Austin12

I think "Stress" depends on the person. I've worked IU, SICU, Behavioral health, Corrections and now ED. I think that they all have an aspect of busy work or "stress." What is Stressful for me is Hall beds and the charge nurse is hammering you with EMS traffic after traffic. I mean really, you can have a GSW to the head in one room , chest pain in the Hall, DKA in the other room and a MVA coming. It's stressful, but that's the same reason I love my job.

Unlike the ED I work in, the team work is great. Sometimes I feel like, ****, I can't do anything for my patient who's getting tubed b/c I have a nurse on each limb getting IVs, one has the RSI, one tech has EKG , foley, RT is bagging, etc.... And all I can do is document and put orders for the doctor during intubation I'm sorry that it's like that for you all at your ED

We do recover and with the God of our understanding, we will survive. In retrospect, I tell myself that I would have done it all differently, but the truth is I needed my life to unravel the way that it did. I have a greater respect for not only my profession but MY life. What is consequences without self-realization. That was the greatest gift that I obtained through my recovery and these trying moments. I understand this is a difficult, trying time but this too shall pass. I speak from experience. I applied to jobs and many doors were closed. When I almost lost faith, my sponsor kept me focused and humbled. What a thin line between humility and humiliation. Gratitude is embedded within the foundation of that thin line. Furthermore, gratitude is easy to display when life provides instant gratification but keep in when our harsh reality presents itself as well. Don't let your arms become fatigued; keep knocking... eventually someone will answer. Some tips: 1. Don't send in a cover letter stating your situation >>>>>>> most employers don't verify licensure until after the interview. To allow them to judge you from paper is irrational. 2. Upon a given interview, your explanation for your restrictions should be last unless asked. >>>>>>> don't allow your prospect employer make a decision before a rapport is made. Sale your skills, your commitment to gold standard care. 3. When you finally explain your involvement in the program, be short, concise and what you've learned. >>>>>>> Don't go into detail unless they ask you. "I want to be open with you as possible, the reason that I'm no longer employed at ----- is because I tested positive for ---- during a random drug screen. I've been in a disciplinary program since ----. However, this situation has not only made me a better person with a better perspective." 4. That last question. Why should we hire you? >>>>>>> they have given you a chance to sale yourself and permission to be confident. Challenge them. "If your an organization that prides yourself in delivering optimum care; if you not only just want to meet the bar but set it the gold standard, this is what I encompass and this is why you should hire me. Furthermore, we all, as nurses, may look alike on paper and, truly, some may look better than me on paper; however, when it comes to delivering patient care I am just as good as everyone and better than most." My first job back into nursing was corrections. I remain PRN there. I am a part-time psych supervisor and I work full time in the ED as well. I have a 18 months left in the program. I say that to say ...Our past does not define us; it is a mere extension of who we are that makes us better equipped for life on life terms. I hope this provided faith for someone. God bless

Excuse my errors, I'm typing from my phone

So, I've been cleand for 27 months and I have been working fo14 months. My license is unrestricted, I have two jobs andI'm continuing to work an honest progra; however, d/t family and spouse I want to move back to pennsylvania. I'm unsure what to expect from tge DMU program. They haven't told me clean cut information to actually sign thi contract. The NCBON is fully aware of me wanting to move; in fact my coordinator has sent them everything such as evals, letter for instructed license etc, though readings his ambuguous contract, it appears I'm starting everything over. This is making me second guess my unitial decision to transfer.it appears I'm going to have to leave two jobs to settle for broke while in job hunting. So many qualms, sigh

It's get hard and no matter what all of us may say, you're going to feel down until you heal on your own. However, like I said my last post it might not come over night but all you need is one person to say yes. After your restrictions are lifted, it's fair game. Stick in there. Work a great program and once one door opens, others will follow.

You will be under the guidance of PNAP; however, you will be in a different program. The stipulations are almost identical though. Basically PNAP is your liaison with the Board. You will not talk to the board directly. I'm in NC and I am signing the contract to transfer to PA not b/c of the stipulations but for family purposes. I be been clean for 26 months. In the program for 24months. My restrictions have been lifted. Which our restrictions are for a yr versus PA 6 months of restrictions. It is difficult when you first start in whatever program your in; however it is not impossible, follow a honest program and all things will fall into place my dear.

