Umberlee

I have a bag I used for home health visits for years but with times changing as they are, I need to upgrade. I'll now be hauling around a laptop and work phone in addition to my nursey things, so rather than a home health bag and a laptop briefcase I...

I'm set to graduate my program here in Colorado shortly, but I've read somewhere about states requiring a new contract due to past action and I can't stop fretting about this. A move to PA is a possibility and when I emailed the PNAP director to ask ...

It seems that this forum is heavily crisis stabilization/inpatient, and the public health nursing forum is heavily medical. As a community-based psych nurse, I'm desperate for a little networking and camaraderie with other ACT/CTT nurses. I'm part of...

I spent 12 years working in a residential setting for adults with brain injuries, but only part of that was as a nurse. Then I went to group homes for the developmentally disabled and then acute psych, then to community psych. So with BI/DD/MI I've...

Different places have different names/titles for direct care staff in psych settings. We used to require our mental health workers be CNAs, but now the job qualifications emphasize more training or experience in behavioral health. Most of our menta...

I'll admit I was kind of appalled when I started working the floor at my psych hospital and saw the lack of comfort that long-term psych nurses had developed regarding routine medical procedures. I've even worked with a few psych nurses who stated t...

Part of the issue is that the fidelity model we're following is one provided by the state, since they are funding the grant paying for our team. It's quite a bit different than the model espoused by NAMI, and missing key components such as having a p...

Yeah, your staffing is insane compared to ours. They expect us to take on 40 clients with the 3.7 FTE staff we have now. And one car, and double-staffing appointments. Honestly we couldn't stop double-staffing even if our team lead and management dec...

Ugh, I feel like such an idiot...I have a client who is getting stable on haldol decanoate, but he is gaining weight due to taking PO lithium as well. I gave his decanoate in his deltoid, per his usual preference, but I was on the fence as to whethe...

This has been a big issue for us too...housing is such a problem, and when these guys disappear onto the streets it can be soooo tough to find them and figure out how to keep them stable/safe/etc. We also have quite a few clients who are chronic can...

Awesome, now where can I find 40-inch heels??

I've been thinking about this more and more recently. My very first job as an LPN I was made to take out my nosering due to my supervisor's opinion that it was "unprofessional." As I'm feeling some sort of early midlife crisis approaching, I have the...

One of my jobs is as a nurse contractor, and that's about the "alonest" of a nursing job I've gotten. I do 90% of my job via phone calls, texts, emails, and faxes. I don't have to staff appointments or worry much about the day-to-day goings-on in t...

I remember a tiny, extremely contracted little lady with very advanced dementia. She was just like a little ball of a woman, arms and legs and back and everything bound up so tightly from strokes and disuse, she had hardly any range at all. When sh...

I typically see the haldol only given when the patient has a history of addiction.

I worry about violence too...I'm now working a mixture of inpatient and outpatient, but primarily outpatient. As part of a local brand-new ACT team, we're seeing clients in their homes and in the community. So far we have a very small caseload so I ...

Right now I have four jobs, and I'm not all that happy with any of them. My "main" job is only 27 hours a week but it's split over four days which is ridiculous and costs me an extra couple hundred a month in day care. Because of that I picked up a...

I'm consistently impressed with the degree of mental health services offered in my fairly rural community. My husband, in the throes of a midlife crisis, is looking at delving into the mental health field as well. Wondering if anyone thinks that the...

Well it sure depends on what kind of psych nursing you'll be doing. The outpatient side is a horse of a completely different color and there are patients all along a continuum of psych disorders which can all benefit from some degree of nursing invo...

I really wanted to get med surg or more home health experience and then work in a wound clinic, hoping to go on to get my FNP and practice wound care. However, after struggling with an alcohol and prescription drug problem, I found myself blackliste...

I work psych, so I've become fond of Phil Barker's Tidal Model of Mental Health Nursing. Apparently Phil is pretty anti-psychiatry and since I'm going for my APN in psych I really want to take a different, more nurse-like stance to practice than the ...

I guess it's preferred that "pseudoseizures" be phased out in favor of conversion disorder (pt is diagnosed with both) but we have a pt now who presented with pseudoseizure activity all day. If she were having actual clinical seizures to this degree...

There is no postictal state because she isn't..."ictal." I think it's a bit unfair to just characterize it as being something she should just knock off. We know what's wrong...she's having seizure-like activity. She isn't having seizures. The medi...

I keep reminding myself of this wise adage, but despite this, I can't seem to get over the desire to try and make amends with my former employer. I worked there for 12 years and reported myself for diverting. If I had known then what I know now, I w...

I tore a young incomplete quad patient's urethra once. I did not insert to the hub (and his anatomy was, ahem, undersized). I definitely got urine return first but wasn't careful about keeping the cath stationary and he must have spasmed a bit as I w...