stram87

I guess I should edit my post. I am a nurse but my long term goal is not to stay a nurse. Unless I end up also doing mental health NP. Thanks so much for your quick replies. I have been thinking about this for 6 months and its a tough decision but I think I will turn in my letter of resignation this week giving them a month notice.

So I work two per diem jobs. One in psych and one in critical care. I am back in school working on my doctorate to become a psychologist so I can't work full time. I usually work 2 shifts a month in critical care and 4 shifts in psych. The psych hospital I work at is great. My coworkers are supportive and its a pretty easy gig. Not stressful and pretty laid back usually. However management has been known to fire people for no reason and randomly. I have never seen this but my coworkers always complain and worry about it. My critical care job on the other hand is fast paced and more physically demanding. I have been thinking about leaving this job for awhile mainly because I get depressed and anxious 1 -2 days prior to my scheduled shifts and it ruins my days off. I have tried medications and therapy with little relief. This job however is union and no one gets fired for no reason. I started in critical care at this hospital so I feel like it is my "home" and I'd feel bad quitting. I use to work full time there before I went per diem. I think part of the reason I get depressed and anxious is because when I first started training at this hospital I was the victim of horizontal violence which the management was aware of but never did anything about. Everyone else there is fine and it was just this one nurse. Even though it has been 3+ years since the event I still get anxious about going into work. I'm sure there are other reasons for my depression and anxiety regarding this job. My concern is that if I only work in psych I will become obsolete to any other kind of nursing. However my long term goal is not to stay a nurse. I finish my PhD in 4 years.

I've found that when pegg tubes clog it usually means someone hasn't being doing the water flushes...but that being said I don't take care of pts longer term with g-tubes.

No I decided to wait another year. Might move across country. Not sure yet.

I think the key word is initial assessments. Data collection I believe is considered follow up assessments. But the real question here is what is the scope of practice in the state the OP works in.

This may vary from state to state but every state I've worked in LPNs cannot do initial assessments. I quote from the link below "While LPNs can do data collection, they cannot do patient assessments." http://www.nysna.org/images/pdfs/practice/scope/rn_uap_guidelines04.pdf

You should be fine. I wouldnt worry too much.

How long till the drugs tests? Did you only take one of the "incorrect" type of pill? I dont know if this is the best site to figure that out. You might try googling other sites that might have more information about the half life of drugs and how long till they don't appear on drug tests.

I'm sorry to hear this happened to you. However this does not mean you dont have to right to practice in a SAFE work environment. We always talk about patient safety but health care provider safety is equally as important. It seems like your taking the right steps to assure your health is not affected. Unfortunatly things like this do happen. Just remember to advocate for your own safety as well as the patients in the future. It doesnt matter what the attending says. Safety is key! Hopefully everything turns out okay.

So would it be better to get a different degree? I want to open my own practice eventually.

I applied for the fall to go to PMHNP school and I spoke with one of the advisers there regarding my career goals of providing counseling and therapy and she said that the PMHNP program would work for that. However I spoke with a social worker with a phd in psych and he said that PMHNP pretty much only write scripts for doctors and don't do much counseling or therapy. Is this true? Would it be better to get a different graduate degree for these career goals?

I would take the level II trauma center. Seems like you will get a better experience. What happens if you leave before the 3 years? Does the 16 months count?

So I got hired for a per diem position at a stand alone psych hospital. I do not have any psych experience at all. I currently work in critical care. The orientation is less than a week. I believe 3-4 days. I think they keep you on probation for awhile and give you less patients or different assignments. I'm not sure exactly yet. But my question is what can I do to prepare for working in this field? Any tricks/secrets?

Thanks for all the feedback. Certainly learning something new everyday.

Wait do hospitals not hire people with Hep B? I never heard that before.

Nope. Never. Though I work in an ICU so its not like a nursing home type situation. Have you been accused of elder abuse?

Don't beat yourself up. Your soo close. Much closer than many. Use this as motivation to complete your BSN and get that dream job. Just because you were passed up this time doesn't mean there wont be other opportunities. As an experienced nurse you should have no problem getting that job once you have your BSN. I know its not fair that just because you dont have a BSN you didnt get the job but unfortunately that's the way the job market is going. I'm sorry you dread your job. What parts don't you like about it? Is there anything that can be done about those in the mean time while you finish your BSN?

I use epic where I work and we never have problems getting emergency drugs. The doctor just puts the orders in afterwards. Hopefully these issues get straightened out for you.

Has anyone had their patient code on the way to CT scan? What do you do? Obviously chest compression but if your in the elevator do you call a code for where your getting off? We have "cell" phones that you can call the operator and have them page a code. Where do you bring the patient to? The back hallways outside the elevator would not be an ideal place to run a code.

I worry that I'll have this same problem. After almost a year in critical care I'm thinking of switching to psych but now I'm even more discouraged.

So I've been working in an ICU for about 5 months. So still very green. I had a patient who had a ischemic stroke but was stable. No interventions at this time. I did neuro checks on her q1 hour just incase. Around 4am she started to be a bit more confused and sleepy. Nothing too crazy still oriented to person place and time and motor intact. I was conserned though because she had been fine all night and this was a change as far as I was conserned. I let the ICU fellow know and he came to the bedside and assessed the patient. He said he wasn't concerned. But to keep him updated. 5 am patient is still confused and a bit more lethargic. I let the fellow know he said he wasn't concerned but would bring it up with the day team. I didn't like this answer so I called and woke up the neuro attending. He said repeat CT scan would be his recommendation. It turned out I should have called neuro surgery (my fault I admit). But I'm sure the recommendation would the same. I reconsulted with the ICU fellow and he said he would tell day shift to do a CT scan. This is around 530-600. So 7AM rolls around and pt is increasing lethargic and neuro surgery comes by and asked why I hadn't gotten a ct scan if my patient had a change in MS. I said I tired but the fellow didn't order it and wasn't concerned. neuro surgery was ******. I feel like crap right now because I knew something was wrong but wasnt able to get something done. Also in the future how do I prevent MDs from not listening to me!!!!!!!??? I wrote in my note all my attempts to get the doctor to order a CT scan...does this cover me? I can't force a doctor to order anything and I can't just take the patient to CT scan without an order. Fmylife is how I'm feeling right now. All and any input is appreciated.

I have never seen any of those used in "traditional" hospital nursing. I thought about getting other certs in holistic medicine (yoga, massage, acupressure, ect.) but seems like a waste of time in most cases. Many patients aren't open to the idea of mediation and I don't know if yoga would go over well either. I'd be interested to hear if anyone has done this stuff and had good results. I wish there was more of it in the hospital. Maybe in long term care.

Pretty much what the other post said. If pharmacy agrees with you then you have someone else backing you up which is nice when arguing with your manager as she is not a pharmacist.

I don't think there is a way. Unless you are considering the IDC to be sterile. We do at my hospital if it is drawn from the collection port.

I didn't mean any disrespect with "at that level." I was going to say "I'm not sure If I would be interested in psych nursing" But that makes even less sense since MHNP is psych nursing. As a MHNP I want to conduct counselling and therapy. I am interested in working with the mentally ill but I've heard a lot of bad stuff about psych nursing (I mean like working as a psych RN). I work with a mentally ill man currently as a volunteer just for fun and have always had an interest in psych. How should I bring it up to the recuiter about wanting per diem as opposed to full time?