7student7

My professors at EKU said that the SPICEE application was only available until 1/12, but I can't find it anywhere. Can anyone tell me how to apply?

So many things to address: *"As a student, are you yet familiar enough with "authority" and "government" sources of information available to clinical professionals and to the general public to know the scientific inquiry process that produces the information and recommendations contained within them?" Why yes, I am a nursing student, but I also have a previous science degree (I have the pretty piece of paper! So, am I allowed to speak now? Sheesh...) and more experience with hospitals than anyone should. I am very aware of the source of our authorities, as well as their limitations (which is where you seem to fall off the tracks....). I know exactly what goes into government nutrition guidelines - a bunch of dirty money, misread journal articles, and big corporate lobbying. This comment exemplifies everything I hoped to avoid in this thread. Degrees and titles are no replacement for independent thought. You don't have to be an RN or MD to read medical and nutrition journals. The difference between science and personal experience is very clear to me. I am interested in both, but I do not confuse them. *The Paleo diet is not about eating raw food or playing caveman. It is about avoiding toxins we are not evolved to tolerate. For most of us, what is considered a toxin is determined by science, not by caveman fantasies. The negative effects of grains, excess sugar, the resulting insulin imbalance and resistance, and various other things this diet says to avoid are well documented. These results just don't make it to the media or textbooks until they've been skewed by "conventional wisdom." *I'm not about to preach at someone who has no desire to listen.*If you are truly curious I already posted two links though. PaNu, is the more in-depth one scientifically.* *The paleo diet can be done raw, but it is fairly rare. Raw vegetarianism is much more common. The human body HAS had time to evolve the ability to digest cooked meat over raw meat, raw diets are not supported by good science, and I never said they were. *About supplements: I don't take any, and many people on this diet do not. Vitamin D and fish oil are big in the paleo community, but the average person is not taking anything else. Mark Sisson literally posts every day, people love him to death, and his books are free. His supplements, in my opinion, are geared toward the body building crowd that would be taking then anyway that wish to avoid the junk in conventional protein powder and such. He does not push them on readers. Plus, the man needs to make a living somehow... *Now I see that nurses have little influence over what patients eat. It all comes from dietitians, and it is too risky professionally to give conflicting opinions. I completely understand that alternative nutrition advice is outside of a nurse's scope of practice. I am not trying to step on any professions' toes. And, I have no desire to jeopardize any nurse's career, including my future one, but that doesn't mean I have to turn my brain off, and a blind eye to medicine's shortcomings, when I'm not at work.* *I was very, very sick for years with an autoimmune stomach disorder and everything the doctors did made it worse. I went from being tired, brain-fogged, and in chronic pain to being energetic. I went from so many meds I can't remember the number to none. I went from the fat, hypertensive, stressed, steteotypical American to a much thinner, happy person with perfect lab values. I know my story is not unique, and there are bound to be nurses with similar stories. I would love to hear them.* *I read plenty of nutrition sites and forums, but I am interested in a nurse's perspective at the moment. Paleo dieters: How do you handle looking at the 60% carb/grain hospital meals, then look at all the diseases around you and not constantly feel like something is very wrong?* *Thank you for the Leigh Peele link! Now that is an intelligent response. I don't agree with everything she says and she even admits, "While the dogma behind the Paleo Diet is not healthy, the basic nutritional principles seem to be sound...." I don't follow the dogmatic aspects, and I agree the name "paleo" is stupid. That paper she mentioned has been torn to pieces by multiple writers, supposedly there was some confusion about grass vs. nuts vs. seeds vs. grains in it. I'm not sure, but regardless, for modern man, carbs do cause dramatic insulin responses and cause cells to store fat (this is in most physiology books), and grains are full if antinutrients and terrible for the gut.* *

I agree with the dietician suggestion. Docs do not have the patience for this sort of thing.

