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Psych, NICU
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Back2PsychRN has 5 years experience and specializes in Psych, NICU.

2 years male psych.. NICU 3 years Just started adolescent psych Feb 18

Back2PsychRN's Latest Activity

  1. Back2PsychRN

    Oppositional defiant disorder

    Just wondering what the child/adolescent psych units do to treat their ODD patients. Not what meds or things like that but what do the nurses to do care for them when they are in the hospital. I work in an inpatient acute unit and we have a lot of patients with ODD. They end off being very defiant when they start making the unit unsafe. They antagonize other patients and cause commotion on the unit. Time and time again I just see them sent to their room, sometimes an entire day. They get bored and oppositional and argue with staff, and then end up in the "quiet room." Then after hours and hours of sitting there doing nothing, naturally the 14, 15, 16 year old child gets bored and wants out. Since they are so defiant and such an antagonist to other patients, we fight back an make him stay in his room, he fights back even more and comes out, then we put hands on or give "Emergency treatment orders" to give medication to make him stay in the room. It's a vicious cycle. I hate it though. It's not therapeutic at all. The patients learns nothing, has nothing achieved from staff or the patient. Of course he wants to come out of his room or the quiet room after sitting there for hours doing nothing. How do you guys handle these patients on your unit? My manager is asking for suggestions. She doesn't want the unit to "punish" patients. We are not their parents, we are a hospital and we are here to help them. We are here to treat them, care for them, not punish them. But it's so hard with patients with ODD. That's who they are. Any suggestions? Thanks
  2. Back2PsychRN

    New Grad Struggles Want Psych Nursing

    Well I for one knew I didn't want any traditional bedside nursing. I started out in psych and went to NICU for 3 years, and now I'm going back to psych. I missed it tremendously. I did travel nursing for a year and had to float to mother/baby at one location. I absolutely hated dealing with the mom. I was clueless and had no desire to be their nurse. I was a NICU nurse, precisely because I didn't want to nurse adults. I knew that from day one, and now I'm going back to psych because it's my passion. Yes, they have a little medical, I'm going into adolescent psych. I could never do cardiac, med-surg, oncology, heck, I could never do any adult, so I understand hating where you are at. If you know it's not just new graduate jitters, then if it was for me, I wouldn't stay. The thing is though, units spend a ton of money to put you through orientation and train you, so think very hard before you accept a position. Ask to shadow maybe. Also, make sure you talk to your unit manager. You don't want to get on their bad side and be put down as a no rehire, especially being so new in nursing. Most of the time they are going to tell you to stick it out at least 3 month, 6 months or a year. Most hospitals wont let you transfer so soon, you'd have to switch hospitals and let the hiring manager know why you might not get the best review from that hospital. Let them know how much you are interested in psych from previous clinicals. You seem to really dislike cardiac, but is there other things? Cardiac isn't the only thing that's going to bring codes and what not, is it just that you don't want to work with adults, maybe look at peds, or maybe you just want psych, which is completely normal. Some people know what they want, and that's it. Be prepared to tell them you didn't apply before or wait for that position. I'm only saying all this because if you decide to leave a position so soon, it will follow you. You'll just have to explain it. People understand that all specialties aren't for everyone. Trust me, I did hospice for 3 weeks, and dialysis for 2 months and left both because I knew it was not for me at all, I wasn't going to stay somewhere I dreaded every single day. Thankfully I still had my old prn job. So good luck to you and follow your heart, your dream. I recommend keeping your cardiac manager in the loop though because they will probably have to replace them. Offer to stay until your replacement is found, that's a great idea too.
  3. Back2PsychRN

    will it get any better?

    Hi, I truly hope it gets better for you. Are you understaffed every day? Is management in the process of filling positions or does it seem that that's the norm and nothing is going to change? Like you, I feel a big part of psych nursing is talking to our patients and not just passing meds and doing assessments. I was in psych for 2 years (I've been out 3 but start again in a week), and we never took care of that many patients. We were an acute facility. When people were picked up by the cops they were brought there. The other facility would be a long term facility, and I believe they take on more patients, more like a nursing home. I don't know what kind of unit you have, and it's ok to have a few bad days here and there and be short staffed if someone calls in or something, but to feel horrible every day you come to work, is toxic. You're new, so that can definitely explain having to stay late to finish charting or what not, but that shouldn't be an every day thing either. I hope you have other co workers who can possibly help or let you know if it's the norm so you can make a better judgement of your future. Good luck
  4. Back2PsychRN

    Utter failure with my first baby that should have been coded

    I don't know if you'll ever see this, but yes, the baby did survive. He's doing great now, I see his mom on FB all the time.
  5. Back2PsychRN

    It Gets Better...Right?

