taydian

substance abusers with personality disorders are by far the worst forme. Can't stand those guys. Nothing but grief all day. I'll take an aggressive psychotic over a manipulating addict any day.

I appreciate any male staff around, nurse or nurse assistant, depending on the type of patient is involved. I don't depend on a male staff member to deal with patients directly if I'm the first one to respond. I'm fine to redirecting or deescalate a patient myself. However, when it comes to potentially aggressive patients, that is when I very much appreciate male presence. Things do tend to go a lot more smoothly when the patient sees a figure that could possibly put him down to the ground should hedecide to charge at me. The extremely psychotic patients who are aggressive tend to be a bit non-discriminate and aren't deterred by the male presence....and that is when I love you men by my side. I've been assaulted once and a near miss once. Both by females. Both psychotic as hell. Both were undeterred by male presence...but even so, those men protected my ass. . I work at a new place now and the weekends I work have no males. All the males work on the opposite weekend, nurses and NA. Our census is relatively low and thus far, there hasn't been any issues with patients so we haven't bothered to grieve about it, though we should because we never know when we might get that ONE patient...... And, sorry, my ladies, even though I love my female co-workers, I love the days when it is majority males staffed. The atmosphere is so much more relaxed and we can BS about stuff and laugh at no one else's expense.....and I don't think about "man, what do these chicks say about me when I'm not around?"

Maybe because I'm on a psych facility, to me shifts are meaningful....evenings and nights are WAY less stressful than days. You mentioned "night". Do you work night shift? If you're a night shift person, then move to day or evening. (or day if you're 12 hour) I think the fact that you get a rush from hectic events does validate your boredom. At the same time, you don't feel 100% confident. I'm in psych and have zero experience in medical so I can't relate (different type of "rush" in psych). However, if it were me, I would spend enough time in med surg to feel 100% confident before I went onto to the more busy stuff...because the busy stuff needs the 100% confidence. There's no time for thinking. It's knowing exactly what you need to do to get **** done. If you don't have that 100% in med surg where the pace less acute, then I don't think you're ready for the hectic stuff. Granted, there are new grads who go straight into ED or the ICU.....but they were there from the start and were trained accordingly. But you admitted being not 100% confident in med surg. Spend more time in med surg and learn as much as you can.....then move on. Nursing in any new position can take up to 1 or a little more to feel comfy. You admitted that you've only been where you're at for just over a year. Chill out....enjoy what you got and keep learning. The butt wiping, the sitting, etc...we're all pros at. We are working with staff shortage. We all know. We're all doing it. Just keep learning and deal with what you got.

Oops. The last response was in reply to Elkpark

I'm not so sure I entirely agree. Maybe its because of the type of facilities I've worked at. I've never worked at a private facility before... The types of units I've worked at were rampant with malingerers. The way I see it, personality types have been very successful in manipulating people in the community. They put on their charm or are really good at garnering sympathy and most of the time they get the response they want. Then they come to a unit like my current one where it is more or less a homeless shelter until their next government cheese payout comes along...then they request an AMA and say peace out. Then we see them again within a month or two. At my previous job, it was a forensic unit...a lot of guys there were trying to get a NGRI (unfortunately for them, many of them weren't smart enough to maintain their facade and didn't take into consideration that nurses and staff actually communicated with the forensic treatment team regarding their behavior when they weren't around). They try to play the same game with the workers on the psych unit but since most of us KNOW what they are doing, most of us don't let them get away with it. It's the ones who fall for the splitting, they like the compliments they receive from these types of patients, the ones who are duped into feeling like "oh, this patient hates my co-workers but he likes me..." which makes them give into whatever they want. It's a shame, too....such a waste. These guys are socially smart. They know how to get their way for the most part. They would make awesome salesmen or could climb the career ladder by their manipulation alone. Instead, they choose to spend a life committing crimes or substance abuse (I'm speaking only about the patients I've worked with on the types of facilities I've worked for...can't speak for others). It is we experienced health workers that don't fall for the charm. I work with amazing nurses and a great treatment team...but because of WHO/WHAT we work for, sadly, in the end, our patients are only being enabled and its out of our hands. We can't change it because it is WAY too big for us to fight against.

