Jusween

That is egregious! This individual committed a crime against you. While the team may elect to continue to treat him, he should be precluded from coming to the office or approaching anyone who is not directly involved in his care. Your employer is not providing you a safe environment. I suggest you contact legal representation to determine your options, such as obtaining a restraining order and to clarify your employer's legal obligations regarding its staff.

Really? It is what it is? Abstract knowledge is hardly worth anything if it is not correctly utilized. Nursing has presumably evolved from handmaiden to a profession in its own right. Nurses who abdicate their responsibilities by failing to augment their skills perpetuate the hegemony that is inherent in the field. The fact is that understanding what is wrong with a patient does not heal the patient; fixing the problem and facilitating health is. Nurses have the potential to excel in this niche but instead, they wallow in their own subjugation and whine about disrespect. Earn the respect you deserve and demand accountability from physicians who fail to meet their responsibilities. That is what professionals are supposed to do.

The fact is that both truck driving and nursing are potentially hazardous and require concentration and focus. If you read the research on napping and cognitive abilities, there are multiple peer reviewed studies that demonstrate improvement in critical thinking and effectiveness after short naps. Physicians have done so for years. Moreover, unpaid breaks often involve leaving the unit so mechanisms are required to be in place that provide coverage for acute patients while the primary nurse is unavailable. You seem very concrete. Perhaps you need a nap.

Many people scoff at trauma informed care but having worked in psych since the 80s I believe it is the single most efficacious model for nursing, behavioral or medical. Trauma informed care essentially says that people are almost always trying to control their environment and that this is a healthy and normative trait that should be encouraged. Axis II patients have often experienced a skewed background in which they have never learned how to self soothe and they don't have the skills to tolerate pain, frustration or intimacy. This means they go about meeting their needs inappropriately. It is important to acknowledge the inappropriateness of their methods while validating their pain and fear. When I can look at a patient and really understand how scary it is to feel out of control, it makes it easier for me to avoid power struggles and to work to provide an environment that allows for as much autonomy as possible. I also like to point out to my borderline patients the tragedy of pushing people away by being provocative when they are feeling most distressed. Confrontation doesn't have to be accusatory or punitive. When you set limits compassionately and only when necessary you are more likely to get cooperation. The most important thing about psychiatric nursing is understanding your own buttons as well as holding yourself accountable for your own needs for power and control. Google "parallel process" for more on staff counter-transference.

"Way more harder?" The level of incoherence and the breadth of ignorance that I am witnessing leaves me speechless. No one who conducts themselves in this type of antagonistic, misinformed and brutally ignorant fashion is worthy of respect or compensation. Professionals communicate effectively. Whether you are a housekeeper or an administrator, you can learn to read and write. Your complaining or opining or whatever it is that you believe you are doing would be better received if it were presented with a modicum of intelligence. Anyone can read a book. Your arguments will thank you. This type of dialogue is an absolute embarrassment.

As as I said, you're obviously not a nurse. You are hardly literate.

If your nursing skills are as adept as your writing abilities then you are correct. You don't deserve a professional salary if you can't spell or compose a coherent sentence. For those of us who actually learned how to correctly assess, monitor and deliver care, the responsibility that is inherent in nursing is worth a higher salary. Moreover, given the working conditions that many nurses tolerate, 13 hours on your feet while charting at bedside, few breaks, 24 hour/365 schedules and the expectation that a two year education encompass what many medical students never learn, including diverse interpersonal skills and technical functions, our salaries are grossly inconsistent with other professionals. Your observations lead me to believe you really have never worked as a nurse. IV starts are hardly as simple as you portray and they represent only a bare minimum of what the professional nurse actually does. Society's interpretation is often influenced by our own. If you see yourself as a cartoon-garbed maid, that's what you get paid for.