    What you are experiencing is completely normal, not only are you new to psych, you are new to nursing, period. You are going to do everything slow, people are going to get things done quicker than you, leave before you, but you'll get the hang of it. Sounds like you have great coworkers with you, don't be afraid to ask for a little help. And give yourself a break, expect that you will not be an expert right away. My advice? Think back on your first days, what gave you the most trouble (besides the fax/copier lol) and what kept you "off your game?" Mine was always PRN meds. I'd go out in the morning and pass meds, do my assessments, sit down to chart, and 10 minutes later, someone wants a PRN, then the next person wants a PRN, and the next. I felt like all I did was pass PRN meds all day. So before I gave meds, I wrote down what PRNs they had and when they could have them. Then any that were avail, I had with me when I passed meds (cause who doesn't want their prn anxiety or pain med, and you could always return them to the pixis) and I told them when their other PRN meds were avail, that way they didn't bother you for it, at least until it was close to due. Keep a little cheat sheet and when you are talking to them, write down things you need to chart so you don't forget. The hardest thing for me to realize was I didn't have to chart right away. That's one of the most time consuming things. I didn't what I needed to do, and charted when I had time. As long as you keep little notes, you'll be fine, especially times. I had a "brain" sheet because dealing with 8 or 9 patients, it all starts to blend in by the end of the day. Also, I learned my best friend was my unit secretary. They always know what when where, because they are the heart of the unit. The psych techs are very important as well. They can be your best friend or your enemy. Hopefully you have some strong techs who can handle things on their own and know when to include a nurse, and more importantly, don't start problems. Bottom line is, you seem like you still like psych nursing very much, so just give it time. Be easy on yourself. The biggest worry I would have is manipulative patients who know you're new trying to take advantage of you. Seek guidance for that. Techs are your eyes and ears, and you always you're your other coworkers. Take their advice, learn from them, and you'll be a pro in no time.
  6. Back2PsychRN

    Registered Nurse VS Psychiatric RN

    Did you not read the entire post? I was not, by any means, trying to demean "pill passing." And my patients don't normally go to a nursing home. I wasn't looking down on "pill passing." I was speaking of the difference between a psychiatric nurse and a nurse in psych. In psychiatry, I feel there's a huge emphasis in therapeutic communication, talking to our patients, they are mental patients. That's the part of our nursing skills that we use. Past co workers I worked with had no desire to talk to the patients, or to treat them, mentally. They came out of the nursing station, passed meds, asked the basic questions of "do you hear or see things?" and then only came out when necessary. That's what I meant by pill pushers. I have mad respect for nursing home nurses. You guys handle a ton of patients and have a ton of things to do. Read and understand the whole thing next time.
  7. Back2PsychRN

    New Psych Job

    So great to hear someone so excited about psych. Congratulations on your first nursing job. It was my first job as well. You definitely want a "brain" to keep yourself somewhat organized. The one thing for me that always got me off was PRN meds. Psych patients live and breathe by their PRN meds. The first thing I do is look at the last time they received them and if they can have them, I automatically pull them with the first med pass. If not, most of them will ask you for them and you'll spend the first 2 hours running back and forth just giving PRN meds. Just make sure you keep track of who's is who's so you can return if they don't want them. Anticipate their needs. It also gives you more time to spend talking to them instead of running around. You can do your mental assessment at that time. But definitely know how often they can have it and if it's not time, let them know when they can have it so they don't bug you ever 10 minutes. Once I learned that, everything else fell in to place.
  8. Back2PsychRN

