psychaz

I signed on as a full time employee for the facility that I had been going to through my registry, but managed to get enough 40+ hr weeks in the 18 months prior that I was able to stick with just one registry. For the first 6 months or so it was patchy though. I didn't always get as many hours as I wanted, although I did make enough money to pay the basic bills. I found that in AZ, even if you are working for a registry that is used frequently for your specialty, you have to work in each place enough that the people who call the registries know your name. There are dozens of registry nurses, so when you are not well known the best thing you can do is accept as many shifts as you can work at a variety of settings, and then if they need someone for a double shift, stay. Let the facility know that you are available for the next night if you are. You can't book your own hours, but continuity of care and convenience actually matter, and they will try to get the same person as much as they can. If you are at a large facility, and you let them know that you are looking for more shifts, they will usually oblige.

On the east coast we usually assessed for SI/HI (suicidal ideation/homicidal ideation), but in AZ we assess for DTS/DTO (danger to self/danger to others).

I'm new to ACT- 3 months so far. I've been a psych RN for a decade, this seems to be a really good fit. We have 80 clients. 1 MD, I am the only nurse, 10 CM's. The psychiatrist and I do not carry a caseload. I have 51 clients on injectables- generally if they are court ordered they are. 2 ppl on clozaril. We do have a few ppl on no meds though. We have a transitional housing unit that is owned by an organization that assists homeless SMI ppl in finding and keeping homes. Some are there for a few weeks, a few have a lease. We also have a number of organizations that help with finding housing for homeless regardless of sobriety. I go with the MD a lot to give injections or do assessments, and the rest of the time I go with a Case Manager. I haven't been there long enough to do home visits by myself but in a month I'll be able to. That leads to one of the things I've wondered. Is it the norm for nurses to go on their own. I know the case managers do. I've worked inpatient and correctional and we never are alone with our patients for everyones protection. This is a different type of nursing though. What are the policies of your organization to maintain safety?