editingeyes

Hello all, I have a question regarding telepsych - with telepsych, can I, as the practitioner, be the one at the remote location? For example, my SO travels a little over 50% of the year for work and once I graduate I would love to join him. However, I am unsure if there are jobs where I could work out of a remote office, or if I have to have a dedicated office in a place of my employment? I am a psych nurse and also going to school for my MSN to become a PMHNP. At my current facility we offer telepsych, however the provider comes in to one of our offices and does telepsych to one of our more remote locations where providers are not at every day. The providers simply mail scripts to the remote office (ones that can not be electronically transmitted) for the patients. Any advice would be appreciated!

Viva, I am so sorry to hear about your husband. I am glad that hospice was able to help with his, and your, pain.

I have been doing psych and substance abuse for a few years now, but have only just now seen my first legit, bad case of DT's. This poor patient was on a medical floor first and they couldn't handle her so they sent her down to us. It has been several days since she slept a wink and she has been given enough medication to take down multiple humans and animals. I have never seen anyone not get knocked out by the amount of medications she has received. Caring for her was one of the roughest shifts I have ever had. I wish Dr's would go old school and treat people with DT's like they did in the past, because what is being done now isn't enough. It was so sad to see. On a brighter note, I've been doing orientation for my PMHNP program and I am so excited to start. My boyfriend and I are going to Vegas soon and I'm hoping to win enough to buy a huge plot of land that no one else can find :)

My provider has been out of town last week and this upcoming week, so I learned just how much I am able to accomplish when I am not interrupted every 15 minutes trying to get vitals, answer questions, etc. However, it also puts more pressure on me as I am the only "medical" person in the office so everyone comes to me when a patient is in crisis mode. I also learned that buying a house just doesn't seem to be in the cards for us right now. We've been looking for over two years and just haven't found what we want where we need it to be. If we could just move our location a little bit, I think we would be golden. However, between his job and kiddos, it just isn't possible. I keep telling myself "one day". I am getting crazy antsy though and need to either move houses or states (which isn't an option for the bf). I am excited to have the next week to get my office all caught up with everything that seems to get thrown in the "to do when I have free time" pile. I also learned that lots of staff are trying to leave my night/PRN gig and that makes me sad because I truly like my coworkers. Change is needed there, though, and unfortunately upper management isn't very in tune with that. Ixchel - glad your kiddo is feeling better!

Haha, I lived in Nashville for a while where eating Sonic ice was an every day thing for people. I have never seen people go to a "restaurant" and just ask for ice chips. It is like a cult thing down there! I'm glad you figured it out too! Probably saved that girl a lot of frustration from being so exhausted!

I learned this week that when you have iron deficiency anemia, you can crave ice chips. I had a detox patient ask me to get her level tested and when I asked her why she thought it was off she stated that she has been craving ice chips lately. For her, in the past, this has been a sign of iron deficiency anemia. Got the order and we got the results: sure enough, she was right! I did some research and learned that a common symptom of iron deficiency anemia is pagophagia. This has led to some speculation that pica can be due to a nutritional deficiency. I am glad that I listened to her and I thanked her for teaching me something new that I don't think I will forget! I also learned a few weeks ago that I got in to a PMHNP program starting in August. I am super excited and, although it wasn't my first choice school (I am still waiting to hear from that one), I figure I can always complete the first semester and then if I get in at my choice school I can transfer some credits. Now if only my boyfriend and I could find a house (he travels for work out of state A LOT) that is between his job, his kids and my job, life would be great. If anyone has land in Iowa we can build a tiny house/put an RV on I would love it :) Lastly, I learned that getting a patient coordinated care so she doesn't fall through the cracks when she moves out of state is more difficult than I anticipated. When you have Medicaid you can't pick up prescriptions in another state, but you can't sign up for Medicaid in your new state until you have lived there 30 days, and getting in to a psychiatrist takes MONTHS where we are located. Luckily, I think between the small town pharmacy and a good timed IM injection, she should hopefully be clear. I wish things could be easier for people sometimes.

I read these every week (and love them!) and finally decided to join the conversations :) I learned that when Medicaid insurance changes in your state it wreaks havoc for patients and staff alike. I have argued more with insurance companies in the last month than in three years combined. They denied an injectable anti-psychotic for a patient that has been stable on it for years. I argued for hours with them, only to continue to have them deny it. Thankfully, with the help of an amazing drug rep, who used to be a nurse, we were able to get her several months of free injectables and she can remain stable while I continue to advocate for her. Apparently the insurance company thinks it would be cheaper to hospitalize her when she lights herself on fire or drinks bleach, both of which she has done when not on her medication. The psychiatrist I work with is correct - "the hardest part isn't connecting the dots, it is collecting the dots". Getting a "thank you" from a patient who went from being acutely psychotic to much more level means a lot. She remembered that even though she had to be restrained for injections due to some violent episodes, that we were all "nice and didn't judge". wish I had more patients like that.