    Psych Unit Interview

    Thankfully they aren't going to expect you to know the laws or regulations during the interview. Sure, it's great to know, it will give you an edge up on the next person because it shows initiative, and can show you are really interested. My first nursing job was in psych, spent 2 years there and now I'm going back because I miss it so much. I start in 2 weeks. They ask the normal things like, Tell me what you do to de-stress after a shift, or what you did when you disagreed with something someone else did. Can you handle having to give someone medication they don't want, injections to calm someone down, can you deal with people hallucinating, being suicidal. Most of the job is about communication. There are certain things you don't want to say to psych patients, teamwork is a must. They want to make sure you're a team player. It's a great nursing specialty, it's not easy. We aren't med pushers like some people think. Good luck.
  9. Something similar happened to me a few months back. I had just started in a position, was only in orientation about a month when my dream hospital offered me a position. I felt horrible but I knew I couldn't pass it up. I knew I was going to be fired right away cause who wants to spend money training someone who was leaving. I struggled with letting my current manager know right away and lose weeks of money before starting my new job, or wait till the last minute and leave. I did the respectful thing and thanked her for the opportunity but my dream job and hospital offered and I couldn't turn it down. I asked if I could still work and she said she never had anyone quit during orientation so she would have to call me later. She never did, and I never went back. Now I don't know if I'm black marked or not, but in the end, you have to do what's best for you. Dream jobs can turn in to a nightmare, but I wouldn't pass up your dream job. Tell them ASAP, so they can hire someone else to take your place. It's going to suck and maybe you do get black marked, just depends on what's more important to you. If it's your dream job and you're there forever, it doesn't matter. But if you leave, hopefully there's other hospitals in the area or other places you can work. It's a lose lose situation. Good luck
  10. Back2PsychRN

    DUI and Entering Nursing School

    Well I was in a similar situation as you. I got a DUI in Aug 09. I was told that I wouldn't have a problem getting into nursing school, as long as I was done with everything (IE probation). They wouldn't allow anyone on probation to start the program. So I plead no contest right away to start nursing school as soon as possible. I started nursing school in Jan 2010 without any difficulty. I did get called to the directors office and had to explain (maybe had to write something, don't remember) that I turned my life around and things like that. I've been a nurse 5 years now and I've had no problems. I have a license in 5 states, and the only issue was the aggravation of having to get certified copies of all my paperwork. Some states require things like letters of recommendations and other stuff if you have a record. Overall, doesn't matter if you truly were at fault, under the influence of weed, or not. Like other posters have said, just explain that you have changed, you're bettering your life, maybe get a letter of recommendation from someone. I don't think it matters if you tell them up front or not, they will see it and call you in. Unless they specifically said "let me know" I don't think it's a problem. And as far as wondering if you can go to court now after you already plead, I don't think that's possible. Again, I'm not 100% sure, but I think once there's a verdict (in this case, you plead no contest), that's it, no changing it. Good luck to you.
  11. Back2PsychRN

    finding positions by specialty/area

    You can also look at indeed.com. I also found nurserecruiter.com.
  12. Back2PsychRN

    Does anyone else just take their housing?

    My first assignment was to Alaska. Like you, it was pretty short notice, and I didn't have money saved up, so I took the company housing. It was a nice 1 bedroom apartment. Nice area, close to the hospital. I really liked it. I decided to extend as well and told the company the only way I would extend was if I was moved because I wanted my pets and I couldn't have them where I was at. So, we redid my contract and I took the stipend. It was a huge difference. Before I accepted the assignment, I knew what my stipend was, but didn't know how much they were paying for my housing. My stipend was about $800 week and they were paying about $500 week for my apt. I went from making $1200 week to $2000 week. I found a short term, month to month apartment that I was able to rent for $1000 month, so I was definitely making out. The first few weeks were rough because all my money went to moving in, and then you have to turn on utilities, furnish the place if it's not furnished, it was definitely a hassle. Then when I left, it was a hassle getting rid of everything. I gave my couch and a few other things to some neighbors and a nurse who I became friends with. So, if you can afford it, definitely take the stipend. Maybe save up as much money as you can the rest of this assignment and use it for you next one. Try to find a furnished place. Right now I am in a 2 bedroom house from Airbnb. It's definitely expensive, but I don't have to share an apartment and I can have my pets. Good luck
  13. Back2PsychRN

    Is this a fair offer?

    I think the OT rate is very low. Like NedRN said, the best way to gauge if an offer is reasonable is if you have offers from different companies. I learned the hard way to have a couple different, at least 3, quote you and give you the #'s for the same hospital before you are even submitted to them. That way you know if that particular company is going to give you the best rates. The hospital will pay any of those companies the same amount of money so it's just whether you are getting the money or the company. Good luck. I'd be interested to see the difference if you check out other companies though. Keep us updated.
  14. Back2PsychRN

    I have no words. I have a thousand words.

