elizabethgrad09

Aurora Behavioral Health is hiring.

Thanks, Whispera, I agree that is much better!

Whenever I've seen "med-seeking" it's narcotic pain meds they are seeking. Some of the "frequent flyers" SEEM to come primarily to get Percocet. I'm new at this and don't know how to deal with it.

"Visible on the unit" means they are not isolating themselves in their room. Is there a better way to put it?

jimkusters, Thanks for the feedback. Can you elaborate on your statement "What seems like a simple, logical request to us, can sound like you just asked the patient to jump off a bridge." It sounds like you are saying that because these are psych patients, they interpret requests differently than the average population. Is that correct? Can you give an example? I agree about being nonconfrontational. It seems to me that just about no one likes to be told what to do, and even more so with psych patients. As an ancient text puts it "A soft answer turns away wrath." Regarding where to give report, we do usually use a separate room. But on that particular day, those two rooms and even the group room were all being used by Drs and social workers, so we resorted to the day room. Maybe we would have been better off using the conference room down the hall. I can understand the pts feeling like the day room is "their" room and objecting to being asked to leave it. After all, they are locked in, have an assigned roommate, have to eat at prescribed times, etc. etc. and then even their room is taken away.

I am a second career RN, recent graduate, whose first career was software engineering. So I went from working with 90% men to working with 90% women. I agree that there is a huge difference, for whatever reason. My sister in law once told me that "men are friendly like dogs whereas women are competitive and catty". Huge generalization I know, but it does seem to be that way in a lot of cases. What I have observed with the unfriendly nurses I have worked with so far is that they are insecure. Perhaps this is more of a female trait because of women being historically oppressed and disrespected. When I was a software engineer working for a large corporation, everyone treated each other with respect (management, workers, etc.). It was a much more professional environment. Also, there was almost no focus on rank or hierarchy. I had brilliant co-workers who had a B.S. or no degreee at all (just came up through the ranks) who had been promoted to higher positions than someone with an M.S. or even PhD. Apparently this would never happen in nursing, where there is so much emphasis on the degree rather than the talent. Thank God I am now working for a supervisor who treats everyone with respect and is encouraging rather than punative.

pandora44 and dave, thanks to both of you for your feedback, it is so helpful! i'm sure that my instincts will get better as i go along, but hearing how other people respond to similar scenarios and the philosophies they employ to be the most professional and therapeutic really feels like it is speeding up the learning curve for me. thanks again for being a blessing to me as well as your patients. i am proud to be one of the company of psych nurses j

dave, thank you for your feedback, it is very much appreciated! my colleague did not make the statement "she was just faking it!" to the patient, but privately to me. i don't think she has been there a year yet, so we are both still trying to figure out the best ways to be therapeutic with pts. unfortunately, there are only a couple of experienced psych nurses around, and we are usually so busy that we are limited in the questions we can ask them, thus the reason that i came to this forum. thanks for your thoughts on the continuum of responses, from soft to hard, and explaining the idea of "being lovingly indifferent". >"we care about our patients, but we do not invest in them emotionally" i will chew on this. also, thanks for pointing out that my attitude toward my pt was judgmental. i do understand that the pts are mentally ill and will behave inappropriately. i understand that the axis ii pts have learned their behaviors as a way of coping, sometimes as a result of horrific abuse. what i am struggling with is understanding my role as a psych nurse and how i can best assist such a person. if someone has gotten into a habit of habitually lying or clearly appears to be drug seeking, is it helpful to discuss this with them? or is it is better to simply react to the behaviors by setting limits, etc? interestingly, a pt who was constantly at the nurses' station the other night with multiple requests remarked to the bht "i know i'm very demanding and a princess". if a person shows insight, would it then be appropriate to discuss it with him/her? by the way, our supervisor came by and told us how to set limits with her by telling her she could only approach the nurses' station once per hour with 5 written requests. the best to you as well.

