Hukilau

I have an associates degree RN, a non-nursing BA and a non-nursing MA. In my experience as a hospital based psychiatric nurse, none of that ever mattered. Salary and raises were based strictly on merit and time with the company. The only thing that added money was the ANCC certification. (+1 or 2 dollars per hour) After 13 years at my last job I was making 132k/year and I'm pretty sure I was just about at the top of the range.

My story is not so much about the test as it is about the wait for results, You see, children, in ancient times you had to wait FOUR WEEKS to get results after you took the test. I had been working as a psych tech while I was in school but as soon as I graduated I could work as a provisional RN. I literally went to work one Friday as a psych tech and went back to the same unit Monday as an evening shift charge nurse. But here's the catch: If I failed the boards I could no longer work as an RN, AND they had given away my psych tech position! During the 4 year, er, 4 week wait my emotions ran the gamut from (I know I passed) to (What if I didn't pass?) to (Oh, No, I'm pretty sure I failed!) and then back through the cycle. On the day the results were posted I had to go downtown to an office where there was a list of names posted on a wall with scores off the right. There was no separation so it was hard to be sure you were connecting the right score with your name. I passed! But I completely forgot that my friend made me promise to call when I got the result. So I'm driving around aimlessly singing Phil Collin's "Something in the Air Tonight" while my friends are thinking I jumped off the Pali. Well, that was many years ago but I still consider getting through nursing school the best, hardest, luckiest decision I ever made.

I was out of travel nursing for 13 years. I used to check a couple of websites that had extensive listings, then I would contact the (usually) one agency that had a listing I liked. At one point I had six active licenses. Fast forward to 2019. INDEED tries to monopolize the Google searches. You can tell if a facility is desperate because they will be listed with as many as 6 or 8 different agencies. Here are a couple of things about looking for a placement that make me want to scream... Facilities that brag that they are part of the LARGEST, BEST, MOST COMPREHENSIVE etc. medical groups in the country. Invariably, the biggest networks have the worst reviews. "Only care about money" "Dangerous" "Severely understaffed" "Management doesn't care about line staff" are common remarks. Agencies that start job descriptions with glowing reviews of neat things to do in the area. Just tell me about the job! I'd rather take a good job in Duluth that work in a death trap in Malibu. Then they spend two or three paragraphs with generic, meaningless job duties. OK, enough venting. How do you search for a travel psych RN position?

The last travel assignment I worked I made it clear that I wanted to work only the inpatient units and not the psych ED. I even got a letter from Human Resources verifying that I would only be placed on the inpatient units. First day of orientation my assigned unit was "psych ED" I said, "That's not happening, I will walk away." During the two weeks of orientation I was told several times, "Oh, you're assigned to the ED" Then, when I finally got on an inpatient unit, it took another week to get credentials for EMR and medications. By way of explanation my manager said, "Well, you weren't supposed to be here anyway." I stood my ground, did my 13 weeks, and got out. You are entering a legal contract. You can negotiate anything you want to. If you don't stand up for yourself, nobody will.

Most of your reply makes good sense, but I am a little disturbed by your last sentence. It's possible that some pts might be strongly opposed to having their room tossed because they are trying to hold onto some sense of dignity during a difficult time in their lives. To suggest that you should perhaps be MORE suspicious because someone objects to such an over-the-top invasion of privacy suggests a lack of understanding of basic human dynamics.

