healer_energy

healer_energy's Latest Activity

1. 

   Psychopharmacology mystery

   healer_energy replied to healer_energy's topic in NP

   Thanks again for the TMAP link. I shared your comments and the site with my preceptor and she agrees with them so I my confidence is restored and I have something to use as a basic start. What I am looking for now is some way of knowing how they stack up as far a side effects. Say someone heavy comes in and you have a choice of drugs for their psychological problem but you want to choose the one with the least weight gaining aspects. Or it might be any other side effect such as activation, sexual difficulty etc. PS I did receive your private e-mail address and will use it if I think it is appropriate. Thanks.
2. 

   Psychopharmacology mystery

   healer_energy replied to healer_energy's topic in NP

   Thank for your reply! We had some TMAP algorithms given to us at school and I dug them up. Thanks for the great websit with them all! However while I was searching on line for them I came upon this website Bush To Impose Psychiatric Drug Regime - Health Supreme which seemed to cast aspersions on the sources for the info. Drug companies with obvious agendas. I was very discouraged and I am delighted to make contact with someone close to the work. I would also love to PM you but I am not sure how to. I also found a great psychopharm book. I am sure you are familiar with Steven Stahl. He put out a Prescriber's Guide which is a bit smaller than a regular size book, has reasonably large print, clear and COLORED sections, LITTLE CARTOONS, a section for each drug called the Art of Prescribing and another called Pearls of Wisdom. And it is listed alphabetically. Also an appendix listing the drugs by classes. Anyway, I ordered it today. You can see what is important to me - yep, no squinting,cartoons and smaller books. Sonya
3. 

   Psychopharmacology mystery

   healer_energy posted a topic in NP

   I am a psych nurse practitioner coming to the end of my training. I have been a nurse for decades but not in psych so I am finding myself feeling rather lost in this new field. Specifically the medications. I am spending a lot of time studying them but it is so frustrating when I read that you give this med for this disorder, but then this other one might work or maybe this totally different classification would be just as good. Or maybe you can combine them. And then there is the side effects. The lists are endless. I know that there are specific aspects of each drug that are the important thing about that drug - such as sexual problems, weight gain and so forth. But when I try to pin it down, it seems that all of them or most of them do this. Is there an source that could bring some clarity to this mess.
4. 

   NP Psych opportunies

   healer_energy posted a topic in NP

   Reading the posts related to a master's degree from another field and transitioning into nursing, I feel I am in the same boat, in some way. I have been a med-surg/critical care/long term care nurse for decades and have a Master's in Nursing Ed. Now I am completing a NP in Psych and I feel like a fish out of water although I am loving it. Would people hire a person like me who has little experience in the psych field? I am confident that I can do it but the structure, the language and all kinds of unspoken knowings are all new to me. Sonya
5. 

   Personality Disorder Test...how do you stack up?

   healer_energy replied to Thunderwolf's topic in Psychiatric

   Oh! Lordy! I have some traits of my mother! I suppose I shouldn't be surprised. I have to look into this a bit more! Sonya:idea:
6. 

   u. of vermont and southern vt.college

   healer_energy replied to Carin's topic in Vermont

   I live very close to this college and it is very scenic. There have been some pretty bad staff turn over's over the last few years in the nursing department but now it is much more stable I hear. My daughter just started this term and she is very pleased with the welcome that she received and the generally friendly attitude. She is not in nursing yet but taking A$P and some other prerequisites. She seems to like the teachers she has met so far. She was lucky enough to get everything paid for through VSAC even though we live out of state. She told me today that the college has just got certified for another 5 years. Hope this helps a bit.
7. 

   CNS in Psych

   healer_energy replied to tjusnjon's topic in CNS

   Thank you for the input. I started school yesterday and so far it seems that I will get what I need. I am going to also take the one credit psychopharmacology course offered in the NP program. I don't particularly want to prescribe meds but if I get the job I want, a working knowledge is needed because this nurse makes suggestions that are co-signed by the psychiatrist. From what I see, the range of meds are very limited - it seems only about 4 are being used in this arena. I am also excited that my interest in alternative methods of healing is also validated by the instructor and I am encouraged to include this in my consideration and discussion. I did start a program to get a master's degree in psychology previously but the students and faculty were so rigid and they seemed afraid to talk about their feelings in the counseling exercises that I dropped out. "Well, I'm going to pretend to be a depressed person." said my partner. Right.. and I can feel the dark sadness radiating from his person. :stone And I got him out of it, at least temporarily, I'm sure. When it was my turn, I had the instructor, and I certainly took advantage of the moment. I got some great advice that helped me immensely at the time. This might seem silly but being quite empathic myself, I could feel it all the time. I didn't think I could conform enough to be comfortable. My new class mates are all nurses, of course, and varied but interesting and open-hearted. I felt immediately at home, which is difficult for me in new groups because of the impact of new people on me. Anyway, it is all good! Sonya
8. 

