vegnurse21

I started 5 weeks ago and this is 100% how I feel about it. It's completely self taught, I would love to have their jobs..they don't do anything lol.

Umm..I couldn't have dreamed up a better job than what Humana has offered me as a care manager. I love the company and love my job. Of course there's metrics to meet, that's how anywhere is. It is a company after all, and a very successful one. I joined awhile back and have no regrets.

I had no idea you could even do this lol. Let us know how it's going!

I know I'm pretty late to this but I would be interested in finding out where some you all that hate working from home in CM are working. I work from home w/insurance and LOVE IT. I don't have kids but even if I did I would definitely have to arrange for child care because well, you're still at work!!! You can "set your own hours" in a way, but if it's telephonic then you kind of have to go with the patients schedules. I would be angry w/7:30am calls to talk about my heart failure lol. So we mostly work 8-5. I get a break up to an hour as long as I'm clocking my 40 hours a week and they are productive (i.e. no starting the day at 7 because what can you really get done?). Yes productivity and metrics are the name of the game for the most part, but isn't that everywhere? You go to the hospital and it's the same thing. I help people, I work from home, I work out on my lunch break, my dog can snooze by me as I work, I can go potty as I please lol...this is truly a dream job.

Intake at my facility was very different. We did screenings via the telephone and got patients from outlying facilities. We only went to the ER if there was a conflict of some kind between the psychiatrist and the ER staff. The patients had to "meet criteria" for admission and that would present some issues sometimes. It was incredibly stressful on my unit because I would have to also do the insurance work too for pre-cert and also do ECTs with the psychiatrist three days a week. We would sometimes have up to 8 patients coming at the same time and NO ONE was hardly ever willing to help me out which put too much responsibility on my shoulders. I loved doing the admissions but hated the lack of teamwork and overload of work that would sometimes occur.

I had to leave bedside psych nursing for the exact reasons you mentioned in your original post. I was having nightmares about knocking a patient out cold because they can just be such jerks. I DO still have all the empathy and caring in the world for psychotic, depressed, and demented patients. They are not included in the nightmares part lol. I'm talking about all of the addicts who do this nonsense and keep getting away with it. And with heroin being so huge right now we have so many of those. I saw a lot of patients who genuinely needed care get pushed out of the way by drug addicts who knew exactly what to say for three hots and a cot for a few days. I still love psych but I had to move on. I miss my coworkers and genuine patients but I am so glad I left.

I am on my feet literally for at least 10+ hours of the day on a step down unit. Sometimes the whole entire shift. It's so crazy because we have tons of post op patients who are out of the critical period but still very prone to rhythm changes, bleeding, etc. We care for vascular patients and cardio thoracic patients and then also are getting all of the post cath lab patients, many of whom still have lines in that we DC on our floor. The beds don't even get cold before they fill it again and you have to catch up on ALL of that discharge charting. It's crazy. I have many many days where I just cannot keep up. We pull chest tubes, wires, IJs, and also do our own discharges. We do our own ABGs as well if a patient is deteriorating. It's a ton. I have a love/hate relationship with the chaos lol.

Etsy has some absolutely adorable nurse things that you can get personalized. A friend of mine just graduated and I got her this really cute sticker for her car with her initials inside of a stethoscope. Highly recommend etsy for gift giving!

From my limited googling on this subject, step-down in any form does NOT count and they want you to have experience with invasive lines and swans. Stepdown, ER, PACU, none of those count. It has to be cut and dried ICU.

Location: Southwest Ohio Pay: $26/hr Area: Step down RN with 1 class left of BSN Years of experience: 8 Full time Shift diff is $4/hr for evenings/nights..no shift diff for weekends at all. This survey is really making me think I should have asked for a raise when I moved to step down.

Thank you guys. :) She never called for my phone appt when she was supposed to btw I was quite annoyed. I have to wonder with the amount of schools offering NP now especially online (which is the way I like to do things) if they are all up to par or if they are just selling fluff. I guess they have to be able to back it up though with passing percentages and stuff.

Thank you Brit! Very helpful! I have an appt today at 3 to speak with someone about the program close to me. :)

LOL I agree with you on that. I have done tons of youtube-ing with this new floor I'm on just trying to get the grasp of things. It's been immensely helpful!

Forgive me for my username...I picked it out 10+ years ago when I was entering nursing school . Just giving my background...2 years med/surg, 6 years of psych, just now started on a cardiac step-down unit. Each unit has been it's own learning experience and has been mostly learning as you go. I will be done with my BSN at the end of the summer and am applying for grad school for the beginning of 2015 if possible. My question is this though...does NP school adequately prepare you to practice? I would hate to come out of school feeling like I do as a new nurse to a new floor. I would want to know that I have adequate knowledge to practice. I'm not sure where my specialty will be. I love psych, I love geris, but am working towards critical care just to make myself well rounded no matter where I end up. Do you feel like the classes you are taking are helpful? Is it more than just the BS your way through nursing classes like my BSN ones are? Busywork is all they are it seems like. Do you take more in depth pathophysiology and pharmacology courses? Do you feel prepared well enough to work independently?

