marilyn crisp

Wondering if anyone else has been faced with this. My psych facility requires the RN to do a shift "nursing reassessment" form on each patient. This includes things like their history and/or risk of SI,HI,SAO,psychosis, falls etc. Then there is the mood, affect, thought process, thought content, medical concerns etc. The nurse is expected to then write a narrative of some sort that would basically support the need for the patient to remain in treatment, or the appropriateness of discharge for the UR dept. to use with the insurance company. Unfortunately, because of the staffing, the nurse that is being asked to do this charting, may not ever even see the patient, or may only have a brief opportunity to observe while the patient receives medications or is seen going out to smoke. Soooo, the nurse is basically supposed to read the group notes written by techs(if they have then done when you're trying to do your notes), ask the tech about the patient (if you are so lucky to see THAT person). So, the bottom line is that the nurse is being told to write documentation based on other's observations - or you can go back to the shift before and write the same thing they did. Never in all my many years of nursing in many different settings have I been told I am to sign my name to and assessment that isn't mine. If THAT isn't enough, the nurse is also supposed to give PRN meds based on the tech's report that the patient needs one. I would love to hear if anyone else has experienced this nonsense!

As a new grad I worked an inpatient psych unit in a hospital that had a CPEP unit. It had a 6 bed 72 hour observation unit. There was a receptionist person they saw first. Then a nurse triaged them. We always had a psychiatrist either in the unit or next door at the hospital who came over and saw every patient after they were triaged. We did use 4 point leather restraints (sometimes 5), lots of chemical restraint as well. We were all trained in behavior management techniques, but when things were really bad the hospital security guards would come and help out. As with any ER, sometimes it was really quiet and sometimes it was like a bus pulled up and let them all out. A lot of it was stuff like they had run out of meds, had no place to stay etc. We also had a social worker type there who would work on getting placement if needed, detox and stuff like that. We patted them down, but didn't strip them in the ER. It was a great place to work!

TOTALLY WRONG!!!! Completely dangerous and no one should be required to do this. Would you put yourself in this same situation with any random person? Nope! You could seek guidance from the board of nursing in your state. Although they can't mandate certain things, they may have documentation on situations like this and injuries to staff as a result etc. that could be used to levy some changes. You might also contact your state labor board and see what they say. These places wonder why they can't retain employees.......

RN 18+ years Psych KY $25/hr 10 years ago Peds SC $27/hr no benefits

First of all, in my opinion, your employer has set you (and everyone else) up for failure, which is totally unfair. I am sure that most of that 2 weeks of orientation was sitting in a classroom learning theoretical stuff when you have no idea what they're really talking about. It's like giving classes on how to ride a bike and you've never even seen one! Crappy orientations are my biggest pet peeve in nursing. I've been a nurse for over 18 years. I worked in Psych as a tech while I was in nursing school and when I graduated, landed a Psych job. I had a REAL preceptor. We worked the same days for 6 weeks, in addition to all the classroom stuff we had to do. She actually taught me what I needed to know and gave me more and more to do on my own, so that at the end of those 6 weeks I felt comfortable. I have also worked med/surg, peds, home health, corrections and most were wholly inadequate. I just started a psych position where nurses basically get 2 shifts on the floor. Most of the units only have 1 nurse, so you best be ready to be charge in 2 days! There are a number of new grads that started with me. How unfair to put ANY nurse, let alone a NEW nurse in such a position. Shameful! In the right place, with the right team and the right administration that really values their employees Psych can be awesome. I have learned so much about myself working with this population. I wish you the best!

Having taken a number of these type of courses over the years, I would never spend money on it. All Psych employers I have ever worked for, both as a tech and a nurse have required it and provided it. When they are looking for someone to become a trainer, they will pay for it.

Being a therapy aid is the way to go I believe.I kind of fell into such a job when I was in nursing school and found that I really loved it. When I completed my RN program I was hired as a result of my experience as an aid. I think psych is something you love or hate-personally there were days I ALMOST felt guilty that I was getting paid!!! It's not easy but you learn alot about yourself and how to handle lots of situations by using your head instead of your hands. These skills are important regardless of the area of nursing you end up in. Lots of patients problems cannot be addressed with an enema or a dose of antibiotics or a dressing change but knowing how to listen well and give support can make all the difference for any patient. Good luck!