What can you do in 7 - 14 days?

I agree that there isn't much more we can do besides keep them safe, administer medications and hopefully plant a few seeds of coping skills as they go on with their journey. That said I almost never over-rule one of my tech's decisions in front of the child unless it is downright unsafe. FWIW I have seen new employees of all disciplines get a bit of a honeymoon feeling that no one else is as therapeutic and your statements "I've yet to have a kid who defiantly tells the doc he's not taking meds refuse them after we've talked. I get the aggressive ones to learn to walk away and come tell me they need to talk, not just for them, but to protect the little ones around them." kind of sounded like so just be aware of that. Don't allow your value of how you do your job fall to hard on whether a kid takes medication from you or not because I promise you will eventually meet one that will refuse and please don't forget to be aware of where they are and what they are doing because even one you think you know and trust can become assaultive. We also take any contraband like inappropriate clothing from their possession so wearing it is not even up for discussion. Good luck, you sound like a caring nurse but make sure you keep your wits about you.

It's hard to deal with kids because on one hand, we want to treat them like kids. At the same time, this age group is definitely one of the ones that will try to pull one over on staff if they can. Kids are crafty little buggers and they're not afraid to play the dramatic card to get what they want.

Not knowing exactly what the issue was (as you won't tell us), it is possible that what your tech said had merit. Nursess in psych need to learn to be firm with patients, particularly kids. This doesn't imply that you have to be uncaring, but you do need to set and stick to consistent boundaries and rules. If you bend the rules once (such as the clothing), then it gets harder to say No the next time. The rules are there for a reason, and while it may seem more beneficial to bend/break the rule, 99% of the time that is not the case. Rule-bending is not a therapeutic decision. And that 1% of the time where it's necessary to bend a rule, it's usually done with a doctor's order and heavily documented.

If you're worried about a scene, then let the kid create a scene--it won't kill them, they'll learn to use their coping skills...and you'd be surprised how fast that scene will stop when you tell them that if they can't calm down you'll have to give them a shot.

Trust me, you have NOT failed if a kid makes a scene or if they refused your meds. Nor does it make you a bad nurse. Nor will the rest of the staff be thinking, "oh, she's a lousy nurse--look at what that kid did". You'll get into more trouble for rule-bending than you will for having a kid throwing a fit. So that's a habit that you need to get into check before it bites you.

I do agree with Jules A in that unless the tech was making an unsafe decision, you should have not overruled him/her in front of the child. Kids are pros at staff splitting and so you always want to present a united front to them--any disagreements should be addressed in private. And I also agree: please don't fall into the "no one else is therapeutic to them but me!" trap. Yes, it's easy to, especially if you are fairly new in psych. But realize that patients respond to some staff or approaches better than others. Patients can also be very manipulative.

You'll keep learning as time goes on. Heck, after a year I'm still learning something new every day. Just keep at it, keep self-assessing and reflecting on your performance, and don't hesitate to ask more experienced staff (this includes techs as well as nurses) for help and guidiance. Some techs have been around a long time, and the fact that they're not nurses doesn't mean that they don't know what they are talking about regarding the unit and the particular population/patient you are working with.

And FWIW, I agree: any day without a code is a good day in my book

I guess I'm just hurt/embarrassed/frustrated with someone getting up in my face in front of the staff and kids when all I was doing was trying to do the right thing.

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This should not have happened out on the unit and you have every right to feel frustrated.

It is awesome that you are so receptive to the feedback offered here. Hang in there. :)

This should not have happened out on the unit and you have every right to feel frustrated.

Agreed, that should have been done in a staff area or off the unit.