I'll admit: I have a hard time being cool with the personality folks and substance abusers (the etoh's, however, haven't been bad at all). I hate how dramatic they can be. I hate how manipulative they try to be....I hate even more when I see staff being manipulated. I hate how belligerent and hostile they can be. Its a different kind of hostility than the Axis 1 patients. It's a whiney, why can't I get my way, everyone is against me, its not fair, expletive, expletive, expletive, etc. I hate how they try to shop around with staff members. They **** me off so much and it is so damn hard for me to be nice to them. When they try to be nice, I automatically feel like they are attempting to manipulate me so I automatically put up a barrier, which they interpret as me being "******"....which isn't really inaccurate. I know they have a disorder but....geez....I cannot stand to have a conversation with them. I cannot stand sitting there with them and hearing them complain about every minor thing they are unhappy with. Just had to rant. Hope someone else can relate. I know my co-workers feel the same as I do but I hope it doesn't make us bad nurses.

I love having a unit secretary. I used to work evening shift at my previous job so there was no need for a secretary. But now I work day shift at a new job. Last Friday, we had so many call-outs campus-wide, including our unit secretary. I'm still pretty new there and I haven't fully learned every little thing at the job. I was charge nurse and the phones kept ringing and I had to make a lot of phone calls as well. It sucked. It was good in that I need to experience things like that to learn, but holy hell it wasn't fun.

One day during a peds rotation, I was taking care of a little boy, around 6 or 7 yo. I can't remember what he was admitted for, but he was soon to be discharged. So, towards the end of my clinical day, I asked him and his parents if there was anything else I could do for them. The little boy stands up on his bed enthusiastically, beings to say, "You didn't look at my..............." pulls his pants down to expose himself......and yells out, "member!" I was stunned...parents were stunned.....We didn't know how to react. The boy is cracking up. The parents were so embarrassed and blamed it on the steroids :)

Do you really believe that every single person washes his/her hands after a sneeze or cough? Do you really believe every health care worker washes their hands after contact, period? Not everyone does the Elmo elbow block. Many people still block their spray with their hand. I'm not a medical nurse, but even I, sometimes, don't have the time to wash my hands and some facilities don't have hand sanitizers in a convenient place ........ Cool if you can quit your job with no sweat off your back....but I don't think it's an irrational required precaution as health care workers as you make it out to be. Some places give you an option: get the flu shot or wear a mask. I don't think its unfair at all........but I'm just one person.

I kind of figured this topic has been worked to death....but, hey, you never know what others have to contribute.....hence the "disclaimer" up top

Oh, not me....I am a "new" nurse. My kids' school nurse is the one who worked at my current facility 15 years ago. Sorry for the ambiguity :)

Probably a recurring question on here............but........... Is this still generally true? Have any of you seasoned nurses treated new nurses badly? I heard about this often, but I, nor other nurses I know who have graduated within the past 5 years, have experienced this issue. The many seasoned nurses I have worked with never treated me in any way where I felt inferior or ever tried to intimidate me. Before I started working at my new job, I told my kids' school nurse where I was going to be working and she was like, "Oh wow. Good luck to you there. They treated me terribly. They were the types of nurses who ate their young (but this was nearly 15 years ago)" But these nurses I work with currently are WONDERFUL. And so were the seasoned nurses at my previous job. I am the baby of the unit, age wise and experience wise and they treat me as if I were their equal (they do offer guidance and help when it seems I need it or if I ask for it). I, personally, haven't encountered any other new nurses who have complaints about being treated with inferiority by experienced nurses. So have things changed? Have seasoned nurses become more "tolerant" and/or "nicer"..... Or have we just been lucky?

Fair enough. However, my patients don't know how I interact with people outside of the unit, so, as far as they know, I fist bump everyone. It does fit my personality and they're all very receptive towards it. But when I see one too many patients engaging in some self lovin' activities, especially when these guys have been on a locked unit for weeks or months, you're darn right I'm gonna lump them up and greet every single patient with a fist bump.

"You're the nurse. You're the one who is supposed to deal with the crap I'm not hired to deal with. I teach. You deal with the yucky physical stuff.............and if I don't send this kid to you, I'll be held liable in a sue happy society". ---sincerely, Mr/Ms/Mrs. So and So.