I have eosinophillic esophagitis and gastroenteritis and the bacterial overgrowth that usually comes with it. The things that helped me in the long term were probiotics- I took the pills, ate Greek yogurt, drank kefir, the works. I cut out almost all grains, especially wheat. I also stopped consuming most milk products (some, like Greek yogurt and kefir aren't so bad). Milk and wheat proteins are murder on the stomach. (look up leaky gut if you're curious). I also cut out most sugar bc of the bacterial overgrowth. Honestly, what I tried to follow was the paleo diet from marksdailyapple.com, but I know people on this board tend to dislike "fad diets". Even if you dislike the diet, you can't argue with the science behind probiotics or avoiding gluten at least! I don't know if it's official medical advice and I certaintly am not trying to give medical advice, but this is what worked for me personally. I went from horrible pains and many vitamin deficiencies to perfectly fine and off all meds in about 6 months. Antiacids don't work, and steroids just trade one type of pain for another. You've got to eat right to get healthy.

I would definitely let your employer know you have a license. An LPN was hired as a MHT at my hospital recently without telling anyone about her license, then she mentioned it later and they were very annoyed at her. I think they let her switch to a nurse position, hopeful you could switch too.

I understand that many would feel uncomfortable giving nutritional advice. That is a valid point. I was kind of assuming any nurse giving such advice would try to be aware of any odd nutritional needs before they gave it though. From what I have seen, Paleo (unprocessed, low sugar, low carb) is based on a lot of good science. I don't think it quite qualifies as a "fad" diet. Also, I specifically asked for informed advice and/or personal experience for a reason. Simply appealing to big authorities or doctors' orders is probably necessary for work, and like I said, I understand being uncomfortable telling a patient about it. But, when it comes down to actual science/ critical thinking, it's just lazy. So, does anyone out there have some direct experience with this specific diet?

Does anyone have any experience with the Paleo diet? Like what you'd see on Mark's Daily Apple or PaNu - PāNu Blog . Did anyone have a positive (or negative) experience with it? Do you see any major flaws? Is this something you would feel comfortable telling a patient about since it is so far removed from the standard American diet? I am looking for scientific information, and/or direct personal experience. I am not interested in vague "common sense" type recommendations or appeals to authority, government or otherwise. Thanks ahead of time for any responses!

I've thought about this an abnormal amount - I think my job makes me paranoid, lol. I have to do 15 min checks at night and we have really loud, old doors. I close all of the doors but don't latch them since the hallway lights don't go out at night. I don't want to wake them up with the lights or the sound of the door latch. Some rooms have weird doors that like to swing open and slam into the wall though, so I'll leave those wide open unless they complain. Sometimes I'll purposely keep a door latched if I want to hear if a specific person gets up. I'm just sneaky like that. That trick works with the bathroom door too if you have the good fortune of working at a hospital as old and creaky as mine. :)

You should never restrain after the fact or as a punishment. Seclusion is less restrictive but inappropriate for any patient with self-harm precautions. Specific reasons I've seen for seclusion/restraint: Court ordered forced medication that the patient refuses - only requires holding someone down for a minute for the injection. Self-harm: ripping open old wounds or repeatedly banging their head against something. Violence: If two patients got in a small fight they might be restricted from smoking or activities. If they continue to escalate we might send someone to the seclusion room (sometimes locked, sometimes not). Unstoppable violence: S/R might occur if the patient is psychotic and truly believes they must attack someone. For example, a patient once threatened and chased a staff member out of the room. He was mixing her up with an abusive family member. He went in restraints only because he would not stop chasing her and also needed an injection - not as a punishment. Make sure threats are real - don't restrain for bluffing and showing off. Remember, restraints are always the last resort! Logically, it just isn't all that useful for changing behavior, but more than that it's just plain unethical to do something so undignified to a person without good reason. There's almost always an alternative.

