2ootsRN

Hello Celle507, I've read your question as well as the replies you received. i have to say that I go along with elkpark and TitaniaSidhe's replies esp. Titania...'s. I too have been in nursing too long to even begin to think about it. I also started my nursing career on a Med/Surg unit and even though I also believe that this is the best way for nurses to start out, I also have to say, "times have changed" and we see new grads starting their 'Nursing Journey' right where they desire to work. I work in a Community Based Psych. Unit. and where I work, the turn over is very minimal. On our unit we have three RN's who are relatively "new" to Psych Nursing. One has been an RN for several years and opted to work in psych and two RN's are fresh out of school-took their boards passed and are working their first ever job as a Psych. RN. I also know that 'Nurses can eat their young' as the expression goes. Do I think this is right-heck no!!!! but it still happens. Fortunately for the new Psych. nurses on our unit, the majority of us feel as I do (but we do have one or two 'old time' nurses that are Passive Aggressive and who can get out of hand given the opportunity) anyway the new nurses on our unit were preceptored with an older experienced Psych. Nurse: meaning they worked the same shifts, had the same days off as their preceptor nurse. Management as well has kept close contact with the new nurses and with the rest of staff and thus far, these two new to nursing RN's are working out okay. They had approx. two months preceptorship and they are still 'learning' the ropes but you know what, so are we as everyday can be a learning experience for all of us new and old to nursing alike. I started out in nursing in 1962 and I love it more today then when I first went in. I enjoy working with the new RN's as well as the experienced nurses but this is me and that's my attitude about nursing as I refuse to 'eat my young in nursing'. Our new RN's also were oriented to the Med/Surg unit of our hospital. I have to say that I also work with an RN who is Mastered Prepared who literally 'falls apart' if she has to 'float' over to the Med/Surg unit when our unit has low census (doesn't happen too much anymore but none the less) as she doesn't have "Med/Surg" skills and becomes very intimidated if she has to go there as she doesn't know what to do, doesn't feel she knows how to assess a Med/Surg pt. and panics as she is out of her element. I have to say that I really believe how 'well' a new grad will do on a Psych Unit depends on the integrity of the unit as a whole and on the new grad her/himself. Like the other feedback you received, doon't think for one minute that 'Psych Nursing is a breeze' because it isn't. People can and do get hurt there secondary to the type of pts on their unit. I have a girlfriend who is out on workmens comp. who probably won't be back to work. She's been a nurse as the saying goes, 'forever' and got injured on the job from a quote unquote, 'Little old Lady'. Two other associates got thrown into the wall as well as got bunched with a fist and 'karated' in the process-why, because one of our so called experienced nurses turned her back and let an acute care pt. get through the door into the nurses station. So Psych Nursing can be dangerous too. I guess you always need to remember to keep your guard up. So before you take a job as a new RN in Psych or any nursing field, check out the 'water' see how the staff is see what you feel during the interview process, the tour of the unit etc. and one last comment. May your journey into the field of nursing be forever fullfilling and rewqrding to you as it is and has been to me. Welcome aboard. 2oots aka 'Sarge' and old but young at heart nurse:) :Melody:

Lisa, have you thought about getting a sponsor (Hospital, MD offices, Co's Mental Health) to provide some $'s so you could purchase podometers and go it from an angle of stress reduction--'exercise' as there is literature out there to suppport that exercise is one of the best ways to manage stress. I go to health fairs and pick up literature with all the intentions of reading it and place it on my table and lo and behold it gets covered up with other mail and eventually ends up in 'file 13' without my reading of it. My suggestion is go with some type of action display: posters with various pictures of stress management, some relaxation tapes playing or aromatherapy and or podmeters etc. I think you have selected a 'Great Topoc' of concern, or at least something that can or could concern each of us at one time or another as well as the preventative angle. Good Luck Katie