This scenario infuriates me. Law enforcement is not charged with the responsibility of determining a patient's psychological competence prior to arrest. That decision rests with a judge or jury after they have heard supporting testimony from experts. The police officer's job is to perform an arrest when a crime has been committed. Battery and sexual assault are crimes and they are easily distinguishable from injuries incurred as a result of intervening with an out of control psychotic pt. Management has NO right to preclude staff members from demanding protection, up to and including arrest if they are perpetrated on and they are responsible to assure staff ratios that are reflective of patient acuity. An exception would be for the above mentioned incident, which is a reasonable expectation for psychiatric care work. Nurses have every reason to expect safety from criminal behavior and a hospital that prevents arrest or that allows this conduct to continue is committing an OSHA violation. Moreover, these concerns should be included within the union bargaining agreement. It is not responsible medicine to allow antisocial behavior in an inpatient unit. That's what jail is for. Danger to others is what seclusion is for. If a patient is dangerous to others he is discharged, arrested or placed in seclusion until dangerousness has been resolved. Get a spine and advocate for yourselves! This is ridiculous!

Your economics class apparently didn't cover perception and marketing as well as the sociopolitical nuances of labor. You may perceive yourself as a barely literate handmaiden to the almighty healer, in which your paltry $30.00 an hour is a gift that you should prostrate yourself for. Alternatively, you can choose to consider yourself a professional, augment your knowledge and critical thinking skills, join a union and educate the public about where their health dollars are going. The truth is that some nurses are concrete thinking, intellectually lazy and wallow in their own subjegation while others have the temerity to challenge a system that is based on exploitation. If we determine that nursing is integral to human interest than perhaps we should support a higher education requirement such as those required by other professions and take responsibility for our own working conditions. This includes lower patient ratios but also empowering and supporting work environments that respect us. Chastising those who dare to aspire is a great example of how nurses continue the tradition of lateral violence. Eating your own young and working like a fieldhand just perpetuates a perception of us as waitresses in scrubs.

An RN is the minimal level of licensure for a professional nurse. Adding your degree, unless it's a graduate degree, is superfluous and only useful when a hospital is trying to achieve magnet status or if you are in a management position. To my mind it only highlights the fact that RNs are one of the few professions that require a two year degree rather than a baccalaureate. I say this as an ADN nurse who is working on my BSN because I honestly don't believe that my education is adequate for today's work environment. Still, you earned it and cattiness aside, you deserve to wear it if it floats your boat. I would be more concerned about the fact that an RN name badge typically includes first name only when MD badges use only the last name. This invites a familiarity that is inconsistent with professionalism and intimates a devalued status that I find truly offensive.

Try searching baccalaureate PA programs and you can find them, although you are correct in stating that the trend is towards graduate preparation. The academy itself prefers a Masters degree but doesn't require it for licensure.The academic requirements are different than a NP but the BSN degree which is the prerequisite for an NP is considered by many to be the most stringent 4year degree available. This is not a contest. I would suggest that the NP curricula is a separate orientation completely from a medical doctor whereas the PA was created solely for the purpose of assisting the physician. They are unable to function autonomously as the NP can, depending on the State nurse compact laws. Again, my purpose is not to devalue one or the other, merely to suggest that they are different.

Actually, all PA programs are not masters level. They are baccalaureates or masters depending on the school. Acceptance simply requires two years of college level study. Alternatively, all NP programs are graduate programs, either a masters or a doctorate level. I don't wish to denigrate PAs, simply wanted to set the record straight.

Establishing rapport does not include creating an alliance by denigrating another member of the team. That's simply childish and unprofessional. At 3AM, unless the pt. is fully alert and asks, I would seek to make my intervention as quietly as possible. Nobody is blowing this scenario out of proportion. You are minimizing it. People like you facilitate the continued oppression and devaluation of nursing by siding with a bully. Shame on you.

Reading your post I can make three interpretations: (1) people who are oppressed often identify with the aggressor. (2) people who are not centered in themselves try to increase their self worth by devaluing others. (3) If you are struggling with your own sense of inadequacy it is hard to make meaningful connections with others. Instead you make one dimensional observations that serve to artificially inflate your own faltering self esteem. I am a nurse. I also read, study and travel. It's unfortunate that you are too concrete to see the value in your own teammates. It's possible that you are projecting your own superficiality onto your co-workers.

Nickfitz1969, I don't believe that the author was suggesting that medications are a panacea for psychotherapy and adjunct modalities. However I would suggest that you take a little time travel back to the days before phenothiazines were invented and see what psychiatric treatment looked like then. Your attitude on medication is at best, unrealistic and at worst dangerous. Medications are simply useful adjuncts that allow sufficient symptom relief in order to benefit from treatment. Even with their side effects they beat radical lobotomies, trepination, insulin shock and ice packing. They are also preferable to melancholic, vegetated depression and psychotic posturing. I see first hand the difference in pt.s treated with SSRIs between the 1980s and today, so please try tempering your own poison with some professionalism.