Good...you'll be good. Just keep applying. All you need is one person is to say yes. Good Luck

Be honest, sell your skills and think before you speak...I always state that my situation has not only made me a better nurse but a better person. I have realized that nurse is not just occupation or privilege, it is a lifestyle. Thus, I have learned to conduct myself appropriately. That's two learning and selling points.

Comments are true to a certain extent... Cont. you to do your job; however, if risk management catches wind of it, you can still be fired, and reported d/t suspicion of diversion. The BON doesn't consider what is, it's what it looks like. This means, people can divert(take meds) and sale it. You don't have to test positive for drugs to be reprimanded. I would tell you to talk to your manager. The best form of action. It happened to me a few yrs back, but I smoked marijuana; thus, I loss my license for a period of time. Sweetheart, just tighten up on documentation and you'll be fine.

I work for Corizon. I'm glad most people enjoy it. I honestly haven't enjoy it. We try to give 10 dollar care on a 10cent budget. The retention rate is low. They've nickled and dimed which there us a need because they bidded so low to get the contract. In return, we practice unsafely. We work under staffed and custody has no faith in medical with exception of some nurses.

I would assume some medical background, or psychiatric back ground; however, I speaking for a county to level. I have seen new graduates. The retention rate is so low that if you have some experience, they'll be interested.

Well from experience, the MD is not there to know what is actually happening. Furthermore, I had an experience when a patient clearly was septic from a ulcer that perforated manifested from his board like abdomen and absent bowel sound, hypotension and tachycrdia, the dr still refused to send him out. I knew in my gut that he was septic and internally hemorrhagin, and I documented EVERYTHING. Well needless to say tge patient went to cardiac arrest on me the next day. I got him back but he lost so much blood that he was brain dead manifested by his blown pupils. The Dr. Said I never called him. Thank God I documented; however, how could I sleep at night knowing I could have done something. The BON can also get you for negligence . I'm not big headed but I have learned to trust my judgement. I'm not to blow things out of proportion; thus, respect when I call. Nonetheless, I'm 7/8. Sue me

It's journey and far from over. Though this was def. a test that I'm overcoming. One thing that I have learned is I can't do anything alone. Thank you. Hardships shall pass

I started of on the ICU, went to corrections and I've been doin psyche for a lil now. So far the things I'm findin out A major part of psychiatric problems are sensory nerves generally in the Basil Ganglia. The Basil ganglia is composed of 4 nucleus: 1. The Striatum ( caudate nucleus and putamen) 2. Pallidium( known as the Globus pallidus) 3. Substantia Nigra 4. The nucleus accendum Substation Nigra is big d/t the role of dopamine neurotransmitters. Also, that's where our reward center, addiction and some motor movement are at. Too much dopamine schizophrenic Sxs become present. Ex:When Somone does cocaine they receive pleasure d/t the dopamine but too much they start to hallucinate and potentially become psychotic. Antiphyschotics can cause EXTRA PYRAMIDAL syndromes( I hope I'm spelling this right). 1. Acute Dystonia : this happen hrs to several days after first dose. Signs are muscle spasms of the face,tongue, neck, back and even laryngeal spasms Which is life threatening. 2. Akathesia: which happens a couple months after first dose. Pt become restless, always has to move, squirming when staying still and very anxious and afraid because this is unwanted 3.Parkisonia syndrom: mimics Parkinson's. 4. Tar dive Dyskinesia: smacking of the lips, twirling , involuntary muscle movement of the fingers toes, and abnormal speech. All of EPS happens in the basil ganglia. The AIMS is required tool to asses patients for EPS. There's more. If you have any specific questions just ask.

To new graduates, to be perfectly honest most preceptors and management expect you to not know anything except the basics. So, breath and relax in time you will be a pro. The more you ask questions the better you will be. I worked NeuroSurgical ICU for a substantial amount of time. Things you will need to pick up on: 1. Know your cranial nerves. 2. Know how frequent your neuro checks are 3. Know the difference between hemorrhagic and ischemic stroke 4. Know that hypoglycemia mimics a stroke thus use your glucometer 5. know your patients baseline 6. Know when Thrombolytics are used... BP and time parameter 7. Now your sedation medication: profofol is the drug of choice esp d/t it's short half-life. All other low doses because the possibility of skewed neuro exams 8. Learn your assessments GCS, NIHSS, ICP, CCP, MAP 9. Drugs: mannitol, 3% NaCL, 23% NACl, Nimodipine, nesrnphrine 10. SIADH, DI... 11. Know the difference between subdural and ventric drains. What is a Pbo2 reading for. Ok. There's a little more. But you'll learn by working. We're all learning