    Such a wonderful insight into a hospice nurse. I have always thought of being a hospice nurse but never believe I can go a single shift without shedding a tear. My father spent his last 15 hours in hospice before passing away. We were all at his bedside when he passed. The nurse heard us all crying, quietly walked in, held his had, listened for a heartbeat and any breaths, and quietly walked out. I have such admiration for hospice nurses, what they do is thankless most of the time, because in their end, their patients pass away. Thank you for sharing your day and giving an insight in to this field of nursing. God bless you.
  15. Back2PsychRN

    Switching from NICU to Psych

    Im kind of in the same boat. Starting nursing school I was the "psych" nurse because that is all I wanted. I did preceptorship on a closed unit and loved it. Worked my first nursing job in psych for 2 years, and then because of management and bureaucracy I ended up going to a busy level III NICU. I love it, love the babies, my coworkers are awesome, but any time we have a difficult family and we talk about psych issues, I bring up my stories and man do I miss psych. I don't talk about NICU nursing like I do about psych, even after being here in the NICU for 1 1/2 years. I just today accepted a PRN job back at my old psych facility. I couldn't help but be able to stay up to date on things and get back to what I truly love. The problem is, I feel I wasted my nursing degree being in psych because it's more communication and med passing then hands on assessments, IV's, things like that. I always said there's a difference between a psych nurse, and a nurse who works in psych. And still, to this day, I find myself referring to myself as a psych nurse... Guess I'm just scared to make that total transition back in to psych. Good luck to you, just wanted you to know you are no alone. People who love psych are a different bread, and no other unit can fulfill that love we have.
  16. I'm at a loss for words and feel so discouraged and like a complete failure as a NICU nurse and am doubting myself as a nurse right now, wondering if I'm really capable of doing this job. I work in a level III NICU, our acuity right now is through the roof. About my background, I've been in the NICU a little over a year. I have taken care of a baby on a vent 1 time about 3 months ago, I've never taken care of a critical unstable infant, never had a micro. I've dealt with the normal a/b/d episodes but that was it. I've never even bagged a baby. I've seen it done 100's of times. I have a seen 1 code since Ive been there and was able to do chest compressions but that's about the extent of my experience. I watch and observe, try to learn at every situation available so when it comes my turn, I know what to do. Even with the code I attended, I wasn't even suppose to be there but I asked if I could observe because I don't want to freeze when it happens to me, with my baby. That being said, I was taking care of a chronic ex 24 weeker who's been through the ringer a dozen of times, but nothing in the past month 1/2 or so. He was doing great, down to 5L. A coworker and I were putting his ND tube back in and the unexpected happened. We think he just vageled but he completely checked out. Once we realized his sats were in the 50's, hr in the 70's and not coming up, I called for RT as were bagging. After another 30 seconds I called the doctor. He told me I needed to call the NP. I work night shift and we always have a Doc and NP here, it's great. Doc's are on until 0300 (I work nights) and then the NP takes over till 7. I called the NP but her phone was going ringing busy. I tried about 5 times before calling the doc back. At this time it's been about 2 minutes. I called him back and gave the situation and he said he was in a delivery and couldn't come. Someone ran to find the baby as we are continuing to bag the infant. It was me, a RT that was from a our Peds, not the nicu, and another nurse who's been here about 8 months now. Within about 4 minutes our NP showed up. I don't know if she did something because I couldn't see, but after 20 minutes his hr came up, slowly followed by his sats. I feel horrible. His HR was under 50 for probably more than 4 minutes. He made a few agonal breaths but other than that, not a single breath. He was grey, completely unresponsive to anything. I feel like such failure, like I completely froze, forgot the basic of NRP, and just basic resuscitation. We should have started compressions within 30 seconds, and no one did. We were all focused on bagging and trying to find someone (NP, doc) anyone. I never thought the first time I would need to bag and (should have) code a baby I couldn't get a doc or Np when I needed them the most. I didn't start cpr, it was my infant, my responsibility. But no one else did either, not the other nurse, the RT. I had 2 very educated nurses standing right out side the door (he had a private room) no one said anything about it. No one has mentioned it that I know of (like to our coordinator or anything,) but I know we screwed up, and now I'm doubting myself. I Have asked and asked for harder assignments, more complex and acute infants. I had a chronic but stable infant who just stopped breathing and I couldn't even do what I needed to do with them. Sorry so long, but I just needed to vent my frustration with myself with people who know and understand. I don't want to talk about it to coworkers because I don't want everyone to start doubting me. Thanks for listening.