Yup, ESH is still there for now. BCTC is buying the land and they're already started doing stuff - they're letting some archeological people do digs around it getting ready for new buildings (possibly searching for old artifacts and graves? ooh...) They already had the groundbreaking for the new Eastern State farther down Newtown Pike. I can't wait for the new building! It seems that all of my friends have gone to Louisville and they're begging me to come too. Louisville is better for sure.:)

Make sure you know the conversions. I remember a lot of those. Our test had a calculator built in to the test btw. It was tedious, but not too hard. The grammar part was super easy. I remember multiple questions about distinguishing between "there" "they're" and "their" and "form" and "from". Overall it was very simple. I bought the elsevier online review course (that website they talk about in the other hesia2 threads is not available anymore). That online course was full of wrong answers and stupid mistakes. Be careful if you buy it. I got a 98 without stressing much. It didn't take hardly anyone the whole time to do it.

Gragg 1 is ok. The entire hospital has great people, even when situations aren't ideal. If you like the geropsych population, that's great, but I have to warn you that most of us hate being pulled to G1. It's a lot more work and a different type of job than the other floors. You will have to deal with a lot of negativity from mhas that get pulled there. The regular staff on g1 truly love it and are great with the patients though. I see elderly people from regular psych floors get moved to g1 and just flourish all the time. G1 is great at getting elderly people back on their feet. About getting hired: please apply! We need people. It takes a while for the paperwork to go through, but it's not difficult or competitive. Tell them you want to work nights and like g1 and they'll probably throw you a party. :)

I live in Lexington, and I'm not too fond of it. The town is very closed-minded and snobbish. EVERYTHING revolves around uk sports, which I guess some people like, but it definitely cuts down on other hobbies. The nightlife is boring. Everything closes early and it's mostly beer and pool type of places. Everywhere you go there are gaggles of giggly sorority girls. About psych, Lexington is home to Eastern State Psych Hospital. I work there. It's big, old, and falling apart. They are in the process of building a new one, but you can tell they've just given up on the old one. Staffing, upkeep, pay- it's all bad. I've never been there, but I hear that Central State in Louisville is a much better place to work, and they supposedly get extra hazard pay. I can't confirm that though. In general, if you are fashionable, a social butterfly, like sports, and are conservative in every way - Lexington is for you. If you like some diversity, go with Louisville.

I have been been clawed at, swung at, choked, spit at, pinched, chased down the hallway, had various body parts touched or commented on, cussed at, told to "smile" in a condescending manner, etc. I do work in psych, but I think that many have a lack of social skills on top of their actual illness, and that a little lesson in social graces can't hurt. I usually make it a point to say "No, that's completely inappropriate" and explain why whatever they did was counterproductive to anyone liking them or getting their privileges back anytime soon. A few of the times I've seen a patient get really angry at me was when I did something obviously to protect myself, like make smoke break 10 minutes late for a trouble-making patient in order to wait for a male to go with me. When they yell at me for things like that I tell them that their behavior has given me no reason to trust them and it's their job to change that, not mine. Some think I'm a witch, but then again I've never been seriously injured (many of my coworkers have) and I plan on keeping it that way. Some of the patients even like me better for holding them accountable instead of treating them like a child. I would never try to press charges on a someone who truly was delusional or hallucinating, but I would on most others if it were serious enough. And, no matter what the diagnosis, I have no issues with running the heck out of that room and getting some help.

I have no clue if it gets better, but I can tell you that you're not alone! Good luck.

Going by how things are at my job, none of the people in those jobs you mentioned get to talk to the patients as much as they like. There's always some kind of paperwork or regulation stealing your time or not letting say something. I don't think you are doomed to nothing but passing pills as an RN, though there certainly RNs out there who do only that. But, there are also RNs (and MHAs/CNAs) that go out of their way to slow down and talk to someone. I've sure you've seen both types if you've already worked on a psych floor. You may not have time to do any full blown therapy but I think you could find time to explain the basics of meditation or give a mini-lesson in communication or some other social skill. I've done it many times (usually right after some sort of conflict)... then again I don't know how helpful those conversation where since they were usually one-time things. But, worst case scenario, life happens and you can't go back to school at all... nursing might not be that bad, or not that much worse than any other job anyway. Also, maybe get away from geriatric psych...? Our geri psych floor is much different from our other floors. The former being more like a nursing home and the latter being much calmer with more time for conversation.

