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puravidaLV's Latest Activity

  1. Rant post: Its not a new concept but its becoming more injected into mental health care setting, but when the phd's get into the mix there is an unrealistic expectation from nursing staff and MHT staff. Its one of those avenues that sounds great with power point slides, but when the code goes down going back to the chart and referencing that one sheet on admission of "what helps you calm down" NEVER happens. Sorry folks the "i feel when you say" statements work great in group but when the individual is punching you from behind that TIC gets flicked. I've worked now through the lifespan as it comes to mental health and I've been attacked through the life span as well. I watch RN come in get trained then never come back because they don't feel safe in the field of acute psychiatry. Its gotten to the point i laugh at the residents looking to me a 300lb RN to come follow them to feel safe...sorry i'm not your teddy of protection. Nothing has changed over eight years of dealing with this. One facility for adolescents completely removed restraints for youths along with seclusion and required staff to do physical holds following the TIC model. It was counter productive since more staff was getting hurt doing holds (RN/MHT) because times would require >30 minute physical holds and transitioning would cause and opening for attacks. Those that were gun-ho on the TIC model of care were never around and always seen closing their door not giving two TICs about the patient or those on the floor doing the physical hold. BTW they got shut down for a while by the fed because of ..“has caused, or is likely to cause, serious injury, harm, impairment or death”. Not saying TIC was the cause but it sure didnt help, but physical holds are not better than mechanical restraints (feel free to to discuss). Another facility took TIC to a new level of "woke" from pretty much banning anything that might "trigger" a patient. No news programs, movies went to a committee to be determined if ok for a patient to view basically making the individual avoid everything only to have reality hit again on discharge. The TIC Phd wanted to decrease seclusion and restraints. Staff being attacked left and right, management frowned on the attacked but not the attackers, and again that TIC phd closed their door at the first sign of trouble which again left RN/MHT to do the physical work with them coming out afterwards to critic the entire process, yet never lift a finger when they knew the fudge was flying. If you're going to remove reality from the equation and attempt to make a utopia situation in a world that is avoided by the majority of society (USA) you're not going to even come close to getting to the gates of Disneyland. None these facilities ever changed physically (safety environment which is stated a lot in the literature), policy (more removal of actual policies and no addition of reflective policies of this model except for the removal of reality from the unit e.g. local news), or care (addition of EMDR or other evidence based care). Its mostly talk of administration office workers or people that run the other way when codes happen...TIC is a pipe dream. Side note i do think a lot of the core concepts should be fundamental in pediatric and young adult, but as the age increases and the diagnosis become more complex its not; especially when care quality does not change in a medical model. Majority of psychiatric hospitals do not work on nursing committee style of policy making fairy tale they follow the you have a boss and clock in model.
  2. puravidaLV

    Have you ever been attracted to a patient?

    Yes I've been attracted to their fist, their spit, and most above all else endless proposals of how i can eat what rhymes with "ship"
  3. puravidaLV

    Secure cases for CPAP machines?

    More than likely your internal engineering department can build the same cabinets that are used in these cases. For the most part its a night stand with a small hole for the mask hose to go through. Its obviously locked and for most CPAP machines all you have to do is breath, but if the pt wants to have it you just unlock it. The electrical flush and mounted securely against the wall. I'm a fellow VA person and just remember for the most part managers never managed any where in the real world so spelling it out requires pictures and short sentences. Oh and adjectives lots of those. Picture below for reference. Perdue Woodworks CPAP Nightstand | Birch Lane
  4. puravidaLV

    Is 2 years Psych Experience enough to Travel?

    yea you could basically travel on 6 months. Certified (deleted my lol) its like a Phd in nursing you're not going to get paid for it, but if it makes you feel better ...yay? if you travel do some research in comps and how taxes work for the state and company youre working for. There are hidden secrets to it, but endless overtime in most cases.
  5. puravidaLV

    forcing baths on dementia patients?

    This is an old topic but someone reads this and thinks on a psych unit you can force a patient to take a shower you need to look at not only operating procedures, legal status of patient (hold or voluntary), have a PHYSICIANS ORDER because otherwise you just might have assaulted the pt.
  6. puravidaLV

    Everyone is in NP school !

    VA pay doesnt equate to work. You could have 3 psychiatrist on an inpatient unit hosting six patients and all three are getting 215k/each. So in economic view the VA doctor is getting more than the private sector provider who has: overhead, staff, malpractice, and other factors limiting compensation. The bar is set fairly low for NP. I recall a fellow bsn student that failed out, matter fact two of them, and within a year of graduating (amazingly) they went to Drexel and were admitted....well they also failed out. The GRE should be required and more and more schools are requiring it, but you also have a bunch of farming schools that don't, I've seen some of the most incompetent nurses stretch out for that increase in care level just to find out when/if they graduate they don't know jack sh!#...and if you don't know jack; he goes to the physician.
  7. puravidaLV

    Violence in Nursing

    Aggressive dementia patient attacks you...ten minutes later no memory. Can't press charges, cant put hands on, and get nothing from management. So a) fight back with the probability of getting sued b) run and sit in a janitor closet c) tell doctor/management of pt aggression which furthers pt away from placement d/t charting pt is violent.... combo blocker of b and c. Run and don't do anything because otherwise the pt will be here for another six to seven months.
  8. puravidaLV

