phattass

I don't think that before Orlando I would have put my hand up to be counted on this site, but if I'm to gain anything positive from this tragedy, it is to find my strength to face environments like this where many are so quick to start hating. I'm an out gay female nurse who until recently was married to an out gay female nurse. Thankfully, I've known respectful work environments for about five years now. It wasn't always, and still isn't for so many. I'm lucky to live in a very large Canadian metro with a huge gay community, so it has helped make us visible. Having said that, Orlando has struck so much fear in me. I would normally go to some of the smaller pride events but feel like I may not this year out of fear. This makes me sad as I've never had this reponse to a senseless shooting before. I do know that this tragedy seems to be having the opposite effect than expected. I see more allies, more love, more inclusiveness. Yes, like on the article thread, haters are coming out in large numbers too, but overall, I think love is winning. Love and healing to everyone affected by this horrible tragedy.

I am so very sorry you are having to put up with this. It is 100% unacceptable! Studies back in 2012 indicated that at least 60% of new nursing grads leave their first job within the first year due to nurse on nurse bullying. I totally get how stuck you must feel, knowing how important that first year is for consolidating your skills, but also for your resume. I'm afraid I don't have any useful advice for what you can do, but I want you to know I am sending you positive thoughts in the hopes that you find the strength to survive and address this.

On the units I have worked, we often needed to call the police. It was supported by management. As for close obs, a nurse can increase the frequency without a doctors order (even seclude but need a dr order as soon as you have secluded and only in an emergency) but a nurse cannot decrease the frequency without a dr's order.

I'm so sorry you are feeling discouraged working in psychiatry. I think you are describing the barriers that are so often faced in psychiatry. I personally think that this may be a combination of the reality of mental health as well as a tough unit milieu. I'd certainly give psychiatry another try on another unit before throwing in the towel. Psychiatry can be so rewarding if it's where your passion lies, but the reality of health care today can really get you down fast. I hope you find the answer you are looking for soon!

I can't stop blessing everyone's heart since I started reading AN!!!!!! The whole office has been blessing everyone's heart the last few days! Oh, you really did finish Social Work school bless your heart

Gosh, it's too late now to change my answer?? I just remembered I married a nurse! Run away fast...very, very, very, very fast!!! Just kidding of course, though I agree, two nurses can be a handful and we never have and never will work together. :)

I think I "get" what you are saying. I'm married to a "head-in-the-clouds" nurse. Head-in-the-cloud got the exact job as targeted in school absolutely against all odds. I would have never guessed it was possible. I'm a feet-on-the-ground kind of nurse. I'd stick with a single conversation about the issue and then drop it. No amount of lead can get head-in-the-clouds back on solid ground and you just end up getting bruised jumping up there all the time trying to convince them to come down. :)

I've given more long-acting IM's then there are people in Iceland. Each semester I get new students and each semester someone has new methods they have been taught. Some semesters I have two differing methods coming at me from new students in the same class. I follow the protocols from where I'm working. I still swab with alcohol (wasn't that supposed to stop like eight years ago), I z-track when possible (been back and forth and back again on that one over the years) I wait with the needle in for as long as the patient (or I) can tolerate it, if it's safe to do so (again, over the years this has went back and forth...usually between five and ten seconds IF possible) and I ALWAYS aspirate. I've drawn up blood only twice with aspiration. I have had about four incidences where the pt spurts blood following injection and have seen quite a few injections where the long-acting oozes out if given without z-track. (Been seeing a lot more bleeding with consta). I've also seen blood spurt across the room and onto the face and arms of the nurse....with no noticable "error" in administration. As for "flicking" safety needles...it depends on the situation. You, the safety of your co-workers and the safety of the patient are all huge factors. I've see a nurse flick and the liquid flew right into her eye off the needle as she engaged the safety mechanism. I've seen too many needle-stick injuries, both with and without the safety syringes (though most during the transition period with new safety syringes). I've done a lot of different methods while in a seclusion room with way too many bodies trying to gain control. In some cases you do what is safest..right or wrong....sometimes that will mean a finger flick, sometimes the bed, sometimes dumping it into the metal prep tray uncapped. It's really hard to do by the book when you have six to ten people in a dog-pile but that is when you have a great chance of an injury. I'd be up on what the facility protocol says and follow that. If the policy is clearly outdated, then it may be time to discuss new protocols. Protocols for long-acting injections need to be specific, as they are not the same as injecting other medications or vaccines. Good luck and play safe!

AWWWWWWWWWW....ask her out! and heed all the above warnings. Good luck!

yay! a fun questionarre! ummm...where is it? 1.) what type of nursing licensure do you have? please check or type your title. registered psychiatric nurse 2.) how long have you been a nurse? ten years or more 3.) what annual salary do you expect as a nurse with your amount of experience? 75k or more 4.) what type of nursing education have you received? bspn 5.) what type of facility do you work for? health region 6.) have you ever worked on a medical/surgical floor? yes 7.) what shift do you work? 8 to 4 or 5 or 6 or 7 or 8 or 9 or when i finally stop 8.) do you like being a nurse? sorry....is this the fun part???? most of the time 9.) what kind of nurse are you? a damn good one

I think you are at your best if you consolidate your skills in the first year in one place, BUT....I like your plan to do some acute psych and medical ER. :) Best of luck!

"Making an early warning signs list", medication management, navigating the ___________system, "making small-talk", symptom management....bonus marks if you make them fun!

Yes, if your staffing ratios are good then it's a great environment to work! Have fun!

IMHO psych ER is advanced practice. I've seen people start in ER and get faced with losing their licenses fairly quickly (usually having to do with someone suiciding after ER assessment). For what it's worth, I would recommend at least a year minimum (two to three would be great) on an acute psych unit before venturing into psych ER. New grads have done it and survived, but ultimately I think it's a huge risk...unless you would be working in an ER along with another seasoned nurse all the time. Most psych ER's I've encountered only have the one nurse at any given time.

Oh shoot.....I wish I would have known about all this BEFORE I got my dead brother's initials tattooed on my ankle!!!!!! Crap....and now I can't seem to find the sarcasm icon.