   CNS in Psych

   healer_energy replied to tjusnjon's topic in CNS

   I am just about to begin a program leading to a psych CNS. I already have a MS in Nursing Education and I did do 2 courses in the psych track before I packed it in. So it will be 15 more credits. I am not a psych nurse at all, I have worked med-surg, critical care, education and presently I am in LTC. But I want to work with either the elderly [i'm really good with demented types now!] or adults who are situationally stressed but not people with mental diagnoses like schizophrenia [unless they are old, of course]. I am not a young person and I would like to retire from the med carts before my legs give out. I see it as something I can do even if I get a bit decrepit. Anyway it is yet another new field for me... something to keep me young.
9. 

   I HATE nursing! (long)

   healer_energy replied to InfoNurse1595's topic in Nursing

   I have to say, from my own personal experience: please don't teach. I have had professors in nursing school that came from situations not unlike yours, and they didn't last. The pressure of nursing is at least doubled when you have six to ten unexperienced students working on your license. Possibly theory would be fine, as long as you promise not to run the students off with horror stories =). " I have to agree with the above. I love to teach and have taught, but when I stopped also working at the bedside, I felt as though I lost my edge that would allow me to keep track of all of them. It is very hard to get a job without having to do the darn clinical piece. I don't think you could teach this in any sort of positive way if you hate the job! :uhoh21: And teaching ain't easy either. The endless prep and then keeping positive in the face of their anxiety which displays itself as criticism, stupidity and missing class. 30 eyes spotting every tiny error on your test, :imbar 30 eyes ripping apart your hours and hours of notes, illustrated formatted, etc. :angryfire Well! I guess I was right to get out when I did ! Sonya
10. 

    Geropsyche, anyone?

    healer_energy replied to NurseCard's topic in Psychiatric

    I work in a nursing home with a locked ward for the Alzheimer residents and generally demented and some psych patients who are above middle aged. When we can't cope with the violence or other horrible behavior [and believe me, we can deal with a lot!] we send them to a geropsyche ward at a local hospital. So I would think that it is basically receiving these out of control people and medicating them until they become more managable and can return to facilities like ours. I would not think anything like talk therapy would be useful IMHO. But I may be wrong, of course. I only see one side of it. If there is anything else to do I wish they would teach us about it.
11. 

    MARS missed signing

    healer_energy replied to mar326's topic in Geriatric

    I think it is an endless problem with no real solution, although I thought having another nurse check them over is a good idea. But then who has the time? I think the environment make a great difference. As long as residents, staff and family feel free to interupt or demand that meds are given out of turn, there are going to be mistakes, I think. No-one respects the med nurse. Or is it so boring that you welcome a distraction? And that endless locking and unlocking, it drives me crazy! And on the demented wing with 37 residents you have the choice of taking the cart out and enduring the teeth grinding, slurping or just plain nosiness of the residents or standing in the nurse's station avoiding people's feet and trying to ignore the teeth grinding, slurping and bellowing of the residents fixating on you just outside the station. And then they put the worst in chairs right there so you can "watch them". :angryfire Not to mention being telephone operator and message taker. Oh yes! they started on the signing the cards business some months ago. I was all gung ho and I was able to prove I was not at fault twice because I signed. Then I noticed how much time was added to the med pass so I couldn't get done in time for the next meal. Then I was admonished for a med error and it even got onto my evaluation. "I know you gave the med because you signed the card". :imbar After that... poof went all my efforts. I noticed that most others seemed to stop about that time. I'm not sure why. I know one thing I have done to help myself is that I never mark the MAR with straws or whatever for the next med pass. I make myself go through everything completely so that I double check myself. I think that helps. But it is amazing how complete blocks of shifts and residents go unsigned. What are people doing? Well, that's my 2 cents Sonya
12. 

    Nurses over 50 &/or with health issues affecting work

    healer_energy replied to Karen4HIM1951's topic in Nursing

    Wow! what a lot of responses. It warms my heart that I am not the oldest nurse on the planet. I am 60 and work in a nursing home. Lots of old nurses there. And those that aren't old have bad backs, cricked necks, bad knees, allergies and are all on psych meds, it seems. There is always someone on light duty. I went through the agonies of looking at SS just some weeks ago when something went horribly wrong with my knee and I thought I couldn't work. Fortunately it got better rather quickly with some physical therapy. I only work 2 days a week - Baylor 12 hour shifts and my aim, since my husband died 4 years ago is to find a way to live on the amount I will get for SS. Since I now own my house this looks possible, which is why I don't work to get that much more than that. I also want to be content not being in the working world and to be used to doing other things such as my work in alternative healing, poetry and making the rounds of my friends. Through the ordeal with my knee I worked through some heavy duty fears and insecurities and suddenly I am now going back to school to get a graduate degree in Psych Nursing. Then I will get into that field and I might have to start working full time again! You just never know what is going to happen next. There are so many careers for nurses that are not at the bedside, it is worth looking about, I think. Sonya
13. 