Benefits are good. My health and dental insurance are about $15 and $6 per pay period. As to the quality, I'm not really sure because I haven't been sick lately. I remember the deductible being high, but it paid for a large % of everything afterward. You earn something like 3.4 hours of sick time per pay period. Vacation is similar but you can't use it for 6 months. Over all I'm very happy with my benefits. I know people who've worked at the Ridge and ESH and they say they prefer ESH. But then again, if they didn't they'd probably be at the Ridge and not at ESH talking to me! :) I definitely find the older population to be calmer than the 18 year olds. As to pay... I know new grad nurses make low-mid $20's per hour. I don't know about LPNs or experienced nurses. MHAs make $10 days and $11.50 nights. Raises haven't been given in years. Disclaimer here... I know I've stated in other posts that I love ESH, well, things are changing. As of this summer night shift staffing has been TERRIBLE, census has been sky high and morale is very low. A lot of us basically feel like the administration is punishing us for being unable to accomplish the impossible. I personally don't feel like I'm doing anything therapeutic so much as keeping the place barely presentable and teetering on the edge of sort of terrible chaos. All of this could be normal for hospitals in this economy and not just ESH though. I think it probably is, because I used to adore this job.

I know my hospital takes some truly awful patients (we're a state hospital). I've only ever heard of one patient being banned. Some aren't admitted because they're not sick enough, but that's a different story. But even we are supposedly a little bit specialized. We're not supposed to take long term head injuries or dementia, but being the state hospital we do sometimes get stuck with those patients for a long while due to placement issues. But yes, every personal care home, nursing home and hospital-attached psych unit in our area sends undesirable patients to us. Not just violence, but annoying or manipulative patients that other places refuse to admit get sent to us. I'm not sure we're even allowed to turn anyone within a certain criteria away. I've heard we're not supposed to get super-violent felons, but we do occasionally.

That's all fine and dandy to tell someone who doesn't have to actually handle actively psychotic people or set limits with upset people on a daily basis, but I think it's idealistic to tell a new nurse. A lot of violence that happens is accidental, or easy to sympathize with - many times they even apologize once they've calmed down, but that doesn't change the fact the the damage is already done. Also, the type of hospital matters. If your hospital takes a lot of felons trying to get out of their jail sentences or patients unresponsive to meds that other places dump on you - you need to be super alert. If you work at one of the hospitals that turfs those problem patients to hospitals like mine, maybe you don't need to be as careful. And I've seen patients fixate on pregnant staff before - it does makes you stand out. Regardless of what stereotypes you may or may not have, be alert. If you get a funny feeling, run. If you feel more comfortable having a male tech go with you into that room at the end of the hall - ask him. Your baby's physical well being is a hell of a lot more important than not hurting someone's feelings. Be careful.

I think it's doable if you're very aware of your surroundings. Yosemite said "KNOW YOUR CLIENTS, KNOW YOUR BACK-UP!" I 100% agree. Tell another staff member where you're going, don't give patients special privileges, know who's violent and know who's sexist. Don't be afraid to ask someone what a patient is capable of. I used to let one really nice guy come with me to set up snacks in a separate room... a more experienced tech yelled at me when he found out because it turns out this guy had strangled his sister while in a confused state! How stupid was I? People are reluctant to admit that psych patients can be very violent. The truth is, confused, scared people act out. I work at a pretty crappy hospital that will accept just about any patient (patients other places won't take), so maybe I'm biased. But, I have hard time thinking of many former patients that didn't at least attempt something violent, be it accidental or not.

