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  1. Scarlettz

    omg I forgot to give report!

    I forgot to give report before, too. I didn't get too far before I remembered and called the nurse to give report via the telephone. Luckily she was an easy going nurse! On the flipside, I had a nurse forget to give me report before. I tried to call her up but did not get an answer back. In a way, it was nice to know that this has happened to other people. I felt somewhat lost, but it worked out. Like others have said, I now cross off the patients' names once report was given.
  2. Scarlettz

    omg I forgot to give report!

    I once forgot to return a PO Ativan that a patient changed her mind about to the pyxis. I went home and discovered that it was still in there! I freaked out and went straight back to the hospital (luckily only 5 mins away.) The nurses all the day shift thought I was a trooper for coming back. One said, "I would have just returned it tonight." I couldn't believe how laissez-faire the day nurse were about this! I always check my pockets first before heading home now.
  3. Scarlettz

    Brand new nurse already OVERWHELMED and panicking

    I moved away for my first nursing job -- across the country. So, I know how lonely and stressful it can be. I began an exercise routine when I first started out my nursing job. I swam, walked, went to the gym. Not only did I lose weight and feel more confidant but it released stress. Find things to help you mentally unwind. As far as nursing knowledge, did you bring any of your text books/NCLEX study books with you? Choose a topic per day to read/review, or maybe a body system per week an read and refresh yourself. I have been a working nurse for four years and I still do this. Get a copybook and write down important information/labs/procedures. It does not have to be as intense as making nursing school notes, but just writing down this information will help you retain it. Small talk gets easier. I worked in a retail job before being a nurse, so I actually think it helped me a lot in this department. Being polite and saying thank you, please, thank you for letting me take care of you, and I hope you get better soon go along way for starters. If you see that a patient is using some cool looking device, ask about it. If they are doing a crossword puzzle and you like crosswords, say something like "I love crosswords" (Just make sure you sincerely do.) If they have flowers in their room, say they look beautiful, if you like someone's nail polish color, mention it. As a previous poster mentioned, people love to talk about themselves and who does not like a compliment? I am quite introverted but my patients still love me because I care and treat them well. I met someone online when I moved away. Of course you have to be careful about doing that. But, it is a way to meet someone if you want to. If coworkers invite you out, go for it. I started seeing a guy when I moved away so I declined going out when some coworkers asked one day. But, I should of done so if I did not have plans. Explore the town. Small talk will get easier with coworkers once you get used to them. Just be respectful of them and I am sure they will like you. Good luck and don't give up! It will get easier.
  4. Scarlettz

    Nursing pay in Lubbock

    Does anyone know how much nurses are paid at UMC and Covenant hospitals? I have 4 years nursing experience.
  5. Scarlettz

    Switched to Psych, HELP!

    I sort of just searched online or read old nursing material/books on psych. I did buy one psych book that was purely about medications. Here are some medications that I give often and are worth reading up on: Seroquel, Zyprexa, Risperdal, Depakote, Cogentin, Zoloft, Lexapro, Prozac, Ambien, Ativan, Gabapentin, Haldol, Lithium, Cymbalta, Klonopin, Hydroxyzine (I never even seen this medication on med-surg but we give it a lot in osych), Lamictal, Trileptal, Abilify, Geodon, Celexa, Benadryl, Trazodone. Some of the things we ask during our assessments: Are you suicidal? Homicidal? Hearing voices? Seeing things? Eating and sleeping well? Depression and rate it between 0-10, anxiety and rate it between 0-10, pain and rate it between 0-10. I usually ask if something in particular is making them anxious or depressed. If they are suicidal, we ask if they have a plan, if they will tell someone on staff if they plan to harm themselves, etc. Brush up on some labs values: Lithium norm between 0.6 -1.2 (they drilled this into us in nursing school) Depakote 50 - 100/125. You'll want to keep an eye on a patient's WBC level if they are on Clozaril. Read about therapeutic communication and de-escalation.
  6. Scarlettz

    Nursing with awkward introverted personality

    I think it gets easier. I am very introverted and even socially awkward but my patients love me still. I think just being nice and polite and having a good attitude goes along way. You don't even have to be bubbly - just care, don't act like patients are burdens, etc. I think sometimes just listening or asking a simple question is enough. Smiling is always a plus. Asking "Do you need anything?" Or simply just thanking a patient or saying "I hope you feel better. It was a pleasure taking care of you." What did you do before nursing? I held a retail job for many years before nursing. I actually think it helps me a lot as a nurse- especially since there is a big focus on customer service. As far as coworkers go, I think the longer you work there the more comfortable you will be around them. Offer to help a coworker with something if you see they are busy - that will go a long way. Smile and say hello to them. You don't have to be a chatty Cathy, but just being polite will be enough for most people.
  7. Scarlettz