    Working with a felony

    Well if it wasn't for "contract nurses" (troubled nursing) most psych facilities wouldn't have nurses working the floors. I worked with one person who headed the state program for the nurses c/ substance abuse problems and let me tell you that list was pretty expansive for the number in the state that had an RN lic. and most were DUI. I got into psych b/c i blew my back out in critical care and a friend brought me in. But #1 place to check....psych facilities.
  9. puravidaLV

    Manager interrupting

    Hey, sometimes you win, sometimes you lose, and sometimes you pick your battles. I have had experiences with a manager on a psychiatric unit that would come in and micro-manage within 5 minutes of entering the doors and have no report, no rapport with the patients, and basically been a milieu-killing machine. Multiple times the manager has stood in the middle of code situations like a lost puppy, has tried to do interventions which were not warranted and which led patients ending up on the floor...take a deeeeeeeeep breath and just remember that manger probably has no memory of it even occurring.
  10. puravidaLV

    Do you have a free charge nurse on your unit?

    I am free of charge....I do charge for free basically. I don't get paid to do it. I have 7 patients. I haven't figured out how to piss off management enough yet to stop getting the assignment.
  11. puravidaLV

    Ditching NP school for MD?

    Well nothing like going back to school and redoing Calculus, Organic chem, physics, studying for the MCAT, doing eight more years of school and residency followed by crippling student loans. Both parents are physicians, I was premed in 97 and one summer I went home and told dad that was my choice of degrees (was going to do biology or liberal arts (yea its possible). My dad asked me to come to his office, opened a check, told me he billed 700$ for services that cost him around 200$ in supplies and rest time, he got around 15$ for a two hours. He and my mom talked me out of it. Sadly I took it as no healthcare for me...till I figured out nursing 13 years later. There are more positives in the world of NP. I am probably one person that goes against the grain when it comes to autonomy (against it for the most part), but NP gives you much more flexibility when it comes to relocating and practicing. You can always be a nurse on the floor. A PA will never have autonomy and when the doctor is having a bad day....well your not getting paid. You can't float around state to state if you want to move c/o a provider being attached to. MD/DO you still have to go through credentialing which can take six months each state. Its never easy starting over. Nursing...well you want to go somewhere...apply online go get a floor job till you find something in the NP world then go back at it.
  12. puravidaLV

    If you could redo it....would you choose nursing?

    Yep, wouldn't have waited till my thirties thought. I think of all the cool JDM race parts, club nights, places i could have done 13 week contracts in/at/around, that 250cc ninja would have been a hyabusa, student loands would be long paid off, NP school done, heck i might even had been able to continue living in palo alto with no house payment. Both my parents talked me out of going to medical school (both doctors and screwed by HMO), I have a business degree (B.S) which is basically useless (Finance & accounting are the only two that matter the rest pretty much are summer camp don't learn anything classes, I've been in management and that sucks, and other well I have an awesome collection of name tags from fast food places which just helps me each year now for holloween.
  13. puravidaLV

    NP Salary vs. RN salary

    If your working psych the likelihood of you getting a raise is near zero to none in the private sector. Most are stuck on the west (US) around 30-35$/hr which comes out to be 70k/yr for inpatient and yes its really easy if your able to put up c/ a lot. OT available or moonlighting is easy since most psych facilities never have enough staff. Yet, dealing c/ personalities on both side of the nursing station takes a toll on you. I'd rather never be a charge nurse again and sit in the medication room giving out hydroxyzine for 30 more years. Going NP can be anywhere from 90k/yr to 160k/yr (yes) and all you have to see is 15-45 minutes depending on each case, hate the idea of 9-5 m/f since I've never worked it, but I have a family now and to be honest I'm not getting younger. My days of being a bouncer are over and coming to a close. NP provides me longevity in a field of nursing I never planned on being in. Pick your battles, ect ect ect, or even better to quote Young Guns "We work for a provider as regulators. We regulate any prescriptions off this property - we're damn good too! Our provider has got a soft spot for runaways, dareless, vagrant types. But you can't be any geek off the street, gotta be handy with the prescription pad , if you know what I mean, earn your keep."
  14. puravidaLV

    Error on official HESI Practice Question?

    Welcome to HESI/ATI you catch the mistakes and they never fix them. I'm fairly certain there are still errors in the ATI books stating smoking is a healthy option for pregnant men.
  15. puravidaLV

    Registered Nurse Salary Purchasing Power Across States

    Well without going through the data itself a search of RN & florida on indeed.com gives estimate salary ranges for jobs there as being: $35,000+ (16397) $50,000+ (12864) $55,000+ (11130) $60,000+ (8610) $70,000+ (3920) so who knows, doesn't account for shift differentials, weekend pay, and so on.
  16. ...but why? ...b/c your annoying... huh...but in the past you did it. [Arnold voice] welcome to the future [/Arnold voice and dawn on sunglasses] directed by Michael Bay.