No I am aware of this but the OP didn't specify NP, they just said psychiatric nursing. And I would NOT feel comfortable going to a PMHNP that didn't have extensive experience first since they are able to do meds, etc. It's just my opinion of course, but I hate the thought of APRNs going into practice without experience. We all know experience is the biggest teacher.

How can the two even compare?? Maybe I'm naive on the psychologist arena, but psych nursing is SO much different than having an office and listening to someone for an hour per day. As a nurse, you are spending hours and hours with your group of patients who can be a walkie talkie like you and I with some depression or bipolar issues. However, you can also have a day spent with a group of patients who are actively very psychotic and hallucinating. As a psychologist I would think you would work with people when they are at a more stable level rather than when they are in the throws of a psychiatric emergency. Psychotic people can do some pretty disturbing things. It really isn't for the squeamish. We also have a lot of MRDD patients that can be equally as heavy. I have seen some CRAZY stuff...and psychotic people really love being naked lol. I don't see a lot of clinic patients disrobing in office visits...but then again I'm not there. Again, maybe I'm naive, but I think it's totally different and like apples and oranges.

It's nice most of you have that time to spend with patients! Before JACHO got so documentation-heavy I used to spend a ton of time with the patients. We would talk, color, watch ball games, etc on TV. Now between all the documentation, drug users asking for meds constantly, and lower staffing I hardly ever get to do that anymore. We don't do groups anymore, but used to. When we did groups though it was in the midst of all the documentation changes and honestly we were so rushed to get that done our groups were rushed and pretty crappy. I guess it just depends on where you work. I work in a huge inner city hospital known for cardiac and ortho excellence and are a Magnet recognized hospital. Therefore, they care more about how things LOOK rather than how things really are. It's disappointing to say the least.

We use it as our first line emergency IM. We usually mix with ativan as well. When mixed it does the job quick and well, but people are a bit too snowed, so unless someone is REALLY agitated I just give the geodon. To help with the mixing issue, we will premix the geodon and store it in the fridge. You have to take it out of the pyxis under someone's name, but it doesn't get charged to them or anyone until it is scanned with our system when we use it. It can be mixed and stored for 7 days.

So frustrated. I do really well in all of my classes through this program and now have an 88 in this one. With the submission of this paper I'm afraid I'm not going to pass. This paper was so unfair and ridiculously confusing. I am usually one to pick up pretty quickly on things, especially of a mathematical nature and this was just not explained AT ALL. I am so mad but finally just said screw it and turned it in. Did the best I could. Added: I didn't ask questions which is my fault, but when looking at other students Q&A, seeing her responses I can tell she is so less than helpful. GRR!

I would say 3/4. There are a few lazy ones but for the most part our PCT's work SOOOOOO hard and are so under-appreciated.

Yeesh. I am so sad to see that so many others have similar or even worse circumstances. Congrats to the woman above who got a new job after the horrid clinic job! SBAR for bathroom breaks?!?! You have GOT to be kidding me!!! sugarcoma - Coulda written that myself. Sometimes I wish I could be like the uncaring "nurses" but at the end of the day I could never live with myself and obviously neither could you. It's a bit scary to me how quickly all of this is happening. Documentation of course has always been important, but even just a few years ago when I did medical I could at least be with my patient a little bit longer than I am now. However, maybe it's because I'm at a magnet hospital now and that one wasn't. It is now though and I've heard it's gotten much worse. I am in school for my BSN and I will not be stopping until I get my MSN. I can't stand this. And you know, while it's disheartening to us nurses, it's even more disheartening to me that these patients are going to be getting cared for by crappy nurses who don't give a damn about them. The real nurses are going to burn the heck out in this field because we just can't do it all and are compelled to try anyways. And yeah, I LOVE how it's ALWAYS the nurses's fault. ALWAYS. Doctor makes a mistake? Nurse's fault. Doctor didn't get a message from another doctor? Nurse's fault - even though you GAVE 1st doctor 2nd doctors number because you were too damn busy to put something ELSE on your plate. UGH. The post about the hospital not giving a damn is just so sickenly true and I hadn't thought of it that way before. They really don't. Just as long as the charting is perfect and nothing makes them "look bad". Disgusting.

