HappyApple

Inconceivable.

Our unit holds 14 pts. Depending upon the acuity & medical comorbidities, it can definitely be extremely overwhelming. I also have two techs unless we have 1:1 pts. We currently have 11 pts. & 4 techs due to having two 1:1 pts. I started off on a hospital med-surg unit with anywhere from 4-7 pts. so 14 has definitely been a challenge. Good teamwork & co-workers can make all the difference.

I am an associate degree RN in UT. I worked med/surg in a hospital in PA for 4 yrs. & was making $27.78 an hr. when I quit. I am making $28.00 an hour at a psych hospital that I have been at for almost 6 mos. We do not get a shift differential. It is a Geri-psych unit with some fairly acute pts. so I still use plenty of my skills. Good luck in all your endeavors.

I agree with all the above posters. I was lucky enough to be a CNA in a hospital when I became an RN. Resultantly, I easily & luckily got a job there. It was a med-surg floor in a big hospital. We dealt with pts from 20->100 , predominantly geriatric. In this pt population I cared for plenty of pts with medical problems who also had anxiety attacks, depression, bipolar disorder, schizophrenia, PTSD, etc. While we concentrated mainly on the medical issues, we also had to deal with the psychiatric issues. It is challenging but I really enjoy it! Good luck in your future endeavors & do whatever is right for you. While I do recommend a med-surg job initially, take a good psych job if you have the opportunity. The job market is pretty tight in a lot of places currently. I recently moved to another state and "fell" into great job at a small geri-psych hospital. I have worked there only a very short time but I love it. The fact that I work with a great group of people & not back-biting gossipers makes a world of difference. I feel my previous experience in med-surg has given a solid foundation upon which to build in dealing with this pt population, & has also allowed me to hone & utilize my nursing skills. Learning to practice therapeutic communication with psychiatric pts is a special nursing skill all it's own. It is however a whole different world from med-surg. I have learned to become more relaxed & not let my anxiety or fear show as they transfer onto the pt. I have not had an opportunity to deal with the more manipulative type of pts in the geriatric population, but I certainly did in clinicals. As previous posters stated, you always have to keep your guard up, be aware, be assertive, be confident, don't ever give personal info to pts. Tell them, " I am here to focus on you & to help you." Develop a thick skin. Always leave an escape route for yourself when dealing with a pt. I have given more IM injections here in a week than 4 years on a med-surg floor, excluding flu shots. It has been a real learning experience. At this hospital I am responsible for staffing, giving meds, doing staffing with another nurse, communicating with drs, taking orders,assessing pts, dealing with behavioral problems, assessing pts, dealing with families & much more.

New nurse that I worked with did not know that secondary IVs needed to be connected to a Y site above IV pump in order to control rate of flow & hung a potassium fast drip piggy-backed it into a Y site below the pump. Pt subsequently began complaining of burning on the arm the PIV was located in, as is common for a lot of pts due this drug being a vesicant. I began to explain to her how to further dilute the drug with a 50cc bag of NS & a double pump when the pt began to yell out in extreme pain. I then discovered the error & the fact that the pt had received nearly the entire 10 mEq dose of potassium in about 10 minutes. Luckily no permanent harm was done to the pt, the nurse felt extremely bad, was re-educated on secondary IV medication, & to my knowledge never made the same mistake again.

I have not read the entire thread but just wanted to throw in my two cents. To take the embarrassment off the pt & family requesting that they have a female nurse instead of me I just put on a smile & say " Less work for me!" This lightens the situation & generally brings a smile to their faces.

Wow... I was a CNA for 3 yrs in LTC & 4 yrs in a hospital before becoming an RN. Previous posters are correct in that the RN really does take the brunt of it all. I have gotten hit & spit on just as often as an RN, if not more, than when I was a CNA. I am not going to ramble off a list of all the things that the RN is responsible for ad it would probably take up a good couple of pages. As an RN I still perform tons of incontinent care, baths, transfers & the like. In regard to a previous poster, I have worked with plenty of aides who are constantly cruising the Internet, Facebook, texting excessively & the like. When you mention that work is not the time nor place for this, especially when dealing with people's lives, they get offended & become indignant. This is especially true of aides, & in many cases RNs, from the float pool who have no connection, & in many cases for some strange reason no accountability to the unit they are working on. I also believe that you need to look for another profession & think that your firing may have actually been a blessing to you, & quite frankly for the residents you were responsible for. Even though I am often stuck at work for up to 3 hrs after my shift documenting, & on many instances jumping in to help the nurses AND aides on the oncoming shift who are "drowning," I would not want to go back to being an aide: this is not because it more physical but because I love to help my patients in a myriad of ways including direct patient care. Apples & oranges my friend. I hope you find something that truly makes you happy as this career does not seem to be it. Peace.

Our floor has a policy where we give anti hypertensives, psyche meds, & pain meds while NPO. We also give 1/2 or all of long acting insulin if NPO dependent upon if they are DMTI or DMTII. For organization I have a list down the side of my brain for each pt's tasks: T O M A S CP FP GP N. This refers to my task list, orders, meds, assessments, screens (fall & pressure ulcer), care plans, fall precautions (I.e. bracelet, socks, fall POC & fall stickers on chart, & fall sign on door), green paper (has to do with RBC), & note. I have been a med/surg nurse for 3 yrs now & was an extreme ball of anxiety the first yr. hang in there...it will get better. I am very confident & for the most part comfortable in my abilities as a nurse. I do still have days that make me feel like a complete ass though. Good luck!