I have worked in at least a couple of dozen different psych units all over the country during the past 30 years. Every place has a different policy regarding safety checks and searches. i can assure you that you are on the extreme end of the spectrum. Q shift checks are way beyond the norm. Having patients turn out their pockets after being off the unit is way beyond the norm. You are correct that there needs to be a balance between safety, privacy, and what is reasonably possible with the resources you have. I would suggest that you research psych facilities in your area, or similar facilities anywhere, and find out what the norm is. Don't expect your nurse manager to be swayed by the evidence, however. One thing I have learned is that, with a few notable exceptions, once a manager believes that things MUST be done a certain way, no amount of evidence to the contrary will change their mind. Actually, this also applies to staff who have only worked at one facility. Here is a reasonable plan based on the best I have seen... usually worked out by experienced staff during many years of practice: 1)Take all pt. belongings BEFORE they come on the unit. Have the belongings searched by staff and separated into four piles: Stuff they can have back immediately, stuff that needs to be locked up and used under supervision, stuff that will be locked up and returned upon discharge, and illegal stuff that will either be destroyed or turned over to authorities. If your pts all come through ER or from other hospitals, it's best if they're changed into hospital gowns before they come on the unit so their clothes can be searched. 2)Do check everything brought in by family/friends. Allow visiting only in community areas that are monitored by staff. 3)Do check pts on return from pass. (Few places actually allow passes any more.) 4)Have Day and Eve charge nurse do room to room rounds at change of shift, but this just needs to be a quick look at each room. 5)If there is reason to believe that there is dangerous contraband on the unit, call a community meeting and have two staff search room by room, with the pt present if they so desire. This should happen rarely. 6) Finally, teach all staff to be constantly observant. When you need to go in a pts room, look around. If you see something that shouldn't be there, calmly let the pt know that you need to take it. Most of the time, pts will act as they perceive you expect them to. If the environment is one of suspicion and total control by staff, then pts will not feel obligated to show any responsibility for themselves or the community. Enough. I hope this might help generate some thought and discussion at least. I have helped start two different units from Day I and also helped two units in the transition from open, totally voluntary to closed invol., so I've thought about and worked on these issues a lot!

:chuckle :chuckle :rotfl: Thanks! I needed the smile...

As I understand it, you will always be diabetic. That is, it is possible that with a proper balance of diet and exercise you may be able to maintain your blood suger at safe levels, you will never get back to the point where eating sugar won't spike it way above what a normal person would get eating the same thing. But you need a lot more information than you're going to get here on the forum. You need one to one counseling with someone who does this for a living. Note: you will find some claims that diabetes can be "cured" through various diet and supplement plans. That goes against mainstream theory, but who knows? If you discover something that cures your diebetes please post it here. The catch is, a standard ADA diet is really what everyone should be eating anyway. (Heh... I used to drink 6 to 10 Cokes a day along with a half gallon of orange juice, quart of whole milk and a Cinnebonn here and there. Then one day at a routine physical I had a FBS of 174. You know the rest of the story...)

When you hit "slideshow" do you get choices like "animation scheme" "custom animation" and "slide transition"?

Yikes! I have 2003... I thought that was about the same as 2000. Hmmm..... Do you see anything that says "slide design"?

When you open PP, click on "view" and make sure "task pane" is checked. The task pane will be to the right of your slide box. Click on the dropdown that says "getting started" at the top, then click "slide design" and "animation schemes". Play around with that for awhile then try a couple of the other features. There's more, but that should keep you happy for awhile!!

I am now wondering if this was a bogus post to begin with. Maybe some kind of class project in a nursing management course. No one could be as hopelessly out of touch as the OP portrayed himself to be.

It is really great that you are thinking about these issues! I believe most of what you stated above was, indeed, the intended use of the Mental Health Advance Directive. But the patient should still have the right to refuse medications, even if he previously agreed to it. That's the part that has been abused. In one state where I worked, an advocacy group went to another facility and had patients sign the AD, which then came with the patient to my hospital. During the interview, it became apparent that the patient had no idea what he had signed! And yet some staff were trying to say we could medicate him even if we had to restrain him to do so because he had signed a document that listed that medication as OK! See the potential for abuse? Your basic admission interview should cover what is most and least helpful to the patient when he is out of control.

I am about to take an assignment with Bestaff in MA. My recruiter, Matthew, kept working on the assignment even though he knew my first choice was somewhere else with another company. Guess what? The other recruiter was not keeping in touch to tell me what was happening. Matthew kept working and maintaining contact. Made me feel like he was paying attention. I hope to keep working with him for several more assignments!

Look at the post. He "heard it through the grapevine." That deserves no credibility at all. I lived in Hawaii for 25 years and worked in several of the hospitals. It's just like any other major city. There are good and bad experiences. Honolulu attracts some of the best and brightest healthcare workers, and some of the worst. Here's the bottom line: You can do anything for 6 months! Go try it!