It this sort of staffing/census situation common in other hospitals? I'm just not sure where my unit falls - is my hospital particularly bad or am I just not handling it very well? Sorry this is so long... I'm a night shift (6p-7a) tech at psych hospital on a floor that is supposed to have 15 patients. We'd been having 20 patients so management magically switched our limit to 20 and then they gave us 23! We're supposed to have 2 nurses for 15 patients, and 3 for 16+. Lately we've been having 2 nurses, even with 20+ patients. Usually only one is an RN and this pretty much guarantees the RN won't get a lunch because there are many things LPNs can't do at our facility. Typically, we have one tech per 1:1 patient and then an additional tech for on the floor (if we're lucky). Many nights we have no tech on the floor and one of the nurses has to do the tech work. I am one of the only female techs that works nights, and also one of the few with any experience. Our experienced male techs are often pulled to the Intensive Supervision Unit (violent patient floor), so I am usually the one left alone. I have to do everything by myself and feel awful when I take a lunch because the nurse has to do my work on top of hers for that hour (lots of paperwork every 15 min). Also, due to our close ties with the Intensive Supervision Unit, we usually end up giving breaks and running errands for them. The nurses help me but they're in the same crappy situation, so it's just all bad. The newer techs are usually placed with the 1:1 patients all night and I'm responsible for giving them lunches, so I that gives me about 2 less hours to get all the floor work done most nights. And, to top it all off, housekeeping, laundry and dietary completely fail to take our census into account so we are always out of towels, clothes, bedding, snacks besides saltines, coffee filters, laundry soap, even hand soap in the snack room for a while. I'm terrified someone's going to manage to commit suicide or something because I was running the hospital looking for clothes or cleaner or teaching a new tech how to do something instead of doing my room checks. Lastly, I'm doubly stressed because day shift gives us terrible reports (they fail to mention important things like MRSA and catheters) and complains about us to the nurse manager for not doing enough work and the manager takes their side because the woman hasn't even met most of us night shift people! I guess this is more of a rant than a question, but I do wonder if other psych hospitals are ever this awful. Supposedly the summer months are in the worst in my area. Man I hope so, because I can't handle anything worse! I LOVED my job at one point, but this is wearing me out.

In a psych hospital I think you need to assume they probably aren't thinking very clearly and don't have the ability to give consent. I don't think I've ever caught two patients fooling around where I didn't think that one of them was probably taking advantage of the other in some way. Better safe than sorry. Definitely do not let them. They need to be focusing on their own recovery in a psych hospital anyway, not on a new relationship. I recently caught two patients together and I told the nurse and it turns out that patient #1 had been known in the past to overly-fixate on other patients and they were really glad that I caught them early. The situation actually did escalate and we ended up having to put patient #2 on a 1:1 observation. So much paper work, ugh. Can you image having to write that incident report? We had a funny conversation about whether or not "humping" or "embracing" or something else was the appropriate wording to document what happened.

Things happen sometimes and it's no one's fault. Even in the most secure situations with staff expecting the worst, attempts happen. We've had scares before at the psych hospital where I work. Even if you're watching them like a hawk they can always pretend to be asleep and be cutting under the covers, or try to pull something while in the shower. If someone is serious about self harm even a 1:1 observation isn't fool-proof. I'm sure you weren't at fault. You had other patients to take care of, and this patient was obviously in the wrong type of hospital. I know it sucks to not catch something you think you should have, but all you can do is move on and try to find the silver lining - maybe your experience will help you catch a similar patient sooner next time. But, don't blame yourself - that won't help anyone.

On night shift we have to take the giant laundry cart down to the basement and put the clothes in one bin and the linens in another. We don't wash linens though. There are washers and dryers on the units for patients to do their own laundry and sometimes we'll end up doing it for them if they are too hurt or confused. I think it's ok for us to be involved with the laundry where I work since it's a psych hospital and we need to demonstrate/encourage it for some of the patients who aren't all that great with hygiene or chores. But I think it's ridiculous for CNAs to be doing laundry at a regular hospital with very physically ill people. That's just too much work!

I wonder what happens to people with a different bachelors degree and an ADN...? I'll have a BS in psychology this December so I have no desire to do another bachelors. I've had enough general education and don't see why a 2 year degree wouldn't be sufficient for someone in my position. I guess they would expect us to do the more expensive 2 year accelerated BSN programs... The 2nd degree BSN in my area isn't liked by many students b/c it's full of "useless fluff" that doesn't help them with the NCLEX. The ADN programs have similar pass rates.