RN4life74

We have been told that there is no such thing as a "do not admit" patient. We admit EVERY patient that comes in to the ED with a psych issue. Patients who have assaulted our staff- readmitted. Patients who have created chaos by pulling the fire alarm-readmitted. Patients who have been sexually inappropriate with females (including staff and adolescent female patients)-readmitted. I could go on and on. We are to keep the beds filled! Eight admissions in 1 shift? Sorry, gotta fill the beds.

My typical night shift: Listen to report, make rounds on patients. Give prns. Do some documenting in computer. Admit patient or patients from ER. Give prns. Sit at the computer to document the admission for at least an hour. Chart checks. Correct errors made by pharmacy, MD, previous shift. Give prns. Throughout the shift I am interacting with and assessing patients that are awake. Try to get the techs to do THEIR jobs. Handle crises as they occur ( acting out pts, takedowns , medical issues, falls, etc) document, document, document. Admit another patient from the ER. Give prn's, Do notes on all pts. Pass am meds. Sometimes I'm able to take a break and eat something. Give report. Do anything I wasn't able to get to due to interruptions. Even when most of the pts sleep all night, it can be very busy and unpredictable. PS I like your username. Reminds me of one of my favorite church songs.

All I can say is You Go Girl!!! Take that great sounding trip regardless of any job. You have many years of very hard work ahead of you as an RN. We "work to live" and shouldn't "live to work". Before those babies come along and you're tied to a career, enjoy yourself!

Thanks, mushymash, for putting into print what many, many of us think every day. This is the reality of being a hospital staff nurse.

Thanks for your replies. I'm glad for all of you who work with such great techs. Fortunately. we do have a few of those and we cherish them. I could tell you some things you would not believe about some of ours. Management favors our social workers and techs over our nurses, which is sad because most of our nurses are very hard working and get little recognition. It's really quite complicated, so I'll just have to say "oh well" and just get on with it. I just wish nurses were more supportive of each other.

Are your techs called "Psychiatric Technicians" or "Psychiatric Counselors"? Are they also CNA's? Is there a huge disparity of workload on your unit between nurses and techs? I ask because this is a problem on our unit. Our "techs" are called "counselors", yet they rarely spend time "counseling" or doing 1:1's. "The PC's are often not CNA's, which means they cannot or will not do things such as showers or supervising showers, dressing or undressing patients, incontinent care, collecting urine specimens, etc. This leaves the nurses to do all of that, in addition to their RN duties, and while the PC's enjoy long breaks, surfing the web, and generally going about their minimal duties at a nice pace, while the nurses don't get breaks or even a meal break, race around trying to get things done, often doing overtime in order to catch up. We have a couple of excellent PC's and they're worth their weight in gold, but too few of them. Management is not helpful with this. So, I'm just wondering if anyone else is having this experience on your unit?

OMG That's exactly what happens where I work!! Your post made me laugh, thanks!

What does your hospital do for nurses for National Nurses Day? Ours essentially does nothing. The day is swallowed up by National Hospitals Week, and nothing is done especially for nurses. Also, they've taken away our cost of living raises. Nice, Huh?

My unit is a hospital psych/detox unit. We deal with vomit, diarrhea, urine, blood, and having various liquids thrown at us. Some of us wear scrubs. I'd never wear street clothes with some of the messes we deal with, plus takedowns. Scrubs are comfortable, easy-care, and everyone knows I'm the nurse. I disagree that scrubs are unprofessional. What could be more professional than a nurse that looks like a nurse. They don't affect the patients negatively, in fact they seem to like the different colors and patterns. And they like being to identify "a nurse".

[quote= Most of the night shift are nurses that are pretty much waiting for retirement and don't want to do much or work two jobs. Marc Um, Marc, did you see my post in the other thread? Most night nurses I know do it for the differential$$$. We work our butts of at night on my unit. We get admissions, we have no secretary. Checking orders and correcting pharmacy errors takes time , effort and concentration, yet we are constantly interrupted. The patients don't all sleep and the ones that don't are usually the high acuity patients. We have lots of medical issues (it's a hospital unit), I could go on and on. Please don't disrespect night nurses by saying we don't "want to do much". See my post above about how "little" I do on night shift.

I completely understand what you are going through. I have done this for 20+ years and I'm sorry to say that it doesn't get better. Please get out while you can. I am very serious about this. My unit is the "dumping ground " of the city. The name of the game here is "keep the beds full". If our census gets low they cancel staff without regard to acuity or incoming admissions. On my last shift our census was 17. They canceled staff and left 3 of us- 2 RN's and a tech. We had 1 out of control acutely psychotic pt who screamed all night long. We had 3 admissions, 2 of whom didn't want to be admitted but were coerced into it, several detox pts in withdrawal, a couple of manics who were all over the place, 2 total care nursing home patients, drug-seekers, and needy borderlines. We had to give up our tech to do 1:1. No sevretary. No breaks. Lucky to be able to get to the bathroom. I started fantacizing about walking the heck out of there in the middle of it all. And this is not the exceptional night. More and more it is becoming the norm. NO support from management, only reminding us about a "T" we forgot to cross. We admit patients whose families want to go on vacation. Alzheimer pts whose nursing home needs a break from them. Homeless people who need their 3 hots and a cot. etohics who need to sober up just to binge again and come on back in our revolving door. Crisis counselors who send inappropriate admissions just because it's the easiest thing to do. This is a voluntary unit. We are sent psychotics who couldn't possibly have signed themselves in. The admission process and paperwork is arduous. Checking through belongings and recording every stick of gum they have with them, recording, counting storing the bottles and bottles of meds they bring in. To do all the work required to admit a patient only to have them discharged hours later because they didn't want to be there in the first place makes me want to puke. Ran out of space..sorry fior the rant. GET OUT ASAP!