healer_energy

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.

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

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.

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

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:

I just saw your messages about these formulas and I am currently considering going to a chiropractor who also uses these formulas. I was wondering how it was turning out with you. Chiropractors very frequently are able to practice with many other types of modalities. I'm not sure how that works but it is common. I myself don't like chiropracty at all and wouldn't get that myself but I do think these herbs, supplements, whatever they are can be very helpful. I have taken them before with a nutritionist and still would be except for the cost. So I was wondering if you would also give me some idea about that. Thanks very much

Thank you for this info. I just can't find any other stuff about it. I think you may be right. It's been three days and I still feel woolly at times. Can you give me any resources. Thank you Sonya

I recently had anesthesia and I think what it does is strip off your aura because all noises and events around me just made me grip my head and ears and want to scream.:trout: It also felt like I was surrounded clumps of white wooliness. After a while I tried getting up and after throwing up I felt much clearer. Maybe I poofed away some of the wooliness. But then the nausea came back and the sensitivity was still there. A shot of phenergen was followed by an almost paralytic feeling sleep. When I woke up from that I felt much more solid. Just in time because a bunch of staff started clanging bed parts around next to me. I know I am probably more sensitive than some and since this was emergency surgery I was upset and afraid most of the time. I happened upon someone that said they knew healing touch and did some brief aura smoothing. However, this just brought on the nausea again. What are other people's experience with this? Sonya

This is my issue too. I am wondering if it is different in psych, which is where I am. I have had decades of experience in med-surg, critical care etc and I have always been focused on the emotional aspects of wherever I was. Now I am in a NP/Psych program and almost everyone but me has been working in the field. I know I can make a connection with a client and working with dementia will help me deal with "crazy people", I imagine. But the language, the theory, a therapeutic response.. I feel so horribly naive sometimes. We were watching a film about some disorder and I was almost overwhelmed by the pain evident in the client, but my class mates were laughing, knowingly. As we ourselves are the therapy, isn't experience necessary to gain the instinctive helping response. I can't just say "Let me consult the DSM or some other clinical text and get back to you tomorrow." I think it is different in psych and I am going to find a job in a psych inpatient setting for the next year while I am finishing up, even though I want an more independent role eventually. Sonya

I am just reading this almost a year later and wondering what happened to you over the year. But I wanted to say that there is a lot of mental health aspects to all types of "medical nursing". I have worked med surg, ICU, CCU,ER and teaching and always emphasized the assessment of stress and the family crises that occurred in the face of illness. [sometimes at the expense of exact hourly measurements!] Those moments of connection were the heart touching times I remember. Finally now, at 60 I am getting into psychiatric nursing with some formal training. I know I will be good at it with a little theory and learning the language. So if you did choose the med-surg route, it's all good and you don't have to lose anything. Good luck ! Sonya

I think all the ideas are good. I personally cannot do them in any other way that straight from the front of the MAR book to the back. Sometimes I go backwards so I hit the farthest away ones first. Sometimes that fools the phone calls that always happen when I am farthest away from the phone. It also makes it more interesting. I work evenings and I do mark the later ones with the tabs so I can flip around a bit better. But I also like to go straight through and recheck the others too. I think one thing that has not been mentioned is too stay really focussed and don't get into situations with the aides, or take side trips for checking this and that. I generally don't divert even for pain meds since I will be there generally within 15 mins or so. I usually put a piece of paper and collect requests, information or whatever and then just do all those things after. And yes, it is really slow at first but it get's better. Honestly. Sonya

I do know this feeling and I think mine started when my husband died 4 years ago. Every day I opened my eyes and the world was still wrong. And now that I am 60 thoughts of retirement and "What's the use of starting something new" keep popping in from time to time. But I have started new things, even though I am not sure where they are going. And, as I tell the residents in the nursing home I work in. "Every moment you are alive, you are making a difference, to yourself and everyone you come in contact with." You took the time to write here on this forum and you bet you have made a difference to almost everyone who read your message. Then they may have discussed in with someone else and so the ripple of your thought goes out... it's a bit mind boggling actually. Many are reviewing their lives and feeling grateful. Others are so relieved that someone else feels like them. Thank you for this. But what helped me immensely was a statement given to me during a practise therapy session. "Loneliness and grief [as well as other feelings] are just emotions. THEY WILL NOT KILL YOU." I was so terrified to feel lonely. I thought that would be just the end. So after that when I feel lonely, mad, sad etc. I remember that and just let myself feel it. I find that it just sort of goes away in about 2 hours. I hope this was helpful. I was dwindling a bit myself today. Thank you for reminding me about it. Sonya

I am in somewhat of the same boat. I am 60 and having completed my MS in Education/Med Surg 10 years ago I am now doing a post graduate track in psych. I am not going to be a NP but a clinical nurse specialist. I have had very little experience in psych nursing except some clinicals. However, I want to do some counseling and working with geriatrics in the nursing homes. I am very experienced in NH work, especially with the Alzheimer's population. And I have been encouraged on more than one occasion that I would be a shoe-in. However I am going to get as much clinical experience as I can get and I do feel that working with demented people has given me great skills in observation, intuitive interacting and so on. At first it was intimidating in class because almost everyone there has a psych back ground but everytime I spoke up with my opinion and comments, it seemed that I had said something intelligent. And I could mostly get what they were saying once I had them translate some of the language. I also think that maturity and experience do mean a lot having taught students in nursing of many ages. So... go for it. Sonya

Yes, I don't mean to be flippant but I think it is a truth that many, many people who go into helping professions are unconsciously seeking help for themselves. I was a bit surprised that you were worried that a psych history would be a problem. And I agree that you are uniquely qualified to help people through your own experience. Maybe things are getting more open now than they used to be but at my work there are many staff members on "meds" and who speak openly about their diagnoses. Their seems to be now disadvantage. Of course, if you work with the demented, anything goes! Sonya

Can anyone tell me about some good web sites for psych students? Right now I am wallowing through the theorists and would love to find some good explanations and comparisons that I could just pop into my notes. Sonya

Pain In Ass staff FYI.... Sonya

Thank you for this. I also will be starting practicums next year so I will print and keep your words. At the moment I work with late stage Alzheimer residents and I feel that this has given me some valuable experience as far as being aware of what is going on around me and responding with genuine caring,without fear, yet with alertness. They do live at a more instinctual level without the overlay of social expectation. I was wondering if mentally ill patients are also hypersensitive to others in the same way. In other words, can they sense or read others more acutely in the same way that a blind person can smell or feel their environment with more depth. Or is it that what they sense matters more to them or affects them more? :uhoh21: A more healthy person might be able to dismiss many stimuli in their enviroment as being non-threatening and so actually attend less to them. Can you also suggest a search term that would get me to the previous advise re clinicals that you alluded to? Sonya

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.

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

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.

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

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.

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

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!

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: