ackiepieRN

Adults for me please, or geriatric. Patients that are my own age or younger usually get under my skin more quickly than I would like to admit.

Yes, I agree with you 110%. I could not see myself working anywhere except psychiatric/substance abuse nursing. I did the med/surg thing for a year to get experience (which I will never regret) but I, much like you, hated the fact that I could not give my patients one on one time without feeling guilty or rushed. Med/Surg is very task-oriented, and I felt like a machine because of it. Meds, Feed, Clean, Repeat. I could go into a laundry list of all the areas of nursing that either bored me to tears or scared the bejeezus out of me. Funny how psychiatric nursing doesn't scare me nearly as much ICU/ED/OR etc. Scream at the top of your lungs that I'm "NURSE RETARD" as you flail down the hallway like a bat out of hell? No problem. At least five different alarms going off at once and praying one of them isn't ventilator related? No thank you!

These are my top 5 choices (no particular order), for what a typical day on our inpatient psychiatric/detox unit is like: 1) Napoleon XIV - "They're Coming to Take Me Away" 2) AWOLNATION - "Sail" 3) Hurt - "Overdose" 4) Shinedown - "45" 5) The Beatles - "Happiness Is A Warm Gun" And when I get out of there, it's more like, the Hallelujah Chorus

As you can see, that certain nurse is my role model (haha, kidding ) I agree with Meriwhen. There have been patients that have pushed me over the limits - to the point that I have cried in the dirty utility closet or tried desperately to "zen and center myself" in the staff bathroom.I know the ones I struggle with the most (borderlines old enough to be my grandmother yet have the coping skills of a toddler, patients who tell me how to do my job, etc), and I advocate for rotating these difficult ones. Exercise, video games, and my husband ( aww yiss) are the best de-stressors after a particularly bad evening!

I have worked all three shifts as well and have found that 3-11 works the best for me right now. I always found day shift was WAY too hectic and had "too many hands in the pot." Sometimes I felt co-workers would overstimulate certain patients and leave me to clean up the mess because "I was the nurse." Night shift was brutal on my body. 4am would be the magic time that I would start to get stomach cramps and horrid nausea. I would give AM meds soon after 5 because GOD I NEEDED SOMETHING TO DO. ANYTHING. Of course, when things got bad on nights, I was really uncomfortable with a skeleton crew. So my only logical choice left was evenings! Sure we put out fires from first shift, take most of the admissions, deal with unruly patients & family, but you are more in control and self-sufficient on evenings. Pay differential is always a plus too, not as good as nights, but I'll take it. :)

We have a 16 bed unit, and if we are "full" (12-16 patients) we can have the following staff: Days: 3 nurses, two techs, 1 secretary, + ancillary staff (case managers, OT, SW) Eves: 3 nurses, two techs, 1 secretary Nights: 2 nurses, two techs That is ideal staffing of course. Due to many, many, many reasons ... we often find ourselves with two nurses and one tech. As for admissions, the emergency room is always pushing too (sometimes pushing to go OVER census if we have scheduled discharges the next day). We have a policy that there has to be AT LEAST 45 minutes between admissions. And NO change of shift admissions - since techs and RNs are in report during that time, usually nobody is around to see the patient. Which is not a good thing!

Hi all! After many months of putting this off, I've decided to get my MSN! I'm a ball of nerves and excitement. My start date is 5/1/13. Anybody with me? ... and on a subsequent note, anyone gone through this particular program? Any pearls of wisdom?

Oh, I have received what I refer to as "the look" many a time before from nurses, doctors, friends, family, etc. when I tell them I'm a psychiatric/addictions nurse. "The look" is a combination of shock, fear, and disgust - usually followed by such statements as, "Why would you ever want that job?", "Aren't you scared?", and "You're going to lose all your skills!" I want this job because it is fascinating and challenging. I can honestly say I am never bored. While it is true that we get many "frequent flyers," we do have a few patients that overcome their illnesses and it is incredibly rewarding. I would be lying if I said there were times I was not scared, we all get that patient every now and again that shakes us to the core but the old saying is true "safety comes in numbers." I don't feel afraid with adequate staffing and, if needed, security and supervisory presence. As for my skills, what about the new ones we learn? I pride myself on my interpersonal communication skills and strong patient advocacy. As for inserting Foleys, IVs, etc. Those things are EASY to re-learn.

I work in a small community hospital in Connecticut. Sure enough, we've had a few cases of patients taking bath salts. The initial presentation is paranoia, violent behavior, and pretty delusional/grandiose thinking. More often than not, we get young teens to early twenties. One of these patients made it up to our unit (psych/detox) after 24 hours. We were all extremely leery, and had our trigger fingers ready to call security - but the patient was "okay" ... he just wanted to lick the window panes made of rock candy. And even his longing for CandyLand passed by the following day. But, bath salts are quite a Russian Roulette ... you never know if you'll get pleasantly paranoid or extremely violent.

I've been a nurse for 8 months and had to take 2 1/2 sick days ... we're only allowed 3 a year, but thankfully I can use my "earned time off bank" which currently has about 100 hours. In nursing school, I had Mono but it wasn't the type that went away after a few weeks ... I was still feeling symptoms for six months. My second day off orientation I had to call out sick. I had a high grade fever, sweat drenching my clothes, and severe body aches. Same thing happened again about two months off orientation. And three weeks ago, I had a NASTY GI virus ... vomiting and diarrhea every hour, so bad it would wake me up at night (now I have a new appreciation for my patients with incontinence! ) I fully believe in the formula: Increased stress + new environment + increased exposure to viruses/infections = illness ... something tells me with that increased exposure, healthy eating habits, and exercise will lead to increased immunity. Too bad I'll be switching to a different floor soon. So with that will come, I'm sure, new found illness.

Like all have said before, its all about the policies and procedures manual. Consider it a second bible. Our documentation of narcotics is ... archaic and annoying to say the least. We chart on the computer what time the medication was given. In the nursing assessment flow sheet there is a box specific for charting PRN narcotics. It is subdivided into further boxes: time, your initials, pain score and location, medication administered (including the amount and route), time of hour re-assessment, re-assessment pain score, your initials again, and circling a Yes/No if the medication was effective. If the medication was NOT effective then we are required to write a nurses note. SHEESH!

Insulin, Heparin, Lopressor, ABX, and Dilaudid! (busy Med/Surg/Tele/Ortho )

A newly diagnosed lung cancer patient with mets, almost everywhere , rings the call bell. I go in and ask what I can get for him. He wants some water with lemon. Okay, no big deal. I get it for him and leave. Light goes on again. The water isn't HOT. Uhhhh, okay. I warm the water with lemon. I give it to him and wait for him to take a sip before leaving. "THIS IS NOT HOT ENOUGH!" He screams at me. I ask him, very confused "Do you want it near boiling? Like almost burning hot?" To which he replies, "Yes, of course!" I do as he requests and bring the water, and wait for him to sip again. He makes a face and growls, "What are you trying to do, BURN me?" ... what the f***.

BARF IS RIGHT! LOL I am totally loving this topic by the way. :redbeathe Since our census at the hospital is high the day shift assignment has been bumped up to 6 patients on most days (which makes 5 seem like cake now). I had a dream that my assignment was 8 patients , all totals, very complex, but I maintained my usual attitude of "suck it up buttercup" and went to work. The time is around 6:30pm about a half hour until the end of my shift and report time. The doctor calls me regarding one of my patients ... a patient I completely forgot about! He's asking about all these obscure things, lab values, assessments, stuff I've never heard of before (my brain must have made these up) like his oxycarboxcilhemeo level and if it was compatible to his other lytes The only thing I could mutter in my defense was, "Umm, what?" while frantically scanning all my medication and treatment sheets, until I came to the patient in question, and realized I hadn't checked on him in oooh, 11 hours. I promptly ended the phone call with a ceremonious, "OH SH*T!" and ran to the patient's room where he was head to toe covered in feces, urine, and blood from pulling out his PICC line and all he said to me was "Surprise!" ... And then I woke up, lol.

I have 75 Qs, finished in an hour, and felt pretty good after leaving the test. 48 hours later, I passed. A week later, my license number is active