I am so disappointed. I have done psych for the past 6 years and did 2 years of med/surg prior to. I did days, then nights for med/surg, and have done days for psych. We underwent a change in management about 3 years ago and it's been crazy ever since. Our manager leads with threats and about what is NOT being done rather than positivity and what we are doing right - things which are rarely mentioned even though we work our butts off for the most part. The management is beside the point though - I know that that is obviously going to be different anywhere you go. We are being asked to do more, more perfectly, and with much less. We are being asked to max out patient assignments in terms of nursing and techs. We have to be budget conscious, which is understandable, but to a severe degree that we can't give out toiletries without the patient asking for them. This just creates even more for us to do as getting a bucket ready with toiletries was a huge time saver. The charting and documentation takes up ALL of my shift almost with most things having to be double charted. Flowsheets must be perfectly filled out and our notes must be detailed and document everything done on the shift. I am VERY efficient with the computer - I type very quickly and know what I'm doing. Even I am having a ridiculous amount of difficulty getting things done on time. That's another thing - we are being told we will be punished for clocking out late. Staying late is the only way we can get things done!! With all that is being asked of us - patient care is suffering. We aren't able to be with our patients who need us. I don't always have patients when I am working, but when I do I can spend an average of maybe 15 minutes with each patient per 8 hour shift. Are you kidding me???? I didn't get into nursing to sit at a computer all day. I get that we need to document and that is necessary but I feel like we are being pulled in 20 different directions and being barked at by 20 different people to do 20 million things perfectly and without a thank you. I am so disgruntled by this profession. However, it wasnt like this when I did med/surg. Is it just my unit? Or is it like this everywhere? I haven't worked anywhere else since the economy started to tumble, so I just want to know if everywhere else has been under such harsh conditions? Nursing is busy - I KNOW THIS. But there is NO reason that going 12 hours with no break should be considered the norm, as well as having to stay late to get things done as well. So do way more, with way less, and do it RIGHT. Sound familiar?

Oh honey, I am right there with you and it is a helpless, awful feeling. We are not quite as gung ho on the ECT treatments as your facility seems to be, but I see people being diagnosed with disorders just after minutes spent with the psychiatrists and it makes me cringe. For the most part, our ECT candidates are properly screened and have the capacity to give consent. Seeing people who really can't give consent being rushed in to have it done would make me sick. Like you, my frustrations lie with patients who are demanding, entitled, rude, med seeking, etc. who are welcomed to stay as long as they want due to insurance and monetary purposes. It's crap! I am tired of being someone's verbal punching bag/slave. Granted, I am getting paid for it, but this is NOT why I became a psych nurse. Plus, one of our psychiatrists just likes to mess with us and it's getting very old. We really can't do anything about the psychiatrists treatment choices or diagnosis. We can only advocate to our patients to choose what they would like to take or how they are treated. I just give as much education as possible and encourage the patient to make their own decision. KarenfRN - I am glad ECT worked out for you. But there's a difference between patients who are willing and able to consent to ECT and someone who isn't. I will have to do more research into doing ECT as a first line therapy instead of last resort. Maybe things are changing and we are just old school lol. Glad it worked for you though. Don't get me wrong - I am in full support of ECT if it works, for sure! I think it's a great treatment for some.

Just wondering. I'm 25, been a nurse for almost 6 years now. I am in the process of getting into a RN-BSN program right now that should take around 2 years maybe? I did med/surg for two years and have done psychiatric for the past almost 4 years. I like psych and that's where I prefer to stay. I know that there aren't really a lot of psych positions right now and I don't plan to travel until I get my BSN. There are other things keeping me in my hometown but I don't want to get into all that. I would like to travel in the future but am prone to the 'what-ifs'. lol Fear of the unknown keeps me here. I hear so much about shady recriuters and that travel nursing is kind of phasing out...especially psych. So it does make me worry. Do any of you have any regrets about travel nursing? This forum is FULL of warnings for new travelers but I want to know if there's any of you that wish you hadn't gotten into this field or if there's certain things you really have issues with. If anyone out there IS still managing to travel doing psychiatric jobs I'd love your feedback as well (ANY feedback - not just regrets!). Thanks!

I've been working on an adult inpatient unit for about 3.5 years now. We got a new manager and things have been going downhill since. The changes have been overwhelming and although some were needed, some are downright unfair. There's a lot of favoritism and new rules. One of the new rules is that in addition to already working weekends (8 hr shift ppl do every other, 12 hr shift ppl do every third) we have to sign up for a weekend on call shift every other schedule. Doesn't sound like a lot but that means your weekend schedule you get ONE totally work free weekend out of that schedule. Esp for the 8 hour people - that SUCKS. I do 12s so it's not as bad but it's still very unfair when it comes down to the "favorites" not having to do it at all and the rest of us minions having to. Ugh. So we have several mental health agencies in the area and I am interviewing Thursday for a nurse care manager position. It's lower pay, but no weekends no holidays (holidays and 17 vacation days are paid). My pay will decrease by what looks like about $100-150 per paycheck. That's a lot. But better hours, and probably a better job. I will have to go into the community every once in awhile to see patients in their homes. Most of the areas these people live in are low income and I will be encountering bed bugs, very poor living conditions, bad areas to be in, etc. I won't lie - that makes me very hesitant to do this job. I know I CAN do it but do I want to expose myself to that a lot? However, that's just one aspect of the job and a lot of it is done in the outpatient facility. Is there anyone here that's worked as a care manager for an outpatient facility that's psych specific? What did you like/dislike about it? And what would you guys do with this? Are the better hours worth the lower pay?