I worked ICU, psychiatry and corrections. I had 2 days of orientation in which I picked up the routine fairly quick. XYZ needs to be done at this time and any unexpected events that we responded to needed to be done, times segment was key; However, my frustration came in with lazy nurses, resistance to officers and poor communication. It may differ between facilities, though I hear that it's similar across the board. For county correctional facilities I find that it is about the money as well. We pay for inmates healthcare i.e meds, Dr.appts, ED visits in which management and providers get their ass chewed out if we send someone to the Hospital if admission is not granted. Therefore, if someone needs to go to the Hospital, the Provider is reluctant to give orders to send them out. Catch 22, if I don't send them out I jeopardize my license and if I do against the Prividers order I jeopardize my license. I send patients out against the providers order if in my gut, I know something is wrong and I'm 7/8. Not too bad. Anyway, I know the frustration. I'm still PRN and there's certain Nurses I trust and nurses that I have to double and triple check when I'm working. Corrections is my least enjoyable job but my patients are my only concern criminals are not.

Short synopsis: In 2010 I was accused of narcotic diversion d/t my outstanding narcotic discrepancy. It was 67%. I was even in shock because I NEVER took a narcotic from that floor; however, time discrepancy and documentation was enemy or in retrospect, my mental well being was an enemy. To make matters worst, I smoked like a chimney. Nonetheless i tested positive for marijuana. It took me 8 months to join the program b/c I was not admitting to taking narcotics; punish me for marijuana... Punish me for poor documentation but I'm not going to be punished for faulty accusations. Mind you I worked trauma, neuro and general surgery ICU ( emergent bedside surgeries every minute). No matter the circumstances that got me here, I chose to join the program d/t my marijuana usage which affected my mental well being. I worked the program as hard as i could, i took two minimal wage jobs during that process and hated every moment. You talk about humility. my sponsor said you don't hit rock bottom until you stop digging. My girlfriend was cheating on me while my mind was at its lowest. I was working steps but if nothing changes nothing changes. It took 2 attempts to get my license back. During the time the program started making sense. The literature says, "everything is subject to change even the truth." My perception started to change therefore my truth started to change. I caused this unmanageability. It took me four months to get a job. I lost my other jobs because I was going on interviews left and right. When the light started becoming dimmer, I got call from a place that was four hrs away. I told the DON all about my situation through the phone and stated that I rather e turn me down than me driving 4hrs away to be told to my face. Needless to say I he appreciated my honesty and hired me PRN. I took the job and commuted to my friends house who lived 1.5 hrs away. There were times I slept in my car (oh, I ended the relationship with my girlfriend when all that happened because she was caught cheating the third time). It was hard and times it seemed impossible to finish my year of restriction but I DID IT!! Two weeks, the BON called me and said my 1yr restrictions were completed and congrats. 2 days later I got called for an interview and I got the job. I'm working two jobs now and I am still attending meetings and meeting with my sponsor because if it wasn't for an active change, I wouldn't appreciate nursing nor the struggle of life on life terms. To all my fellow nurses who have similar situations keep fighting, it gets better.

I agree with the above statement. If it has never been documented, it has never been done

If you're not a harm to yourself or others as of right now, he has no legal support. Also, gather your work appraisals to build a case which is your mental state has not placed any of your pt's or the community in harms way. ALSO, like all healthcare professionals, he has to obtain signed consent for ROI to the BON to support his case...

If you were missing anything, they will notify you of what're needs to be submitted. As long as you submitted EVERYTHING they ask for you should be fine. In retrospect, the hardest part is when you sit in front of the panel of board members. I almost wet myself. If you're confident about your recovery and are working steps honestly, you'll be in tip top shape. Enjoy the journey. It's a process.

There are nurses who have gotten DWIs while in nursing school and still subjected to the monitoring program; therefore, I doubt that legal representation will help all. Tough it out and good luck.

I understand your frustrations. It's tough but this is the best time to practice those principles. It will def. get better but you'll have to do a lot prayer and work. The madness did not happen over night so easy does it.I remember being in your shoes; Afraid of the unknown and bills piling up. Understand, no matter how many doors close, you'll only need one "yes!" I'm in NC and I have found job with my restrictions. Right place, right time with the right mind. Bless you.Stick in there

That sounds good to me. I was tested 4x's in one month; 76.00 every test. I wish I had a flat rate.

I got your PM but it won't let me reply. Email [email protected]