ms_miyagi

In an effort to emphasize how important it is for my patients to continue to take their medications after discharge, I advise them that their illness is just like any other run of the mill illness that requires daily medications, i.e., HTN, Diabetes, High Cholesterol, Seizure d/o etc. The majority of my patients have these co-morbidities and with the exception of a very few, they are without fail compliant with these medications. So, I play off that information and remind them that their MI is the same type of thing, if they want to get better and do better on a daily basis, so that they aren't stigmatized, they MUST take their medications as directed by their physician. I also advise, when asked, that, at least, where I live, an employer cannot ask about medications a potential employee takes on a daily basis. It is at the employees discretion to divulge that information. And, that as long as they have a prescription for drugs that appear on your average, daily drug screen, that's alright as well. As for sharing personal experiences, if done with the appropriate tone, to instill hope, there is nothing wrong with it. I have in the past shared my struggles with grief and depression with patients in the appropriate situation. These are all teaching tools and as nurses, part of our job is to teach our patients, about their condition, coping techniques, their medications and the side effects of the medications. We must all look for teaching moments, even if the patient is deep in their psychosis, it does work. I don't know how many times I have had patients come in deep in their psychosis for days on end and I will still sit and talk to them as much as time permits, whether or not they acknowledge me and days later, after their medications have been adjusted and are working, they will come to me and tell me thank you for believing in them and taking the time to talk to them What I have seen in my patients is they look at the staff as a bunch of people who have absolutely no clue what their struggle is, and to a large degree they are correct. I have absolutely no clue what it is like to have a/v hallucinations or they type of Hell they create, nor do I understand the paralyzing paranoia that some of my patients suffer from. All I can do is reassure them that they are in a safe environment and that nothing can hurt them there. But depression, grief, and addiction (from an enabler's perspective), these things I can talk about from personal experience and share how I made it to the other side. We do this in group, we share coping techniques, because even other patients can be teachers and share techniques that have worked for them in dealing with their issues. I can also share how my friend's have dealt with their Bipolar d/o. Believe me, when we personalize our care of our patients, we humanize ourselves to them, which go a long way in our treatment of them. When we can connect with them on a level they understand, they hear us, and at least in Acute Adult Psych, this can quite literally save your life.

For my drive into work at nights, at a Behavioral Health Hospital, it's always: "Highway to Hell" by AC/DC and for the drive home: "Welcome to the Jungle" or "Wonderful World" Depending on how bad the night was and how absolutely rotten traffic is.

I fell into Psych nursing right out of nursing school. I had sent out 100's of resume's and this one, little, free-standing Psych Hospital, was the only call I received in response to my application. Funny thing, when I was in nursing school doing my Psych rotation, I SWORE up and down I wasn't EVER going to be a psych nurse. Now 3 years out, I've dipped my toes into Med/Surge for 8 miserable months and went running back to Psych. I discovered that not only is Psych nursing a rewarding field (you can see a completely different person from admit to discharge), it is for the most part a fun field. That's not to say that it isn't one of the most dangerous fields of nursing out there, because your patients can turn on you in a nanosecond and if they are deep in their psychosis, they will hurt you without even realizing that they are doing so. Psych nursing isn't for everyone. I have seen more nurses leave Psych nursing within their first 2 months than any other field. If you don't have a thick skin, and aren't unable to laugh off some one telling you that your fat, ugly, stupid, and the list goes on, then maybe psych nursing isn't for you. Because you will be called everything but what you are, in some very creative ways and you have to be able to remain calm and continue therapeutic communication and education with a patient who can't stand the sight of you at that moment. All that being said, you will never, ever be bored, you will never have 2 days that are the same. You might not get the skills that you would as a NICU, ED, Med/Surge, etc., nurse, but you will gain a set of skills that most people wish they had. The ability to deal calmly with the most violent of patients and be able to calm them down at the same time. You will deal with patients from all walks of life from the very, very rich to the extremely poor and homeless, but we must be our patient's advocate, because out of all the patients in acute care hospitals, psych patients are really the ones who can't speak for themselves, even when they are taking their meds and doing well because of the stigma that is placed on them for having a Psych diagnosis. Even in this "enlightened" day and age, a Psych diagnosis can still cost a person their job, marriage, access to their children, etc. So before anyone jumps on the Psych bandwagon, and none of this was to discourage you by any means, because, here at least, we are seeing a shortage of qualified psych nurses, think long and hard about whether you can work 12 hour shifts with patients being rude and abusive because you don't have their "meds"; being sexually inappropriate because they have no clue at the moment what appropriate boundaries are, getting water thrown in your face when you offer a patient medications when they don't want to take them, having to be creative to get said patients to take their meds when "all I take is a baby aspirin". The list goes on. But, if you find that all of this sounds interesting and highly entertaining, by all means, come on down! We'd love to have you.