    PP review material

    Hi all, I applied to a postpartum unit and wanted to brush up on postpartum material. Can you recommend some good websites to review, books that are not too expensive, or any topics you suggest I review? Or perhaps just share a tidbit or two that would be helpful. Thank you!
  8. Scarlettz

    Tell me about your PP job

    I am currently working as a psychiatric nurse (FT) and medical-surgical nurse (On call, PRN). Prior to this, I worked medical surgical FT and would float to our PP unit at times. I am interested in making a career change to PP. Some of the things I have include: assessments on mom and baby, gave IV antibiotics to newborns, performed a hearing test on a baby, did midnight weights, did accu-checks on a baby. Attempted to do a PKU but I was so awkward and slow at it (does it get easier?) and some other tasks. Can you please share with me different things you do/are responsible for as a PP nurse? Also if you are caring for a baby on IV antibiotics, do you have to put the IV in the baby or does a NICU or nursery nurse do so? What is the most challenging nursing skill as a PP nurse? Please feel free to add anything -- I just want to be more educated in this field. Also, I am not really interested in L&D. Do you ever have to float there? I am not totally oppose to L&D but would rather not work on that unit
  9. Scarlettz

    L&D Nurse After Stillbirth

    I do not work in OB/GYN nursing, but I am visiting this board because I am interested in going into Postpartum/Mother Baby nursing. I just wanted to share my birth experience as both a nurse and a patient. As a nurse: I worked as a medical surgical nurse, but I sometimes floated to the postpartum unit. I remember floating to the unit at some point after having a miscarriage. It wasn't right after the experience, fortunately, but maybe 6 months later. I can't deny that I was somewhat jealous or sad, but it wasn't unbearable. Actually in a way, it was a hopeful experience. According to one of my patient's charts, the client's first pregnancy ended in a miscarriage. To experience this woman having a full term healthy baby was so wonderful and it gave me hope that I would get my chance someday. As a patient: I had a scary birth in which my daughter had coded for 15 minutes. As a result of the code, my baby had to go to the NICU because she was still very sick and it wasn't clear as to why or what went wrong. I did not know what her outcome would be. It was such a horrible experience going to the post-partum unit without an in-room baby. I've always liked floating to PP as it was usually such a happy time in one's life. I could not wait to be a PP patient someday. So of course, my PP experience was not like what I imagined or experienced when floating. I will say that I had one wonderful nurse that made me feel like a mother. She congratulated me, asked questions about the baby, was sincere, and just went out of her way to make me feel comfortable. I had some nurses that were okay but seemed distant or did not congratulate me or ask questions about the baby. Maybe they didn't know what to say - I am not sure. Or maybe because I did not have a baby in the room, they weren't as available as I would hope. If I decide to go into post-partum nursing, I think my experience will help me care for those mothers who do not always have a happy PP experience. I think that your experience will certainly help you be a wonderful nurse to those who have a similar experience.
  10. Scarlettz

