mariav

I would highly recommend making an appointment to speak directly with an advisor at a university that offers a DNP program in mental health. I'm a BSN, RN but my first bachelor's was in Psychology. I worked ten years as a clinician in inpatient psych before pursuing the BSN. There are a lot of prerequisites you must take before you are even eligible to apply for a BSN program. It took me a couple of years to complete them all. The next step is getting accepted into a program. If you still need to work, then a regular track BSN or ADN with a bridge program to BSN is best and will take around four years to complete. However, if you are able to take a year off from working, you can apply for an Accelerated BSN program which is for students with a non-nursing Bachelor's and is condensed into one year. That's the route I took but be warned, it will be the most brutal year of your life. Not only will you be in class eight hours a day, 4-5 days per week but you will also have clinicals on many of the days you are not in class. For most of mine I was expected to arrive at 0500 or 0600 to meet with my preceptor for an hour and discuss the patients I was assigned to that day. Work 12 hours then meet again for an hour afterwards to discuss the shift. Once you are home you will spend 3-4 hours researching your patients' diagnoses, labs, comorbidities, and medications. I averaged around 2-3 hours of sleep per night during clinicals. Your grades cannot fall below 77% (I think. I graduated in 2013 so that may have changed) or you will fail the class. Most people don't know how hard a BSN is to earn and how much work you put into it. You really have to want it. I'm only now looking into BSN to DNP programs and it looks like I have another four years of debt and brutality to look forward to. Are you sure this is the right path for you? This is why I suggest speaking with an advisor. They can review your transcripts and give you a good picture of your path to a DNP. Hope I didn't scare you off. Nursing is the hardest job you will ever love.

Trust your own nursing judgement. I'm assuming this situation is in regards to PRN medication as opposed to scheduled. Only you can decide if a patient's presentation warrants the use of a PRN medication. Some of the PRNs we give to psych patients can have dangerous side effects that call for serious consideration. If I were in your situation, I would look at the patient's history and the information passed on during shift change and make an informed decision in the best interest of my patient. If redirecting works for you and your patient, by all means continue doing it.

I've been working in in-pt psych for 12 years. I've definitely had my share of assaults. I file a police report every time and leave it up to the DA to determine the appropriate course of action. I don't factor in whether my patient knows right from wrong when filing a report because it's not within the RN's scope of practice to make that determination. The reason I file a report is to start a paper trail documenting that individual's history of violent behavior so that when law enforcement comes into contact with him/her they can see that there is a history of violent behavior and to proceed with caution. A history of police reports can also help a DA or judge determine the best course of action for the patient in regards to psychiatric treatment/monitoring vs incarceration. At the very least, filing a report sends a message to your patient that violence is not okay. As healthcare workers, tolerating or excusing this behavior only allows it to continue and, at the end of the day, we have to take care of ourselves. I love being a nurse and I love working with the mentally ill but I won't be able to do much good if I'm stuck at home on disability because of an assault.

I'm a psychiatric RN and I work in InPt psych. On February 27th of this year one of my patients committed suicide on our unit during shift change. It was my night off but the daytime charge nurse called me earlier in the day asking if I would come in because they were short staffed. I said no because I had plans to meet up with an old friend that night. My patient killed himself while I was having a beer. I have not forgiven myself for not going in ever since. I know it's essentially not my fault but these are the people I care for every day and I abandoned him. He was only 29 years old. I feel like I failed him even though I know deep down it's not my fault. It's incredibly difficult to distance oneself when you work with this population and something bad happens. I just wanted you to know, I understand exactly what you're feeling and I'm here for you.