No it's not easy. You just don't know what you are doing. If you are correctly assessing your patients, planning and delivering their care, documenting properly, advocating for them and preventing crisis, then you are doing a good job and it's hard work. Anyone can hang out. That's not nursing.

Try Largo Medical. They will hire anyone. Grit your teeth and tolerate it for six months and you can transfer anywhere in the HCA system.

The "view point " expressed is shared by every professional group in healthcare for a host of reasons. It's unethical and more than a little ill advised to date a psychiatric patient. It's also exploitative. The writer who suggested that this consensus was "know it all" concerns me. Do you work in psychiatry? If so you are dangerously uninformed. The lack of boundaries notwithstanding, maybe you need to examine the differences between viewpoints, facts and moral imperatives. The OP obviously came to the correct conclusion on her own and I applaud her for it. However, suggesting that a psychiatric patient needs a boyfriend is naive and superficial. I can only hope this individual doesn't work in the field. With an attitude like this, it's an accident waiting to happen.

If you are serious about training your staff look into Mandt. They are a lot better than CPI. Also, there is a woman in Chicago who has created a program called virtual tranquilizer. It focuses on using neurological approaches to deescalation with minimal use of medication. Trauma informed care is a great model to institute and it's free. With a Geri population you really want to keep meds to a minimum as they tend to backfire on you. Avoid use of benzodiazepine and haldol.Resperdol is least dangerous. Structure, reality orientation in the milieu and regularly scheduled de-prescribing sessions for multiple meds are integral. Med holidays and closely monitored renal functions are also useful so you don't end up with organic problems.

What amazes me about this thread is that a few weeks ago there was quite a hullabaloo raised when an article suggested that physician bullying was epidemic. Outraged nurses across the country wrote to chastise the author and revel in their own collegial relationships, as if bullying was a concept fabricated by an incompetent ne'er do well seeking to tarnish the blameless. It is quite apparent that bullying is indeed alive and well and it is such a part of the culture that we spend inordinate amounts of time attempting to understand its origins and come up with creative ways to address it. With all due respect, this is bull. Physicians bully because they can. The power differential is alive and well until we act to change it. Join a union and use your collective power to force hospitals to be accountable for the work environment. If every time a physician acted inappropriately, it was documented and the hospital was subject to a hostile work environment investigation, it would become expedient for them to cut their losses and change the expectations for physicians who desire admitting privileges. After all, multiple studies suggest that empowered nurses provide better care and there is no reason on earth to allow any individual to jeapordize that climate simply because he "didn't get enough sleep." Adults behave accordingly and by not demanding respect, we are colluding in our own degradation.

Re Triksters response: Perhaps your problems have something to do with your written communication style, which is mysogonistic and condescending. If you were my subordinate, I would sanction you, regardless of whether or not you have a member. Your nursing skills do not abrogate your responsibility to speak appropriately and conduct yourself professionally.

Suggesting I "grow up" because I would prefer not to be used inappropriately is just what I mean by lateral violence. Somehow I would bet you don't talk to physicians with that degree of condescension. Are you one of those nurses who eat their own? Best practices, JACHO etc. strongly recommend that physicians enter their own orders to minimize medication errors and protect nurses from liability in the case of "forgetful" or worse providers. It is also company policy. Moreover, having to enter orders on top of a 9-1 pt. ratio contributes to an extremely stressful environment that precludes me from doing my own job. In an emergency, if a provider is extreme busy and asks for my help I will provide it gracefully. Expecting it as his due because he is above the governing rules is a misuse of power. When someone uses their power to subvert my role it is abusive. What you describe is criminal. You sound like a battered woman who is happy she just gets yelled at instead of being punched. If you want to be a tool, knock yourself out. Just don't confuse it with sanctimony.

Even doing a background check doesn't mean anything. Plenty of new nurses take six months to find a new job. I would never suggest you lie but new jobs often don't work out and if you aren't claiming experience, it's perfectly acceptable to just start over.