"When it looks like things are not going your way. When it looks like everything is working against you. When it feels like the end of the world." Wow. I feel "blah" at times..........but never ever close to this kind of "blah". This is beyond "blah". With that said, I'm grateful for never feeling beyond "blah". happy turkey day.

I thought nursing school was extremely hard compared to the science prereqs. However, someone above said that she felt the prereqs were harder than nursing program. The prereqs are, I feel, 100% memorization, while nursing program requires a high percentage of critical thinking. Maybe it is possible that you're one of those who do better with critical thinking than straight up memorization of facts (I got straight A's in prereqs....but I will not lie: I struggled in nursing school. I think I received a total of 1 or 2 A's on exams my entire program [i did pass nclex on first try, thank God]). Nursing program is very competitive and it would be ashamed if you did turn out to be a good critical thinker but your difficulties with the prereqs keeps you from being accepted.......I wish you luck!

I think more men...big men... are needed in psych. Some patients respond.....and get right the hell up quickly, a lot better with that male presence.

It's not really a warped sense of normal. Normalcy is also adaptation......and nurses, especially, psych nurses, in a sense, are a part of that abnormal "culture". Med nurses, I do feel for you. You have to deal with physical deficiencies along with psychological..but for psych nurses, we are around it so much that we do become desensitized by what is seen as abnormal. I wouldn't call it "warped". We're just used to it. It has become a part of our lives that it's just an "eh" thing..............................................unless that person is aggressive. Then it's like........f___!!

Holy crap. I really admire medical nurses. I'm not demeaning psych at all by any means......... but medical nursing. Much love and respect to you all.

I don't have my BSN....but I'm not offended by it because I realize it's a marketing ploy. They are business who hired another business to recruit students for the sake of capitalism. It's a manipulative tactic, and, evidently, it gets many nurses caught in a bunch. It's not aimed towards us. It's not meant to offend us. They are not thinking about us when they produced this. And, really, why should they care? Its sole purpose is to recruit and make money. And sometimes business will do whatever they can to sell.

I'm used to documenting patients as "clients" (although verbally I'll sometimes refer to them as patients or clients) from my previous place of employment. At my new place when I document, I am having a hard time breaking the habit and always having to delete "client" and replace it with "veteran" or "patient". It's not that I have anything against calling them "clients". As someone else said, it is just semantics. I just want my documents to conform with the normal practices of that unit.

"Or is it just going to come with training/experience?" Advice that 25 year psych nurse gave me: build a rapport with each patient from day one ...or within a few days of admission....and during each shift you work, meet with 2 or 3 patients a day and just shoot the poo poo with them. Have a friendly conversation with them with some therapeutic nursing stuff squeezed in here and there. That way if someone becomes agitated, you've become trusted enough that you just may be able to redirect them before any escalation occurs that could result in a take down or psych emergency. For me, having a peppy personality and using humor helped put the patients at ease with me. Of course there are always going to be a few patients who are just not approachable due to severe psychosis.......I, personally, leave them alone for the most part until they are more stable. But even many stable patients can just be unapproachable. But, very important: don't let patients intimidate you and don't show them you fear them no matter how effing scared out of your wits you are on the inside. Don't let them manipulate you. Be consistent. Again, it all takes practice and experience. One more thing: Always fist bump. Don't shake their hands. On an inpatient psych unit, you'll have an idea of where that hand has been. And you won't want to shake it.

Doesn't/hasn't affected my life outside of work.............. However, I do often find myself "diagnosing" guests on a particular TV talk show -- that is a constant train wreck I can't avoid watching late at night on youtube---- with mental or personality disorders.

Psych nursing requires some serious interpersonal skills. However, unlike medical nursing, it is easy for psych nurses employed on a psych floor to "avoid" patients. But in order to be a true psych nurse, one has to make that choice to be interactive. I've seen some amazing psych nurses at the VA where I work now who actually take time to sit and have some 1:1 time with the patients...unlike my previous place where most of the nurses hide in the nurses station unless they HAVE to come out and intervene during an escalation or crisis. Psych nursing really does take a certain type of person to make it what its suppose to be. It's the ones who hide in the nurses' station that give all of us a bad reputation.

I've only been in government. First for the state. Now for the fed government (VA nurse). If you want to make a difference, don't go government. That's all I'll say. Good luck to you.