    Starting back into LTC-need help finding a good nursing assignment sheet

    healer_energy replied to katygirl's topic in Geriatric

    I have always created a report sheet of my own, so I understand where you are coming from. I also don't like to use more than one sheet. It was when the sheet were copied with the back side upside down that I finally gave up on the official one. And not to dampen your zeal but what info do you need to have in the report, I don't write anything down that can be found elsewhere - so code status, doc, diagnoses, med stuff, VS, I don't need. I can look at the chart, the MAR, the VS board for all that. What I need is the current issues and concerns and things I need to take care of on my shift. With such a large number of residents I need to be able to easily pick out the important things like urine dips, family worries, labs etc. I came from intensive care to long term care and I had a real culture shock learning that it is OK not to know everything and be tracking everything. So for me, I take a doctor's order sheet and write in the names as I get report and make three rough columns. What I am told in report, what happens on my shift, and the to do column. Then I use the back to make a running list of routine things to do which I just cross off as I go. Generally most of the day's events get on this list so when I get through report I just go over it to make sure I told everything. Good luck!
14. 

    LPN's just glorified nurse aids in LTC? Huh?

    healer_energy replied to onehusbandsevenkids's topic in Geriatric

    I have had just the opposite experience. As an RN working in LTC, it is the LPN's and aides that point me out as the RN, trying to make me responsible for this and that. Apart from some things like the rare IV's, we are about the same. Many LPN's are much better at aide work than me because they have been aides. I am hopeless because I haven't. I know a lot about various clinical subjects because I have worked in other positions and I have taught. I think we all respect each other for what we know and help each other out that way. And if anyone looks down on aides they are truly idiots, they do a big job for a pittance. They vary in their performance, just as RN's, LPN's and everyone else. Sonya :uhoh21:
15. 

    RN starting new position with mentally ill in LTC

    healer_energy replied to SusanS44's topic in Geriatric

    :uhoh21: Hello ! Have you had experience in the psych field. I must presume so. I work in a locked demented ward and we are getting more and more psych diagnoses which are mixed in with the otherwise demented. I suppose we are the last resort. They are usually a bit younger than the rest 50's and up and I often wonder how wise it is to subject these poor people to the unsocial and unpredictable behavior of the other residents. We also feel very unqualified to respond to the mental health aspect. For example, our general response to a demented person being violent or doing other socially unacceptable acts is to smile and coax, or redirect them away from the exacerbating environment. However, I understand that some psychiatric reponses should be more commanding, or reality based. We do have a psychiatric liason nurse but we are not receiving any training in this issue. I wish you well in your new position. Sonya Burdge
16. 

    Interfering with other nurse's residents

    healer_energy posted a topic in Geriatric

    I have an issues with a certain nurse at work who gets into everyone's business. I'll call her Mary. I finally had to speak up. Some weeks ago I had a dying patient who was fairly young. I spent some time at the beginning of the shift talking and listening to him to find out where he was re acceptance, and even went as far as to clearly inquire as to his feelings about hospitalization, family visits, hospice. Although not at acceptance, he didn't want anything else at this time. So Mary goes and visits him... Voila! He wants to go the hospital! He suffered a lot there since they denied him meds, not accepting his level of addiction over the years to pain meds. And he was back in 2 days, not trusting anyone. Then last week I had a resident fall out of bed on her face, blood everywhere and sort of twisted. Mary asked if I wanted help and I said no as I rushed to get the paper work done and the squad called. The aides stayed and there was nothing else to do. Sure enough, Mary had to go in and started ordering the aides around. Thank God, none of them would turn her over. She even laid on the floor beside the resident. She kept getting BP's somehow on an arm that was flattened against the floor. I told her to stop... yep they were low... now what! When the squad arrived she kept on yabbering on and telling them what to do. In fact one of them had to physically remove her hand as she was trying to put a Teqaderm on a skin abrasion... they were trying to get Telfa and a Kling on it. When the squad finally left, Mary came out looking pleased with herself and I asked to speak with her in the back room. I sat her down and said "You really have to keep out of my business. I did not ask you for help" Then I gave her some compliments about her being a caring person and a good nurse. But that was cut short as she lept to her feet, rushed out of the room and slammed the door! I open it and said "I take the last remarks back." But I think she was totally surprised by what I said. Of course all this was passed by the ADON who supported me and it was just lucky that Mary was just getting off, and going on holiday. But from now on I am not letting her go anywhere my side. If she is so sensitive that she slams doors. I don't thnk I need to say much. "Oh! Mary, remember what we spoke about?" that should do it....