    Tell me about your psych job

    I have been working as a psych nurse for about a year and a half and I am not so sure if I like working there anymore. I think maybe it has more to do with my job duties than working in this specialty/psychiatric patients. In our facility, we have a charge nurse and a medication nurse and 4 mental health assistants. I work as a medication nurse and the job has become so tedious anymore. I work nights, so I spend a lot of time pulling meds for the HS and AM med passes. Of course there is stuff to do in between- but even those tasks have become boring/annoying to me. I would rather have a smaller load of patients where I do their assessment, notes, med pass, etc. My question is, what is your facility/psychiatric unit like? Is there a charge nurse and a medication nurse? Or, are you on a unit where you divide the patients up and each nurse takes their own group of patients? How many patients do you care for? Also, do you have a computerized charting system or paper system? Do the assessments include both a psychiatric and physical assessment? I am just trying to get an idea of what other places are like. I debating as to whether I want to stick with psych elsewhere or explore another area of nursing that interests me.
  11. I find that just being polite and respectful will go a long way. I had a new patient who came up to the med window being loud and aggressive demanding this, this, and that right off that bat having just met. I asked her, "Why are you yelling at me - we just met? I will try and help you with that. But just give me a minute so I can look into it." I am a pretty quiet person and I don't like confrontation much so I was proud for standing up for myself. Turns out that she was just mad because the previous shift had been promising her medications that she did not receive for hours - which happened to be true. So, I can see why she was frustrated and realized she was just taking the frustration out on me. She quickly changed her attitude and apologized to me. However, I would have worded it differently in the future. I probably would not have said, "Why are you yelling at me?" as I remember in psych nursing that Why questions are not really therapeutic questions because it seems like an attack on her and can close communication. I would have said something like, "I can see that you are upset. Let me try to help you" Or, "I can see that you are upset. Do you want to talk about that?" But sometimes in those heated moments you don't always get the words out exactly how you want to say them. But, I think my willing to help her made her change her attitude. It was also a learning experience for me. Sometimes being quiet and listening is a better option. I had this manic woman who got upset at another patient and then she started to be verbally loud at me when I tried to speak with her. She started rambling about something unrelated to the situation that made her upset. I tried to speak with her, but that seemed to set her off more. Instead I let her finish what she had to say and she just climbed right into bed and went to sleep. During all this, she was actually inching closer to me as she was screaming and I just kept taking steps backwards as she moved forward. I have had a very small handful of patients say something about my appearance. It was actually not even to attack me directly. The couple people who mentioned my appearance were manic and just spurting things out. I just ignored their comment and changed the subject. One time I wanted to be say something, but I stopped myself because I knew the patient was sick. One time I went in to a patient's room to give her medications. The room was somewhat dark and she screamed, "Well turn on the light!" in rude voice. I said, "Excuse me, I came in to you to give you your medications" and she said, "I'm sorry. Thank you." It is okay to stand up for yourself - because many times these patients need the help with certain social behaviors - it is all in your deliverance. You want to be strong and firm yet respectful, caring, and calm.
  12. Scarlettz

    Best type of psych experience before becoming PMHNP

    I would suggest working as a nurse on a psych floor or facility - as simple as that may sound. AT my work, we have a medication nurse and a charge nurse. The medication nurse is responsible for passing meds, transcribing orders, doing treatments (wounds, etc.) The charge nurse is responsible for assessing (talking) with the patients. Our techs write patient notes on the more stable patients but the charge nurse has to sign off on their notes. The charge generally oversees everything. I work as a medication nurse, but I still interact with the patients. I've learned so much about psych meds (and other medications as well) and I honestly think it is a better fit for someone who wants to be a PMHNP. I kind of wish that in our facility we dived our patients among 2-3 nurses and I could assess, do notes, and pass meds to 7 patients or 15 patients instead of just passing meds to 30. That way I could invest more time and energy into a smaller group of patients in a holistic approach. I'd try and find a facility that ran more like this idea. I think a mental health floor in a hospital would be more fitting to this idea instead of a psych facility.
  13. Scarlettz

    Struggling...please help

    Do you ever get the opportunity to float on another floor in the hospital? Or do you have a specialty that you are genuinely interested in? I had some anxiety, fears, and uncertainty when I started out as a nurse but never so extreme. You are just about at the point where you should be able to transfer to a new floor or get a new job. But, I encourage you to explore what you want to do so not to hop around to different jobs in a short period of time.
  14. Scarlettz

    Changing Specialties

    I never liked med-surg during nursing school and didn't think I would end up there. Anyway, my first nursing job ended up being med-surg and I liked it more than I thought I would. I still work PRN on med-surg (usually 2 shifts a month.) I work ft in mental health now. There are pros and cons to both specialties. I was always drawn to either psych or post-partum. I've floated quite a few times to postpartum at one of my jobs and I really like that unit as well and I sort of want to test that one out.
  15. Scarlettz

    Question about holding meds?

    I work in a mental health setting and I had a patient whose blood pressure was 89/something and the aide rechecked it and it was 91/something. There are no parameters in the order to say "Hold BP medication if SBP is I guess my question is more of an ethical / legal question mainly. I know this will happen again and I just want feedback as to whether or not I went about this the right way? I followed the order but at the same time I worry that I was denying the patient of his right to take the medication. I usually ask patients if they are feeling dizzy, lightheaded when their BP is low, but I did not ask him this time. It is a low dosage of the BP medication. Of course it was explained to him while it was held. I just want to make sure I did the right thing for the patient - as I hope they will re-examine his meds with the other psych meds he is taking. WDYT?