I'm so sorry to hear.

I did essentially the same thing - went from working 3 12hr night shifts, EOW/H, etc to a Mon-Thur 10 hour a day job. No weekends, no holidays, no call. I took a $5/hour pay cut. Don't get me wrong, it was pretty rough on the wallet at first, but I just changed my budget around and got it figured out. I also stayed PRN at my original job and earn extra cash that way - is that a possibility for you? Every single Thursday at 5pm I thank my lucky stars I got my job because I get to go home and enjoy my weekend with my family. I think you are making the right choice as you will be in better situation re: mental health for your family.

I'm not sure where you are located, but I can tell you that PMHNP's at my jobs make between 80,000-100,000. I am in the Midwest.

Just yesterday my patient told me multiple times all the reasons I was going to hell. For one, he knows that I am fornicating and that is a sin (I live and work in a small town - he says he saw my boyfriend and I at a store holding hands, so obviously we have sex haha). He then told me that he was going to pray to God that I didn't sleep for 7 days, and that when I went to hell not even "1000 ice chips" could help me. I tried explaining that 1000 ice chips was not a large amount, but that didn't matter. After he left I got two "anonymous" voicemails that consisted of whispers stating "hell...that's where you are going". The whole day cracked me up!

(disclaimer - I work psych, so I get insulted every day pretty much). Just today a dad of a patient got upset that I wouldn't refill his kid's meds because she hadn't shown up for her last 6 appointments (she is underage so it is his responsibility) and I found out she had another prescriber that last filled her meds. He apparently didn't like my answer so he called me a "******* retard" at which point I promptly hung up on him. I had a borderline patient that I was a 1:1 with call me so many terrible, horrible things that I thankfully found hilarious. At one point she told me I should go work on the street corner like the "ratchet white a** hoe that I was" because I would probably make more money. I told her that I probably would make more and asked her which corner she suggested since she seemed to know so much about it. I'm one of those people that tends to laugh when people are mean or disrespectful but I come back with a slight barb of my own if needed.

I did the same thing as a previous poster - in 8th grade science, students all had to read paragraphs from the book and my paragraphs had the word "organism" in it. Dang if I didn't say "orgasm". I kid you not, my teacher went through the rest of the book and highlighted every time the word organism was written - want to guess who had to read those sections? To this day I still take my time to say the word for fear of messing it up!

I work psych so I hear interesting things every time I work. I had one patient who came out of his room with his socks falling off his feet - me: "XX, your socks are falling off, do you need help?" pt (completely deadpan): "You make me stiff". My coworkers and I could not stop laughing! When I went to give a patient an injection, he said "you'll like it, I left my butt all crusty for you". Um....thanks?

Graduated August 2012 with my BSN (previous BS in Criminology) Took boards in October 2012 I didn't start applying to jobs right away because I knew I wanted to move out of TN but I wasn't sure where I wanted to go - eventually decided on Iowa (regretting it this winter). Applied for two jobs in November got got offers on both at the end of November/early December. I started in January 2013 because getting my license switched over took forever (one of the jobs was across the border in IL). My full time job was on a psych floor that I still love and work at, and my part time job was on a med-surg floor that I hated and left not long after.

I work as an RN (BSN) and I live in the Midwest - I make nowhere near $80K. Every hospital in my area starts between $20-$25/hour. In my area you can't even remotely expect to pull in that kind of cash. I wish I did, though! Thankfully if I pick up OT my hospital doesn't call you off later that week - management knows if the OT is needed then that helps us prove that more staff needs to be hired (which is not easy on a psych unit).

I also graduated recently and got my first job in a psych unit at a hospital. I really only applied to psych jobs, since that is what I knew in my heart I wanted to do. However, I enjoy the more medical side of nursing as well, so I also got a PRN job on a med-surg/oncology floor. That way I get to do my psych nursing and I still get the experience in case one day I want to move to an ER or something along those lines. Maybe PRN medical is an option for you? Good luck!