Please start to realize that if you are getting the SAME patients for your 2nd and 3rd shift of the week, you do not need the minutiae of what brought the patient into the hospital in the first place, that hasn't changed. However I will be more than beyond happy to tell you ANYTHING that has changed in the patient's condition during my shift.

Here is what I do with angry, belligerent doctors. When they pause their tirade long enough to take a breath, I very politely state, "Dr. when you calmed down enough to speak to me in a civil tone of voice and as one professional to another, please feel free to call me back at 212-555-1212", and then I very calmly hang up the phone. It usually takes about 5 minutes for them to call back and apologize, because by doing that, they can't turn you in without looking like the complete ass that they are, and you have very effectively let them know that you will not be treated like a second class citizen who can be belittled for doing your job.

You will not be able to pay or see your quick results until a minimum of 48 hours after your exam start time. If you are lucky, your license will be up on your BON prior to have to spend another $8. At least that is the way it is working here in Texas for the most part.

For all the soon to be nurses in their 40's. Please let me assure you that passing the NCLEX is an achievable goal. I passed mine last week with 75 questions and I am almost 48, so if I can do, so can all of y'all! Best of luck to all that are taking the NCLEX in the few weeks. Take your time, breathe and PRAY! Ms_Miyagi

Doesn't it feel great to be able to say that you are now an RN?

Try the trick, you may be pleasantly surprised.

I mostly used the NCLEX 3500 (you can find the link on here) and Saunders 5th edition (yellow book) and I took a Kaplan assessment to see areas I was weak in and focused on those areas. That's pretty much it, I didn't really study that much, because I felt that if I didn't know it by now, cramming it in wasn't going to help me pass.

Also, know your nutrition information. Foods that are high in potassium, calcium, sodium. Know your Lab values with criticals, write them on your white board when you are allowed to do so, this keeps them at your fingertips and you don't have to think about them until you need them. Always remember Maslow's and ABC's Know your contact, isolation, droplet, airborne precautions and what diseases require which precaution. Also, remember the harder the questions get, the better you are doing on your test. There is a 99% chance that you will walk out feeling like you have failed your test. Just remember we all do , it's of little comfort but it does help a little. When you get home, do the PVT (read on here about that) and it should relieve your anxiety somewhat. Best of luck!

Word of advice from one who as been there and done that....breathe!!! The NCLEX-RN is so random there is no way to know everything that will be asked on the test. Your best defense is to know how to answer the questions. As a general rule, you can easily narrow your options down to 2, from there apply your critical thinking skills. The day before the test, do NOT study!! Allow yourself some relaxation time. Day of the test, eat a good meal before taking the test, pray and take that test!!! Good luck!!

Took my NCLEX-RN last week, cut off with 75 questions. No matter how many questions you get, you will walk out of there feeling like you failed! Focus on Select All That Apply, prioritizing, delegation and infection control. Know your basic med calculations, drug classes/actions and PRAY!!!! Here are some hints I learned: For the SATA; treat each answer as if it is a true/false question. If it is true for the question, select that answer. For prioritizing refer to your ABC's and Maslows. For Delegation, do not delegate what you can EAT (Evaluate, Assess, Teach). Hope this helps. BTW, I passed that bad boy and am officially an RN!!!! :w00t:

The NCLEX 3500 has a great bank of SATA questions. Some one has posted a link to it here on AN. You should be able to search for it on here. I used it exclusively for questions because the rationales are awesome and I used www.quizlett.com for flashcards for lab values. Just seach there for NCLEX Lab Values I took NCLEX yesterday and passed with 75 questions. Best advice I have for you all, First, realize that you know this; you wouldn't have passed nursing school if you didn't. Second, BREATHE! Third, on test day make sure you eat a good meal that will stay with you for awhile right before the test, you don't want to be distracted by a growling stomach, Fourth, know your lab values and write them on your white board when allowed to do so (brain dump), that way you have them at a glance and don't have to try to pull them out of your head. And last, but certainly not least, PRAY!! You can all do this, go in with the mind set that you WILL pass, think critically and take your time. You will do fine.

Screw calling them back weekly!! I'm telling you if you call her everyday, she will process your ATT, for no other reason than to make you quit calling!! You have to get assertive with these people, they hold your livelyhood in their hands and every day you have to wait to take the NCLEX, the more you have a chance of forgetting. So stand up for yourself, you have just finished, I don't know how many years of school, in an effort to better yourself and follow your dream of being a nurse, and you are going to let some employee of the BON tell you that you must wait even longer? I don't think so!