Swanee

We could start our own 12 step group lol. I'm suppose to be finishing up a few notes from last week and here I am still writing. This is pathetic. Time to make the donuts. (shoot, he died this week)!

When I told my aunt (PHD nurse and teacher)I had decided to go into psyche nursing she begged me not to be a stupid nurse. I did not know what she was talking about until I became a nurse. WOW!! We need to continue to learn, remain open minded and for the love of God or whatever you believe in, THINK!!! Just because we have ADD doesn't mean we can't problem solve and use common sense. In 2006 let's work on solutions, not who's right or wrong. A secure ego doesn't need to be right, just try to understand. Thanks for your posts. I remain hopeful!

I hope Margaret is still teaching. I know that I'm in psyche because I understand having to struggle and feeling that I'm different from other. Today, with age, experience and understanding, I try to accept the bad with the good and focus on the good.

ritalin LA has minimal side effects and lasts for 6-8 hrs. It doesn't keep me up all night like adderral did. Ask your MD. Straterra did nothing for me.

I've been where you are, 20 yrs later. Ritalin LA was better for me than adderral. I was up all night on that and my face broke out at 40! Ask your doc. I've found that now that I'm on meds and 13 yrs sober, I don't even want to work in rehabs or the ED type setting. Outpatient nursing of some kind (I'm in psyche) - clinics or other small group work. I'm going into program development/marketing for psyche nursing. Stay away from the type of nursing or the type of setting that is the most difficult. We struggle at work with this diagnosis, don't add to it with a hard job. I was transcribing meds by hand in the ED once. My mentor suggested it wasn't for me! I couldn't see it. You're so young and there's a shortage. Talk to other nurses and you'll find something that works.

Funny Metron that you started this. I'm a psyche RN, 13yrs sober and ADD diagnosed 3yrs ago. I was pulled in by my supervisor on an inpatient unit and she sent me to a doc at Yale who specialized in ADD. I happened to live right outside of New Haven so it was convenient. I was always in fist fights growing up, couldn't listen or keep friends and spent my life being independent and picking the high stress jobs - case manager, MR to psyche and then psyche ED as a new nurse. We transcribed orders by hand there and I was always missing things! I left the job before getting fired and ended up in the inpatient psyche unit when my supervisor sent me to the doc. Once on meds, people kept asking me what was wrong because I was so quiet. The clincher was when I noticed that people were being nicer to me. I was able to listen to them and even care! A friend of a friend said something that stuck with me. "It's so nice having beth around now that she doesn't need to be the center of attention." I never realized that I couldn't sit still. My brother and I drove my mother nuts! We have determined that it came from my father (it is passed on by the way). He's text book and is getting worse now that he's pushing 80. I feel like I'm at an AA meeting. I thought my problem was only alcohol but now realize that I was medicating with alcohol. It helped me relax. After the last 3 1/2yrs, I'm realizing that it's time to get out of home care. I'm being given an opportunity (with 20 yrs of experience) to develop a psyche nursing program and step out of direct care. Home care is bad for us! Can't get started and never finish. It's a pitiful cycle and the demands continue to increase. It's sucking me dry. Finally I'll be in the idea business where I thrive. The ideas never stop flowing which is one of our assets!! Wish me luck and thanks everyone for sharing. I will keep in touch.

Start with inpatient and talk to other psych nurses. I started as a case worker before becoming a nurse and then went to inpatient psych. Talk to human resources at hospitals and mental health centers to see if there are any openings. I got lucky and a nurse had just retired. I got a day shift at a state mental health hospital. Great experience. Teaching hospitals are very good for learning and then you can always go back to school. I'm now in homecare and thinking about going back myself. Good luck.

Develop a plan with the pt and psychiatrist if ignoring doesn't work. Apparently he/she is looking for attention so get him/her in group, assess for AH/VH if too disorganized to attend groups. The pt could be at risk because other pts may get annoyed enough to harm this person. You get to go home. The other pts are sick and can't get away from this person. Don't wait for something to happen.

Provide education and use colleages for support. Is this the nursing report? Who is making the comments, other nurses or mental health workers? Address them individually and discuss your concerns because that type of behavior trickles down to the patients and they sense the disrespect. Good luck.

It's the day after Christmas and I keep thinking of the patient I was working with who jumped in front of a train 2 wks ago. I saw the signs, got him admitted to the hospital, but he was discharged in the same condition into the same environment. Psyche homecare isn't working for the treatment resistant pop. They need intensive case management. Todays version of intensive case management is a visit once a wk from a social worker. In the mean time, these people are home alone, mismanaging their lives and suffering. I've been watching the deterioration of services for these folks and the hospitals keep pushing them out, expecting them to initiate services. Anyone want to donate a group home? If DMH followed the model that DMR uses, these people would be living in supportive housing and would be involved in some kind of program. I can't do this work any more. I need to be involved in a solution, not a bandaid. Thanks for letting me share.

I worked with 77 yo nurse who was seeing her GP for psyche. She had been demented for three yrs. Utilities were maxed, life insurance was gone because it lapsed. He said she was a little confused but was taking her meds and appeared to be OK. She urinated on towels at home and by the time her family got to her, the house had to be professionally cleaned. Her savings was gone and she thought she was in a time wharp! The GP said he just didn't know?! I'm thinking that's negligence. Her meds hadn't been filled in six months and the pills were fused in her mediset. She's now with a 24 hr sitter. The agencies will pay for the visits if you have the nurses rotate between psyche and med. There's no such thing as quick training. They should make a referral.

There's got to be a balance some where! We have the same problem. No psyche nurse will sign on now that it's known that wound care is part of the package. The assistant director is the only one that insists on keeping it this way. There is value in every discipline and that's why we need them. After my declaring I wasn't going to do the 45 min tunneling wound, my boss called today to ask for my expertise on a medical pt with worsening psyche symptoms. I'm getting mixed messages. No matter what, I need to take a class next semester. If I survived pathophysiology, everything except pharmacology will be cake! Nice chatting with you!

Ditto!

Sorry about the negative. I love the patient contact however, the paper trail associated with homecare and the pressure to always do more is too much. I did get better at saying No! My answer is to go back to school so I can have my own practice. Yes making money is important, but quality of care is becoming less important, not just in homecare to be fair. Good luck.

This is reasonable and expected. Psyche patients are living longer and have many chronic illnesses, mostly from life of smoking among other things. Training is important. Inservices are rare now and few get a break to go to a conference any more. Education is key. Thanks. I'm going back to school....again!