PRNMEDS

We have 1-1 eye contact, and 1-1 ARMS LENGTH eye contact. The later is for our very impulsive, self-injurious. for our regular 1-1 staff generaly sits in doorway of room. Also often the order will be for "While Awake" so that when patient goes to bed at night staff has a little more flexibility and monitors every 5 minutes.

You constantly hear that you should get at least a year of med surge under your belt. I suppose there is no harm in that - but for me I knew I wanted psych and went right to it. 7 years later and I don't regret it at all. I can't imagine doing med surge full time, so why waste a year?

I have never heard of it being contraindicated. I am pretty sure have given (though can't recall when). Did you check med book? I know Benadryl and Cogentin are contraindicated but don't see how cogentin and Haldol are.

Our hospital has recently gone to the nurses either wearing Scrubs, or having a lab coat. However, they also don't seem to mind if wearing a smock type top with cartoon figures or what not on it (its children and Adolescents only). At first the nurses were peeved, but it has really been a non issue.

$28 - 30 to start in suburbs of New York. It really depends on years of experience, type of degree etc. These will alter what you get. I believe salary is the same as med/surge.

We have a 63 year old RN who works 3p -7am on Fri, Sat, Sun, Mon. Don't ask me how she does it but she does week in and week out - So I imagine sat & sun wont be that bad. Good luck.

I never heard of an incompatibility. We give it all the time at work. I will double check with our pharmacist, but again I have personaly given it a few hundred times over the years.

Great movie - hard to believe its only like 50 years since that stuff happening. If you liked that try FRANCIS - another great movie about Francis Farmer (an old actress) and her plight throught the psych world. CHANGES - less restraints. Restraints not lasting for hours, days, and weeks. Right to have court review if really need treatment - non vouluntary treatment decreased.

Cost of living or no - I think I am ready to move to Northern NJ - WOW $82 an hour!!! Thanks to all those that responded.

I have not seen anyone with EPS from Geodon - but I am sure it can happen. My esperience with EPS is that when you see it - you know it. It would be difficult to fake - the muscle tension etc is hard to maintain if not for real. I can't believe the doctor would not treat it. You should speak with your Nursing Supervisor or Director about that. Haldol and Benadry can be mixed. Its Cogentin and Benadryl that cant be in syringe together.

I hear this argument at work a lot. Staff will say what are they learning? or what will they do when they are home. My answer is usually - they are NOT at home they are in an ACUTE psychiatric setting. Its hard to gage when someone is "really" feeling anxious, why do they need to become visibly anxious and disruptive to get a PRN? That they are in the hospital indicates that something is wrong. That they are choosing to ask for meds to get through a hard time seems reasonable to me. If they are getting to many - then the doctor should be notified, and it should be discussed in Treatment Planning. Perhaps the doctor does not have them on enough standing meds.

It seems to be a taboo subject, but I am wondering what the average wages are in various places. Does it vary a lot from state to state? (guessing yes). Anyway at my hospital in suburb of NYC - RN start at $27 - $29 an hour (more if have many years exp.) How does this compare with others that use this site?

I also had BA in Psych. For me I went back and got an Associates in Nursing. I was able to transfer most of my classes (except Bio, Chem, and of course the Nursing classes.) Took me 2 years. You could go back for Bachelors in nursing, excelarated classes etc. To me the Associates in Nursing is fine - I have a BA, and my Nursing license and most hospitals are not requiring a BA in Nursing. So why spend extra time and money for something you don't need. Associates degree is much much cheaper, and faster.

During the past year my hospital has also had a big push for NO RESTRAINTS. It has involved a huge change in philosophy. Charlies example of patients up struck me because we have done very similar. We also had a strict lights out, in bed policy. We still dont allow patients to use TV or common area but they may sit in room and read, play cards, games etc. This is only one example, during the day we have stopped fighting the kids on many fronts (going to room during quiet time etc.) and amazingly the restraints are dropping. Also if a patient is in restraints 2 times during a 72 hour period we have a special team meeting to come up with ideas to prevent further restraints. Its hard getting staff to buy into it, but if everyoned working together you would be suprised (I certainly am) how they can be reduced, and with less restraints - less staff injury.

I worked during my time in Nursing Program - but only part time and very flexible schedule. It will be hard doing full time Nursing and working full time. I did most of my sciences and stuff PRIOR to being in Nursing - but did take a Bio (A&P II?) and Chemistry class while in program. If you plan to work full time you may be better off delaying entry into Nursing and get as much of the Bio and Chem classes out of the way. Believe me the Nursing Program is going to consume your time and energy.

I graduated BCC in January 99. It is a very good program. However, be prepared to work very hard, as it is very demanding. The proffesors (at least while I was there) were knowledgable, but very strict and demanding - its a no nonsense school. The good news is when you graduate you are well prepared, and the licensing exam is easy compared to the tests at the school. Good luck.

I have had similar experience. You have to do what makes YOU happy. If they want to clean bloody wounds, ****** stomas, and all the other things I hated on med surge - good for them. We all have our likes and dislikes, and some of us are meant for Psych.