Greetings Claire, I work in the State of Wisconsin. Our facility is Community-Based Psychciatric Care and in 1999 we moved out of the main hospital Bldg. Our hospital expanded the AODA facility that we had and we now function on the catagory of "Behavior Health". This encompasses: Inpt. Psych, Outpt. Psych and AODA (alcohol and other drug abuse). Our Axis II pts are mixed in with the 'rest' of Psych. Our team consists of Psychiatrists, MD's, Nurses (RN's LPN's and CNA's), Psych Social Worker and AODA Social Worker, Psych. Therapist (geratric, adult, adolescent and child) AODA Counselors, OT (occupational therapists), Chaplain and a Client Rights Specialist as well as people out in the community such as CSP (Community Support Program), and the various County Mental Health Coordinators and probably a lot of others such as our local police department, employers, religious persons (priests and pastors, ministers), Nursing Homes and John Doe Public in the form of Mental Health Alliance Groups. I believe that because we are considered living in a "rural" area, we are a melting pot of all Axis's of Mental Health. I love my work and everyday is a challenge, as they say, "Never a dull moment". Our nursing staff RN-wise consists of a master prepared RN, BSN RN's (four year nurses), Diploma RN's (three year program nurses), ADN RN's (two year nurses). Some of our nurses are Psych Certified.Until a few years ago, a Psych Nurse with 'x' amt. of hours could take the test for certification, pass it and become certified in Psych. but then it was changed so that you had to be a BSN nurse before you can take your certification test. My personal goal is to complete my Maters in Advanced Practice Nursing as a Psych. Nurse and work in our facility as the first Advanced Practice Psychiatric Nurse. Needless to say this will be a few years (3) coming. Good Luck in your endeavors. Katie

Greetings the program we use for our computer documentation is Affinity. When our somputer documentattion screen opens up this is the name of the company: Quadramed Affinity Healthcare Information System. One very important info I would also like to share with you is to make sure that all the other departments that you work with i.e. Lab, Xray are able to interface with you as for some reason initially at our hospital this was overlooked and it really created big HA's esp. for our Lab and for nursing. This company can be accessed via internet for further information.

Greetings. Our facility has been doing computerized charting for quite sometime now. Initially we all moaned and groaned when we were told that we were going computerized, now we moan and groan when the computer is down. We have a 'Nursing Informatics group along with each nursing unit having a 'Super User' who goes to these meetings and is responsible for helping staff learn the new 'info' as well as bringing staff's concerns back to the Informatics Team. We use 'Affinity' program for our charting and we have acess to a 'portable' computer to use during admission...it certainly cuts your admission time down. I can see if I can get further information for you this following Monday if you'd like (the next time I work)?? Katie

I live and work in a Behavior Health Unit (BHU) in Wisconsin. We have three levels of care: I, II and III with level III being the most restrictive. Pt's on all three levels do have the opportunity to smoke, if they are appropriate as smoking is a privilege, not a right. At our facility we have Acute, Sub-Acute and Open Units. For the most part Sub-Acute and Open Unit pt's are allowed to have their 'cigs' in their possession. We do not allow lighters-we have build in wall mounted lighters. Persons in the Acute area may also smoke if they are not a DTS/DTO's but their smokes are kept at the nurses station. We normally do not allow anyone to smoke during group time. Our hospital is a smoke free facility and we have signs posted outside to this affect and also stating 'Smoking not allowed withing 15 feet of Bldg.' A short while ago, there was a movement to eliminate smoking altogether throughout the entire Hospital Area. Our management did not concur with this proposed policy and met with the hospital Administration and as a result, smoking was not banned in our area, but designated smoking areas were enforced. We felt that it was not in the best interest of Staff Safety and our Pt. program to 'Ban smoking'. Many of our staff, do not smoke but by far a greater majority of our pt's are smokers. We still offer our pt's 'Smoking Cessation Information' at time of admission and during their stay with us if requested and we found that many of our AODA pt's have chosen to quit smoking while an inpt at our facility. We have a specific enclosed smoking patio and if we have a patient that wants to go outside for fresh air, we allow them smoke free time in patio area. I guess I believe that when dealing with Psych. Pt's, you have to consider the overall good of the unit (pt's and staff's safety)when banning smoking and the lesser of two evils... Do I want a 'Code 10' (pt. out of control) or do I want to be able to work with my pt.( allow him/her to be able to smoke when appropriate and get their medication under control. I don't know about anyone else, but I don't want to have to put someone in 'Leather's' or have to use a 'Chemical Restraint' when a few minutes of 'smoke time' would have defused a situation. Katie