I worked a full time job while doing an accelerated BSN program. Several of my classmates did as well. None of us were close to failing - you just have to prioritize your time amazingly well. On another note, I graduated in August from a school in TN and moved up to IL in November. I started applying for jobs the first week of November and had a job 3 weeks later. None of the jobs I looked at required a Masters, but 95% did require a BSN, so I think you are very smart for going that route.

I am in a similar situation - I applied for my IL license (took and passed my NCLEX in TN) last week and it was not an easy process. No one ever answers the phone on any of the numbers you call. What I would suggest - apply for the temporary license as well. That gets to you within 2 weeks after they get it (supposedly). The permanent license takes 4-8 weeks! My employer will let me work on my temporary license until my permanent one comes in. I sent off my permanent application and my temp license application separately. The IDFPR website is just not put together well, but it is what it is. Good luck and I hope you get your license soon!

mcuatlacuatl - thanks for the post! I'll definitely look into Mercy in Clinton. What type of floor do you work on? That is a good sign that you have been there for 9 years - they must treat their nurses well! Thanks again!

Yup, Illinois isn't, but hopefully will be soon (legislature has been written to get them to be involved as a compact state). I'll definitely look in to Janesville. I forgot about Clinton - thanks for reminding me! I have also peeked at a few hospitals in Davenport. Right now I am so open minded as to where I will go it is crazy. As long as it is driving distance then it is an option for me. I know that, regardless of what the news says, it is still not the easiest thing in the world to get a job with no nursing experience even with the degree. What type of floor do you work on now?

ColleenRN2B - can you give me some names in the border area of Wisconsin that have good hospitals? What type of pay difference are we talking about? I am also looking at Quad Cities, which includes some Illinois towns, and I imagine they might pay more as well. Here in Tennessee the pay is not all that fabulous - we start out about $20 or $21, but to earn that after 7 years is crazy! I have two Bachelor's degrees - one in Criminology and then in Nursing. I eventually would like to work psych, but I feel like I need regular nursing experience first. Driving isn't a horrendous deal for me, I just have to re-learn how to drive in the snow! I grew up right outside of Chicago but have lived in TN and FL for the past 10 years, so that skill has diminished, lol. I appreciate all the help so far! docbacon - hey, have you tried the Red Cross? I can't get their class website to pull up, but I imagine if called they would answer. Eastern Iowa Community College shows that they have both classes, but I'm not sure when they offer them. Here is the link for that: EMS Classes - Eastern Iowa Community Colleges

Hey everyone, I am hoping for some advice. I graduated nursing school August 9th and am taking my boards at the end of the month (eek!). I live in Tennessee currently and that is where I am taking my NCLEX. I plan on getting a job down here until I can find a job in Iowa (and get my license transferred, etc). I am moving in with a family member in a small town in Iowa that is about 30-45 minutes away from Dubuque and QC. I was wondering if anyone could give me some advice as to which hospitals hire new nurses (no experience...I have worked in the criminal justice field for years) and just general views on the hospitals in each area. Trinity in QC had a few new nurse jobs open, but I have heard that they still expect experience, just less than 1 year. I appreciate any and all help, and can't wait to start my career up there!

I just went through an 18 month BSN program while working full time. For the first semester I even worked full time and held a part time job, out of financial necessity. Like you, I wasn't able to quit or only work part time. Like the above posters said, it is not easy and you will miss out on most things you used to do. Friends calling to go out to dinner? Gone. Taking a Saturday morning to just relax? Maybe once in a blue moon. You have to prioritize. I had calendars everywhere - in my purse, in my planner (which made it have 2, but that is what worked for me), in my car and at work. On my lunch breaks I studied. I didn't sleep much; I would have clinicals until midnights on Tuesday and have to be up at 530 to get to work on Wednesday. I didn't get very many A's, but B's were not out of the question. Partner up with another student or two and make study guides for the exams - that was one of my saving graces. Good luck, and you *can* do this!

I am curious if anyone is in the Mt. Juliet night program (for those that already have a Bachelor's degree) right now? Either currently enrolled or starting in January. I am starting in January and am feeling like they are very unprepared. The teachers are set up and there is no exact schedule yet. I am beginning to get concerned about the reliability of the program. When I applied I was told it was 5 continuous semesters (Spring, Summer, Fall, Spring, Summer) and now I am told they might not have summer classes, which would put me a year behind. I am hoping to get information from someone who is currently in the program. Do they seem to have it more together once you start? What is their reputation like? I know the day program gets good reviews, I just don't want to waste $40,000 on something that won't work out well. Any help is very much appreciated.