Your feelings are normal. I work with Adolescents, and often feel the same way you do. Just remember that many of these kids have never had anybody care enough to say no, or to try and teach them the "right" way to do things. Of course sometimes frustrated, and not the most thereapuetic - even though we are nurses we are still human (I think anyway :rotfl: ) so nothing is 24/7. Do you have a more senior nurse or therapist you can speak with when feeling extra frustrated. I know at my hospital many people feel what you described and we sometimes vent to each other. Believe me I would be shocked if you were only one there who feels that way. My advice - get a few co-workers together and go out to "Happy Hour" - feel a lot better when you return to work on Monday.

Once you get your license you can apply to any kind of hospital you want. So can choose if want to work with Alzhiemers, or general psych, or Adolescent Pcyh etc. (wheter you get hired is another matter). I would think there is a need for LPN's as there is a nursing shortage. However, I would advise you to go on and get your RN as the trend (at least in NY) is for RN's and LPNs are less in demand. As for having a Psych degree - that is a plus, cant hurt. "Getting ahead" not sure what you mean. If you mean money, not sure there is big difference between psych and med-surge (if specialty like ICU, or PICU then imagine is bigger difference). IF you mean advancement to administrative things - then get your RN or you will be really limited. The bottom line is if you enjoy Psych, then this should not be a big deal. Don't worry about being "new" and posting, this site is for everyone and you should not feel ashamed to ask, thats what this is for. Hope this was somewhat helpful, good luck. :balloons:

I have a BA in Psychology, then went back for my degree in nursing. I think it is helpful to have the Psych Degree for a few reasons. For one it gives you a better understanding of the different disorders that your patients have. Also gives you a better background on developmental theories (ie Erickson, Freud, etc.) if you end up working with children or Adolescents (my nursing school only gave an overview of this, in Psych learned a lot more). Finally when going for a job as a psych nure - how could it hurt to have a psych degree? With regards to everyone saying get some med-surge experience, I think that is basicaly good advice (though I personaly believe overated), but is mutualy exclusive from getting a psych degree (along with your RN). You can get both degrees, then work in med-surge for 6 -12 months. Good luck.

Agree with Charlie. and check your PMs

We had the same smoking problem (18 + could, 17 or younger NO) - but last year went to a total NO SMOKING and it has worked great - less contraband, less sneaking of smokes etc.

At our hospital - 18+ is automatic ADULT Unit (we only go up to 21 years of age) - regardles of any other criteriea. We have allowed 16 and 17 year olds on the Adult unit IF the treatment team decides that the patient is more suited for the adult unit and would benefit from being on that unit. OMH (Office of Mental Health) has been givign hospital a hard time about this of late, and now the hospital must give rationale for move, and request OMH approval PRIOR to moving anyone under 18 to the unit.

At my hospital (I work with Adolescents) we only give IM if there is no other choice. If a patient (even if out of control, violent and/or requiring restraints) is willing to accept a PO PRN that is what they get. What is the point of giving IM if they can take it by mouth? The IM will work only slightly faster then the PO (especialy if liquid or Zydis). As for Adolescent Rights - at least regarding meds - it is basicaly NO different then that of adults. You can't force them to take meds, unless they are a danger to self or others, in which case you then may need to force an IM. But in case you describe this does not apply since the kid is WILLING to take the PO PRN. I think you should bring this to the director or Safe Care, the Medical Director or the Director of Nursing. Giving an IM is invasive and should be avoided, especialy if patient willing to take by mouth. Again - What is the benefit of IM rather then PO?

I think this issue has been discussed numerous times in this forum so you may want to check some of the older threads. That said I will post a quick reply that hopefully will be of some help. REMEMBER: 1. Be yourself. Don't try and act a certain way because you think it will impress the patient or gain their trust etc. They will spot a phoney immediatley. 2. Always treat patient with respect, and dont lie to them (make false promise etc.) If you say you will do something - DO IT. If not you lose there respect immediatly. 3. Maintain boundaries. Sounds easy but can be difficult. Patients will try to erode this and be your friend. Your not there to be a friend, yout there to provide profesional help. You want a Theraputic Relationship, not a personal one. 4. Always be alert and ready to respond. No matter how calm or rational a patient may seem there is always potential for irrational and possibly violent behavior. Remember they are in a Psych hospital for a reason. 5. There is always other staff and or supervisors that will assist you if you need it, and dont be afraid or ashamed to ask for help. As for what should be thinking about: How can I help this patient. What can I do that will help him or her most. POSSIBLE SITUATIONS: ANYTHING. You never know what you will encounter. Depending on type of unit you may encounter violent patients, self injurious patients. Patients that are totaly psychotic and make absoulutely no sense at all. Unlike med surge where you can kind of prepare for things (know dealing with post op Knee surgery or Tonsilitis etc.) in psych each patient and situation is different and you just have to ASSESS the situation and do what needs to be done. Final piece of advice. Try not to be afraid, or at least not show it. Patients pick up on that quickly and if they think you are not in control it makes it even harder for them to be. Good Luck - and would love to hear how you make out.