patient requests/comments

    How about asking the patient, "What kind of dog do you have? When did you last see your dog? Have you lost your dog before?" Listening to the patient answer questions like these questions might inform you about the patient's orientation to reality. If their answers make sense, you will also have more information to give to the social worker if they can follow up.
  5. HangInThere

    Social Media and Patient Care: Understanding the Rules

    Believe it or not, I feel much more connected to friends and family since I deactivated my Facebook account two months ago. It is liberating!
  6. HangInThere

    Who is in Charge Here?

    "Who is in charge here?" said Mr. D, a 67-year-old retired police sergeant with dementia. "Mr. D., I'm the Charge Nurse tonight," I said. "What's your concern?" "No! Who is the manager of this institution? I wish to make a formal complaint," said Mr. D. "The manager's name is Ms. G.," I said. "This place is run like a madhouse!" he shouts. "I don't know when my blood will be taken and I don't know when my medication is coming!" His voice deepened and he fixed his stance. "They took my phone, and my mother is worried about me, and how can I call my mother? They took my damn belt, and my pants are falling down!" "Okay, let's take one thing at a time," I said. "You took my phone! Who has my phone? Where's my phone?" he said as he glared at me. "That, oh Charge Nurse, is against the law!" Just then, my colleague Nurse Maria approached us. She stood about 8 feet to the side of Mr. D. She said, "Mr. D., do you have your mother's phone number?" Still staring at me, Mr. D answered, "I have it in my mind." "Let me write it down for you," Nurse Maria offered. "It's 3:30 a.m. You're in the hospital, and everyone is sleeping. In the morning after breakfast, the phone is turned on. I can help you make the call. Let me write that number down." Mr. D nodded while still glaring at me, and said the telephone number. She wrote it down and said, "Now you can rest, Mr. D., because you will call her in the morning. Remember, Juliana and I will help you make the call." Mr. D. did not break eye contact with me but also nodded. Nurse Maria said, "Now, it's a good idea to go back to bed." Mr. D. nodded and turned toward his room. What happened? As the interaction escalated between the patient and me, a more experienced nurse interpreted the emotional nature of Mr. D.'s demands and acted as a third party to diffuse the situation. Veselinova (2014) writes, "An individual with dementia may be sensitive to the tone of voice and may feel intimidated or frustrated by extreme levels of speech and tone" (p. 164). Nurse Maria introduced a calm, measured verbal redirection that was fluent with Mr. D.'s actual need for emotional support. Nurses who adapt the way they communicate can encourage increased communication with individuals with dementia (Veselinova, 2014). Through the night, to build the rapport initiated by Nurse Maria, I returned to Mr. D. to address his needs. He told me he could not sleep, so I offered to set up a recliner near the TV in a quiet corner of the unit. Once his feet were up with a pillow behind his head, he said, "This is fine." Later on, when he said, "I'm tired of this," I walked him to the dining room for a change of scene. The next night at 4:00 a.m., I asked if he would like to play cards to pass the time. He replied, "Black Jack." We played until 5:00 a.m., and that's when he began to tell me about his memories, his family life, and his police work. The interactions with Mr. D showed me that once a patient has at least one of his needs met, he feels heard and understood. Nurse Maria's keenly placed offer to redirect the patient initiated a workable relationship between a patient with dementia and me. Not only did this diffuse a situation that might have escalated, but it also opened a door to a trusting relationship between Mr. D. and me. The next night, Mr. D actually slept a few hours and at 4:00 a.m., he asked me to play Black Jack with him again. When your patients angrily confront you, what do you do? Reference Veselinova, C. (2014). Influencing communication and interaction in dementia. Nursing and Residential Care 16(3), 162-166. Retrieved from http://www.magonlinelibrary.com/toc/nrec/current
  7. HangInThere

    Magnet status...yay?

    I work in NYC, and our DON says we now have 75%, but new hires will bring it to 80% by 2020. That 80% threshold seems to be his goal.
  8. HangInThere

    Magnet status...yay?

    You just made me alternately lol and sigh so many times. Thx. I got pulled into a committee by free pizza - like, really decent NY pizza - but crawled my way out asap. Got my BSN, got my certification, and soon will have 5 years to be vested in the pension. Now I can hang tight and watch the show, I guess. Good luck to you.
  9. HangInThere

    Magnet status...yay?

    You just made me alternately lol and sigh so many times. Thx. I got pulled into a committee by free pizza - like, really decent NY pizza - but crawled my way out asap. Got my BSN, got my certification, and soon will have 5 years to be vested in the pension. Now I can hang tight and watch the show, I guess. Good luck to you.
  10. HangInThere

    Magnet status...yay?

    I work in a large city hospital. We were taken over one year ago by a larger hospital system, and most of the top-tier administrators are new. We keep hearing about shared governance and introducing a clinical nursing ladder, but I just realized they're prepping for magnet status. Nursing administration is top-heavy now. Our nursing union rep says that these processes separate nurses and threaten unity. I see her point. I have my specialty certification and they are reimbursing me for my completing my online BSN this year. I am alternately cynical and hopeful for positive changes. At the same time, we nurses throughout the hospital want more IV decks, more nursing aides - and my unit has requested a second vitals signs machine for three years. They can't seem to find even that small amount of money in their budget. (Don't throw us parties, give us a #@%& vital signs machine!) From the point of view of wanting to keep my job and managing the stress of change, what else do I need to know to play this game? And, where has climbing the clinical nursing ladder taken you?
  11. HangInThere

    NYP Acquiring NY Methodist? Any insight?

    A long time has passed since the last update, and since December 2016, we are New York Presbyterian Brooklyn Methodist Hospital. Press Release NewYork-Presbyterian and New York Methodist Hospital Establish New Relationship to Enhance Care in Brooklyn - NewYork-Presbyterian Brooklyn Methodist Hospital NYSNA is strong and our contract ends 4/30/18, so negotiations are starting soon. Anyone with insights on negotiations, please post. I worked nights when the last negotiations were happening, and stopped in a few times at the church basement for a bagel and watched for an hour. We have a new president and much of the upper administrative staff has changed. Governance Governance - NewYork-Presbyterian Brooklyn Methodist Hospital
  12. I'm in the program with six classes to go. Top-notch program with sophisticated interfaces and access to research sources through the SUNY online library. It can be demanding, so I take 4-5 classes/year. Tuition is reasonable.
  13. HangInThere

    Night-Shift Nurses: Get Your Sleep!

    In the meantime, I need anecdotes and suggestions! Commuting home from a night-shift is a big problem. It's 8am and the sun is up and glaring in your eyes when you exit the hospital. You have to be alert, especially if you're driving, but also crossing streets or on busses or subway so you don't fall asleep! Then you get home and you feel wide awake, but it's 9am and you have exactly 9 hours to sleep, shower, eat, check email and phone, review a new policy, and make your lunch. How do you possibly relax and got to sleep when all the events of your last shift keep running through your mind?
  14. HangInThere

    Night-Shift Nurses: Get Your Sleep!

    Very interesting. Did you see improvements that correlated with your educational program over the 2+ years?
  15. HangInThere

    Night-Shift Nurses: Get Your Sleep!

    I had a problem with getting the right foods at the right time. Unfortunately, I was in the habit of eating breakfast after my shift and right before conking out. Silent reflux and sinus infections resulted.
  16. HangInThere

    Night-Shift Nurses: Get Your Sleep!

    Oh, that's cool. For me it is for an undergrad class in health promotion. Do you work the night-shift now? How's your research going?