sassifras85

Where to begin. I have a BSN in nursing. I have been a nurse for 7 years. I graduated summa Cum laude, did great in my clinical, and all my preceptors praised me up and down. Right after graduated, I accepted a job in a large health system (we'll call it system A)on a ped oncology floor. I lasted 2 months (orientation) when I realized I absolutely hated it. I talked to the nurse manager who approved me to transfer within the system to a psych hospital in the health system that I was interested in. I loved it and stayed there almost 6 years. However, I was working 5 days/week and rotating shifts like crazy with no end in site because there were no other openings to switch to. A job opened up in the same health system in an ob/gyn clinic with great hours. I always had an interest in ob/gyn so I figured I would take the position. I ended up LOATHING it. It just was not my thing (even though everyone there commented they couldn't believe how fast I picked up on everything) and I dreaded going to work. I stayed 7 months. I talked to a nurse administrator at my former psych hospital who said they'd love to have me back but at that point, a job in psych in a DIFFERENT health system, at a community hospital, opened up. I heard good things about this hospital, the pay offer was outstanding, it was close to home. I figured that I knew what I was getting into-i love psych and felt it was my 'niche' and thought if I had experience in a reputable psych hospital in a large health system, this little psych-unit-within-the-hospital would be perfect...I figured why stay in ob/gyn when I knew it wasnt my passion, when a psych job (and I knew psych was my passion) opened up. Well, I have never been more wrong in my life. I went to the 4 day hospital orientation and on day 5 went to the psych unit. From the minute I stepped onto the unit, I got a gut feeling this was a horrible mistake, but figured it was nerves. Another RN with psych experience was orienting with me. I'll spare the lengthy details,but to sum it up, apparently this health system has a ton of nepotism and the nurses dont take well to outsiders. We were treated like we were scum. We werent even given a tour of the unit and every question was dismissed without an answer. I thought to myself "ill just wait to ask my preceptor" but I found out the leader of the pack WAS my preceptor. The nurse manager is "one if them." Aside from all this (I can deal with mean nurses) the main thing is the unit's complete lack of policies and what I consider unsafe practices. It seems that if you werent there when the building opened, too bad, you didnt learn the rules then, and they arent written down, so too bad for you. After 8 hours, I left like I was in a nightmare and couldn't get to my car fast enough when the day was over. The other nurse echoed my setiments exactly. As soon as I left, I called the nurse administrator at my original psych hospital at health system A to see if there was any . Openings and explain my plight, but she was gone for the weekend. I am so disenchanted with being a nurse at this point that I am considering trying a new profession. After investing 11 years (including school) into this profession, there was only one job I enjoyed on a psych unit with a very specific patient population. There are no current openings on that unit. The nurse administrator, if anything, would likely offer me a job on another unit. I think nursing just isn't for me. I feel I've given it fair tries, but I cant practice something I have zero interest in (ob/gyn) and I cant practice in an unsafe environment at this new job. When i think of going back for my next day of orientation (scheduled tomorrow) I just sob and sob and sob. I dont think I can go back, and I dont think I could ever be comfortable being a nurse there... What do I do? If you made it all this way in the post, thank you. I think I know in my heart I need to leave nursing, but I feel lost and scared as this is all I know. Do I try again if I could even get a job at psych hospital A on a different floor? I'd likely be able to tolerate it, but do I deserve to have a career I'm passionate (or at least not a depressed, nervous wreck about)? I feel like a failure when i see other nurses and their careers. I feel awful because i know im a good nurse and can "do it" but i just dislike it. My self-worth is in the tubes. I just want to be happy.

Based on this Meriwhen, what do you think about what the above people are saying?

Are you currently a psych nurse? If a patient in an acute, emergent risk to themselves or others (whether voluntary or involuntary patient) they can be medicated over their objection in that acute situation. Now, you can't g o and force a standing, daily medication over their objection until your state's requirements for initiating that process are fufilled. If a patient was actively cutting their wrist with a knife, for example, and wouldn't stop and wouldnt take a PO med willingly to help them cease this acutely life threatening detrimental behavior, then administering the med IM is appropriate. In fact if you didn't medicate them in this situation, in an effort to help intervene and cease the behavior, and say they ended up severing an artery, you would be in a very bad position as a nurse. Battery wou ld occur if you f orced a med on a patient in the abscence of an acutely emergent situation (ie they said/did something you didn't like but which did not meet criteria for an acute emergent situation in which they were risk to self/others).

Hi everyone! I have a question regarding PRNs. Say a psych patient has an order prn ativan 1 mg PO/IM for severe anxiety. If said pt suddenly became an acute danger to self/others but refused this med PO, could this med be given IM to them (over their objection) due to the emergent situation? What I am getting at is, I know this would be ok if the PRN was written for 'agitation' but what if it was written for 'anxiety' as in the above example? Am I splitting hairs? My gut tells me thatyou would administer the med to protect patient/others in this scrnario, and I'm probably over thinking this, but just wanted opinions.