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I find this conversation is a perfect example of Benners stages of clinical competence. The novice/beginner is asking "why do I have to ask questions about suicide in a ED" and the competent ,proficient and expert nurses are trying to help a beginner nurse rise to a higher level of nursing.

I am an old ER nurse Movement of pts is dependent on the decisions of the medical provider. Typically one hour before the doc is scheduled to go home they stop seeing new pts and they make final dispositions. At 600 or 1830 the doc reports off to the admitting provider and simultaneously the nurse can call the admissions dept or the supervisor to get a room. Just like the ER doc wants to complete care of their pts, the ER nurse like to report off to the accepting nurse.It is a higher standard of care. But you get your room assignment at 7:15 or 19:15. The floor nurse refuses to take report. I learned to beg the on coming floor or unit nurse to take report and then beg the on coming ER staff to hold the pt until 800 or 2000

I am concerned by your support system's bias against the mentally ill.You are experiencing the stigma as a PMHNP (and you haven't even started the program!) just as your patients face the stigma of mental illness. You are choosing to work in a challenging field.Mental illness is a waxing and waning disorder.You will face the dual challenges of addiction and psychiatric disorders . I enjoy the challenges of being a PMHNP-BC. In my opinion,salary is important but you need to enjoy your profession. Keep in mind there is a reason PMHNP-BC are paid a higher salary .

"[COLOR=#000000]On another occasion when I was giving an IV medication, the MD corrected me about something".Based on that statement I think you have more to worry about than getting respect.Instead of worrying about what others are thinking you should spend your energy learning how to be a safe and effective ED nurse. When you clean up a suture tray do you practice how to use the equipment? After a code do you restock your room so you know exactly were all your supplies are located? When you know all your tools ,their function s and purpose,you won't make a mistake in the chaos of a code .Have you joined the ENA and started studying to be come certified ED nurse? There are psychomotor skills and specific academic knowledge [/COLOR]to master in ED nursing .There is also the finesse of working with folks in the pressure cooker environment of an ED

Young or old all nurses should be allowed a seat at the nursing station. Excluding a nurse based on their chronological age sounds like ageism . Do nurses still have to wait for an old nurse to retire or die to gain seniority ? Do young nurses still resent older nurses with more seniority getting first choice of vacation time .Do young nurses continue to resent working less desirable shifts because the nurses with seniority get the day jobs? This is an ongoing challenge for all nurses. The question can be veiled as a "safety issue" I believe it is a power and privilege issue.If you want to retire at age 62 I hope you are saving and investing a large portion of your salary today.Some folks wish they could retire at age 62 but can't afford to quit work.

I am interpreting " stress of "cleaning up" after the previous shift " that you work an off shift. As a 24 /7 operation it is normal to hand over patients in the ED.If you are cleaning up messes it might be a provider created problem.Yes, ED providers bed block too. The goal of the provider is to complete care ,report off and leave. Do the the ED providers change their shift at the same time as the nursing staff? A common ploy is let all the beds fill,then close to the end of their shift make final dispositions.Typically about an hour before shift change decisions to admit are made.The providers know the floors won't take new admits during shift change or the ED must hold the pt until additional staff arrives The E D bed is occupied but the provider has completed their care. The provider can go home on time.... The danger and the frustration I experienced as the on coming nurse was giving a poor report/poor continuity of care to the receiving floor. I learned to beg the "bed czar" to find out what the bed assignment.Yes I know at 7pm there aren't any clean beds in the facility,I just want the oncoming shift to get report. I learned to beg the departing nurse to call report( I would complete the documents) and beg the on coming shift to accept report .I would negotiate a transfer time with the on coming shift (Sure I can bring them up after your shift report is complete).I would listen in the the report because I would be responsible for the pt for the next hour.This all had to be done between 701pm and 729pm. This is just one of the tricks of the trade. Remember you are making more work for the receiving staff,you are not their friend ..at that moment.I hope you are investing in your continued education,not just online CEU's but going to conferences. Sometimes working off shifts you can get isolated from professional support systems and family and friends. I think ED nursing rocks but I am one of those "seasoned nurses" I went back to school at age 51 .Now I have a day job with weekends and holidays off. Still when I hear an ambulance siren I catch my breath.I miss the intensity and the camaraderie of the emergency room.