I am a second career new grad RN. My first job was six months at a nursing home, and I have now been working for 2 months at a freestanding psych hospital. I have loved psychology since childhood, and am enjoying this opportunity, but would like some feedback on how to better handle some situations. Prior to nursing school, I recognized that I have codependent issues, and I worked on them for several years and continue to do so. I no longer worry about what people think of me, but I must still present as a people pleaser, based on how people react to me - that is part of my problem. So, I am working on becoming more assertive and confident in my reactions to people. Yesterday at the start of PM shift all the rooms were taken, so we decided to do report in the day room. One patient I'll call A was in there. I asked him to leave temporarily, and he said in a very irritated voice "I'm not leaving, you people treat me like crap, I have a right to this room." I need to exert my authority, but I feel like if you meet anger with anger, it escalates the situation. What would have been a good response? How about "A, we're just asking you to leave the dayroom for 15 minutes so we can take report. You can come back here then." Is that too soft a response? Do I need to confront A's bad attitude because he is being disrespectful and if I don't confront it it will just lead to more of the same? I truly am not bothered by whether or not A is respectful to me or what he thinks of me, I just want to get my job done and have a good milieu. Next scenario: recently a "frequent flyer" came back, a young woman. Another fairly new nurse assessed her. She appeared completely out of it, kept repeating some nonsense phrase, and had to be practically carried to her room because she was too limp to walk. A little while later, she walked to the day room and calmly ate a snack, stating "I was just tired". My colleague said "She was just faking it!" (which I think she had suspected already, this just confirmed it). What would be a therapeutic response to this behavior? Next scenario: a 40-ish female pt is admitted. She claims to be a BSN who just got fired from her job "for teaching the MAs how to give IVs", had her two kids taken away by CPS because of her boyfriend's drug use, etc. She claims to be in a lot of pain. I call for initial orders and am able to get her 1 Percocet every 6 hours. She isn't happy about this, but I explain that this is all she can get now and will have to talk to the internist tomorrow if she needs more pain meds (our hospital is cracking down on pain meds so as not to enable drug seekers). She is constantly at the nurses station and tries to split the nurses. I am polite to her, but not real attentive as I don't want to encourage her attention and pain seeking behavior. I was off for a few days, and then she was my pt again. By this time we had found out she was not an RN or any other licensed professional by checking the BON website. She told me that she had 10/10 chest pain that was radiating down her arm. I thought I detected BS, so I had her VS taken and they were OK (BP a little high, but not majorly). Since she had no other objective s/s, I didn't do anything else. I found out yesterday that a colleague sent her out to the ER while I was off for these same complaints (she was sent right back after getting some morphine, which I guess is what she wanted). My colleague stated "she knew just what to say". My question: should we call her on her BS i.e. "we checked and found out that you are not a nurse"? I don't feel offended by her behavior but just want to be wise and therapeutic. Also, what's the best way to chart on this? "pt c/o chest pain 10/10 radiating down arm but after assessment & VS found no objective evidence so just continued to monitor"? Doesn't seem very CYA which they are always telling me to do. Sorry this is so long! I appreciate any feedback.

Not too long ago I was terminated from my first nursing job in LTC after six months. I was devastated, felt like a failure, and was afraid that my new career was completely derailed. However, I resumed my job search and got another job 3 months later, and even had some interviews earlier than that. So it *can* be done. My new job is in a different area than LTC which is a better fit for me, so it actually turned out well. I agree with the previous poster that although leaving meds at the bedside is not the right thing to do, I saw it done by others at my LTC facility. I don't believe that another facility would hold it against you if you explained what happened, that you learned from it, and would not do it again. So, think positive! I also suggest a lot of prayer, as that is what helped me the most (both to persevere, and to get the new job). Blessings to you!

Excelsior (an online program) is one option you could look into for completing your RN. Best wishes and hang in there.

That was great! I wish it could play on TV as a public service announcement.

It is wonderful that you are choosing to spend time with your sons rather than working more hours. They will benefit so much more from the time you spend with them than from the material things you could buy with the extra money. The time spent with them is precious and something you can never get back. There is absolutely NOTHING to feel guilty about. You do not have to defend your choice, but if you want to you could say something like "My time with my boys is worth more to me than money."

The article says that all four students who posed for pictures were expelled, not just the one who posted the picture on facebook. So, the expulsions were not primarily about facebook, but about taking pictures at an off-site facility with a body part.

My cover letter has been mentioned by interviewers before, so I believe it is well worth it to write one. I also think the more personal the better (i.e. if you had clinicals there mention that).