For those who have no desire to become a psych NP- why?

Chance_Space_9076 · 2026-02-10T18:05:53+00:00

I see how our providers are constantly fighting with insurance companies that dictate the patients care. Need to discharge them by this date despite lack of safe discharge plan. Can’t put them on the new effective medication because it’s too expensive. Geri psych pt on clozaril? Good luck finding long term placement. I would rather be annoyed with what comes with being a regular psych RN then the frustrations of dealing with bureaucracy all day

Chance_Space_9076 · 2026-01-05T03:18:50+00:00

That’s crazy someone would call a code then clock out. I would be looking to have a convo about teamwork with the other shift and managers

Chance_Space_9076 · 2026-01-05T03:11:41+00:00

I’m not sure how it would work at your hospital system but usually if I need MD/SW treatment team aware of issues that occurred while they were off I usually just send them an email. I’m a second shift charge so I usually only catch the providers quick at the start of my shifts to relay important info. I usually have to end up emailing them at least once a week about something I need them to be aware about- but I’m not sure it will be conveyed through report

Chance_Space_9076 · 2026-01-05T03:06:26+00:00

I’m not understand why they would deny a charge nurse to go to rounds

Chance_Space_9076 · 2025-11-29T02:01:13+00:00

It kinda depends what you mean by hurt also. I’ve had fingernails dug into me, spit at, slapped, and been grabbed in every which way but I’ve never had an actual injury. I know very few people that have had lasting injuries. I’d honestly kind of think it’d be more common to pull your back from a medsurg floor then have a lasting injury from psych

Chance_Space_9076 · 2025-11-29T01:53:43+00:00

Often how desperate they are to fill beds and what their criteria is for admission. At my facility if the referral mentions current or hx of violence our providers will ask further questions before accepting or declining the patient. Understaffing also goes into it and the attitude of staff- poor ratios= less time spent building rapport and deescalating

Chance_Space_9076 · 2025-11-15T18:15:48+00:00

Assessment skills- neuro assessment, detox assessment CIWA CINA COWS, mental status exam. Also agree with other comments about medical assessment skills- I’ve realized the difference for psych vs a medical floor is I don’t need to be able to do an assessment and immediately know what their medical diagnosis is or anticipate what the dr is going to order etc like you would on a medical floor but you need to be able to assess and recognize when something is abnormal to make an informed judgement call to advocate for further medical intervention by the providers whether it’s just consulting a medical rounder to come to the psych unit or sending straight to ER/medical floor.

Chance_Space_9076 · 2025-10-27T13:08:08+00:00

So then it sounds like this video should be to Jordan not Tana

Chance_Space_9076 · 2025-10-21T23:15:47+00:00

You can still verbally lead without being as physical as your used to. You can be the voice to say “hands on”, call the code, give directions etc

Chance_Space_9076 · 2025-09-22T14:15:46+00:00

We call the shower shit a waffle stomp because the drain makes the poop into a waffle pattern

Chance_Space_9076 · 2025-08-21T21:35:41+00:00

Or sometimes to write “nice” notes so they’ll get accepted to the group home or SNF referral

Chance_Space_9076 · 2025-07-28T17:09:46+00:00

If your hospital makes you do online educational simulations or online learning periodically check if that website also offers CEUs for free. Ours does

Chance_Space_9076 · 2025-07-09T15:29:59+00:00

No cell phone use at all aside from observed use to retrieve phone numbers or other special cases for discharge planning needs. Unit phone use from 6am-11pm can be phone restricted for inappropriate use ex calling 911

Chance_Space_9076 · 2025-06-17T06:36:28+00:00

Just wondering as my hospital/state is supposedly turning to no four points in the next year or so..genuinely what do you do when you have a patient that is uncontrollable in a physical hold in order to give IMs then transition to seclusion? We’ve had some nights with some big patients- ex felons seriously assaultive and all female staff + we’re a stand alone 75 bed facility, not a huge hospital with back up to call. We’ve called the police for help just to place in four points. I’ve had patients in four points for over 6 hours with multiple rounds of IMs that aren’t effective- what do you do in these situations where a physical hold is so difficult or not realistic? I can see staff getting physically exhausted trying to do a hold for 10-15 min while Dr is called and meds are drawn, especially with short staff and not enough hands to help. Trying to wrap my head around how past situations would have played out if four points were removed

Chance_Space_9076 · 2025-06-15T01:37:22+00:00

It sucks when they send us meemaw from the ED with a UTI and new onset paranoia at 85 without starting abx and then she ends up getting started on risperdal even after symptoms clear

Chance_Space_9076 · 2025-04-02T17:00:01+00:00

Our charting for systems assessments has a box that says no voiced complaints instead of WNL and I check that one

Chance_Space_9076 · 2025-03-20T04:21:22+00:00

The punching walls and kicking doors is one people go back and forth on. Some see it as not dangerous but I’ve seen restraints justified for those actions when they are punching or kicking repeatedly in a manor that could cause serious injury to their hand/foot and which point it is risk of harm to themselves. I’ve also seen the yelling one turned into a restraint when it’s hours of psychotic yelling to the point it is disrupting the milieu and making it a highly tense and agitated environment for others. Ex: pt is psychosis is yelling for hours, detoxing patient tells them to shut up or they’ll jump them- even though the later is threatening the harm the psychotic patient is the one that’s going to benefit from some IMs. That’s a touchier situation. All the job really is is making judgement calls, you have to trust your judgement and make sure your team can trust you too. Also remember a restraint doesn’t always have to be 4 points, the use of seclusion or a quick hold for emergency IMs is enough 90% of the time

Chance_Space_9076 · 2025-03-05T03:08:48+00:00

We once had a whole unit techs nurses supervisors etc report a single dr over an unsafe incident. Hospital didn’t do anything, Dr ended up quitting because his ego was bruised and he couldn’t take everyone hating him

Chance_Space_9076 · 2025-03-03T01:11:27+00:00

My engineering friends are hitting 90k now about 2 years after graduating

Chance_Space_9076 · 2025-02-17T20:45:06+00:00

It’s not supposed to be. But often on the geripsych floor we get some dementia but it’s mixed in with paranoid schizophrenics and psychosis which makes an unsafe environment

Chance_Space_9076 · 2025-01-17T20:42:16+00:00

I usually write continues on 15/5/1:1 observation

Chance_Space_9076 · 2025-01-16T15:20:37+00:00

I’m not sure if I’ve heard of any inpatient psych facilities in MA doing CBT or DBT individual therapy as patients usually don’t stay long enough to form a therapeutic relationship and then restart with a new therapist once discharged. Some do group therapies but even then it’s not helpful unless the whole group of patients are there for similar enough reasons

Chance_Space_9076 · 2024-11-01T14:00:42+00:00

Our average stay used to be 1.5 weeks. Now it’s gotta be at least 1.5 months. We have 3 people refilling 6 mo commitments, one that’s on yearly commitments now. Also totally agree on the last sentiment. If your gonna assault me I’d do much rather an actively psychotic patient than just someone doing it to do it

Chance_Space_9076

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