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pinkiepieRN

pinkiepieRN

adult psych, LTC/SNF, child psych
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I started out as a psych nurse, thought there was greener grass and am now coming back to psych. I've never stopped using my psych skills and never regret having not worked med-surg.

pinkiepieRN's Latest Activity

  1. pinkiepieRN

    Can you take phentermine during a nursing shift?

    Do you just "skip" it on clinical days? Most people with valid prescriptions take their meds as prescribed and know how their meds effect them. How would they even know you were taking it - a drug test?
  2. pinkiepieRN

    Writing order and having Dr sign later..your thoughts?

    Whether you call a doctor or lie about it, an MD still has to sign off on that order within 24 hours for it to be valid, so I'd call someone!
  3. pinkiepieRN

    Writing order and having Dr sign later..your thoughts?

    Definitely call a provider if it's a med needed for discharged and they're going to be discharged before seeing someone to write that order!
  4. pinkiepieRN

    Geri-Psych Admissions: Where's the Line?

    If someone purely has a psych dx of dementia, I'm not sure that an inpatient stay would do much for them. I worked at a facility in the past that had two geri-psych wings: geri-psych mood disorders and geri-psych psychotic/dementia. Patients with dementia often aren't appropriate for a general psych floor because medication management is difficult and they're not really able to benefit from groups or the milieu environment. Generally I'd say that someone could be accepted to a facility with mild dementia and an underlying mood d/o dx but not something like advanced Alzheimer's because it's just not likely to be therapeutic or helpful for anyone. Suicide precautions also aren't necessarily indicative of the need for an acute inpatient psych stay - but the increased monitoring and interventions would obviously set off some alarm bells and you'd hope that the provider checks their psych meds or sets up follow-up/after-care. Also, I think it would be best for a patient to complete tx for their UTI to see if the confusion/agitation allays with resolution of the UTI.
  5. pinkiepieRN

    Imminent danger

    I work with kids right now so YMMV but with kids there are often few warning signs that something is going to get out of control until a child places their hands on staff or another patient. There are often warning signs in my experience with adults but kids are impulsive AF. Generally speaking, if someone requires a physical restraint, that's almost always a time where IM/emergency meds are indicated but your mileage may vary. I find that if I can de-escalate someone and move them to a quieter space (even if just the "calming room"), PO meds might still be an option but there's a threshold for danger that warrants emergency meds. Does that make sense? Often my providers don't order PRNs so it's a call to the on-call even for a PO PRN and then they might give the order "give PO chlorpromazine 25 mg. may give IM if pt refuses PO."
  6. pinkiepieRN

    First Instructor interview..... help

    Teaching CNAs in a high school turned out to be the opposite of a dream job for me - no support from the other educators and unmotivated teens. It was a learning experience and I've actually taught CNAs again since then (and not much enjoyed it) just for the teaching experience. How's it going?
  7. pinkiepieRN

    Transition to concept based curriculum

    I just accepted my first faculty position after graduating with my MSN in Nursing Ed 2 summers ago. I'm starting with a colleague who's been in this position for a year but they're changing to a concept based curriculum for the fall and following semesters. I've read a book on the idea and it doesn't sound incredibly complicated but I know no one likes change. I figure I might have a leg up because I'll start out with this concept based curriculum and not have to face a transition from something else. I'm also a fast learner and have only been out of my BSN program for 9 years, so I vaguely still remember what school was like. Any suggestions?
  8. pinkiepieRN

    Writing order and having Dr sign later..your thoughts?

    That's what the on-call is there for!
  9. pinkiepieRN

    I am not "such a good nurse!", a vent

    Did this patient even have capacity to refuse? I've spent so much time working with involuntary psych patients that I realize even though people can be declared "incapable" of making their own decisions, it's a ****** to get people properly medicated if they're not interested in their own health. Nursing is responsible for catching some stupid sh!t sometimes, aren't we?
  10. pinkiepieRN

    Psych Nursing - Boring?

    PM shifts are definitely more patient time centered. It's also for me when less groups tend to be going on and patients have more "down time".
  11. pinkiepieRN

    Why nurses don't want to talk to a ward psychologist?

    I'm sorry if I missed this somewhere, but what is your *ROLE* as a psychologist on the unit? Is it to counsel staff or act as a clinical liaison between staff, patients and families? I guess it could be both but I'm wondering if you're trying to step out of your scope by being "helpful". Also, nurses are more likely to talk amongst themselves and commiserate about a common issue, looking for suggest or venting than they would to a psychologist, an outsider, a "non-bedside" clinical staff.
  12. pinkiepieRN

    Driver's license and other documentation

    This seems like a silly question, but here goes. I'm on contract for 13 weeks. I've got mail forwarded here and will be putting this address down as my "permanent" address for certain things until I otherwise have somewhere else to go - but what about my driver's license? And voting?
  13. pinkiepieRN

    Psych RN out of state relocation

    I hear the "Institute of Living" in CT is pretty awesome.
  14. pinkiepieRN

    Switched to Psych, HELP!

    How's it going?
  15. pinkiepieRN

    Ped Psych RN

    Maybe not your cup of tea, but you could always consider Adult Psych. Adult Psych often has more medically complex patients (depending on what your unit accepts) and there's of course the obvious co-morbidities, like asthma, COPD, HTN and obesity. I just left an Adult Psych unit that did IV fluids, PICCs, TPN, wound care and handled a patient with a trach. You can still use your psych skills but it's a little more challenging. I left Pedi Psych to go back to Adult Psych. I was on nights. I like kids and nights but it got boring because kids mostly sleep through the night and if they're up, it's a PITA.
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