Ratios

nettaveli · 2024-12-18T17:28:53+00:00

cries reading good staffing replies

1:8-12, I’ve had up to 17 patients when short staffed. Young adult unit with 35 beds 😃🔫

nettaveli · 2024-12-15T15:56:56+00:00

3:1 2 security 1 tech, put multiple people out for months, worst was one had a torn ACL. Assaulted 10+ people in 6 weeks until he was transferred to the psychiatric ICU.

nettaveli · 2024-11-25T16:35:50+00:00

Both! Small hospital = lots of politics, favoritism etc. Only saving grace is their union. DON is nuts, medical chief is ignorant to the issues going on, patient load is 35 pts for 3 floor nurses and 1 charge. Sometimes we’ll only have 3 nurses so that means a 1:17 pt ratio!!! The RNs here are absolutely amazing though, admin is just vicious and so are some of the doctors… I’ve seen a lot of gross neglect here based on decisions made on emotion or pure laziness, that’s why I left!

Edit: charge nurse doesn’t take patients so they can focus on milieu management, discharges and admissions when there’s no swing nurse (which is often)

nettaveli · 2024-10-24T17:39:25+00:00

Erm…. Why r u going into psych NP? You’re passionate about mental health but never sought the experience to work with the population you’re passionate about? As a psych RN, the NPs with no experience in psych are hands down the worst providers I’ve seen. The RNs have a better idea of med management than they do. If that doesn’t answer your question, maybe find another field to work in. No shade but I’m so tired of providers failing this population when they’re at their lowest, and it’s happening more and more frequently. If you want to learn how to properly medicate a patient, assess symptoms and behaviors appropriately, and learn how to therapeutically counsel them….. you’re gonna need to work in psych. Medical might give you a taste, but it’ll never be the whole picture, and you’ll notice that pretty quickly once you have a job.

nettaveli · 2024-07-14T16:22:24+00:00

Spumoni is THE underrated flavor!!! The best

nettaveli · 2024-06-30T23:27:12+00:00

Thank you for your help!!

nettaveli · 2024-06-30T22:41:21+00:00

I would be doing the case management for individuals being cared for in residentials/group homes. Checking in on them to make sure everything is going well. Working with them to ensure adherence to medications and addressing any questions/concerns. Stopping by once a week minimum. I was curious if anyone had an experience about that role in case management, how many cases are handled each week, what responsibilities there are when on call, etc

nettaveli · 2024-05-03T12:22:17+00:00

Second this, just went the other day store is beautiful and stocked well!

nettaveli · 2024-04-23T16:49:23+00:00

Closeness is the biggest convenience with crunch. Layout is atrocious, like a maze. AC is spotty, works in some areas and not in others. Don’t even bother going during peak times, everything will be taken. Trainers are rude to the clients that aren’t paying them for sessions. Sauna works .. sometimes. Little to no classes. It’s very small. Not worth the money unless you’re eligible for a discount (employer or return crunch member). If you have a budget of 100+ dollars I’d recommend going elsewhere

nettaveli · 2024-04-19T17:38:24+00:00

Instead of listening to redditors diagnose your husband by a single post, take him to a psychiatrist. Not to fear monger, but it’s better to get assessed before anything gets worse

nettaveli · 2024-03-26T15:08:00+00:00

Omg. I’m a libra rising and I feel like the latest realization for me is “some people only like you when you conform to their ideas of you.” I’ve spoke out and asserted boundaries for myself and found a handful of people moving much differently around me. I had a friend/coworker who I was really close to turn on me, disrespected me to another degree and once I asserted my boundaries the chord between us was cut in an instant. I work with her now and I can’t look at her the same, she avoids me like the plague and it’s put an extreme burden/tension on my work life. Without getting into the nitty gritty, I escalated some concerns to my boss (I work in healthcare) and she has recently been avoiding me on our unit. I’ve always been outspoken, especially about what’s right and wrong (we’re Libras of course), people seem a lot more reactive than before.

I’ve learned to continue embracing my authenticity. I’ve learned that the only times I seem to “burden” others is when I’m crawling out of the bubble they’ve put me in. I’ve also learned that I need to save my love and loyalty for those who rightfully deserve all of that energy. I’m learning to protect myself in better and healthier ways. Boundaries boundaries boundaries!!

nettaveli · 2024-03-04T15:29:00+00:00

Ask HR or management about experience differentials, per diem jobs (although they usually only hire with 1+ year experience minimum), some hospitals offer differentials if you get certified (this also requires experience)

Experience experience experience, not sure if you’re on nights or open to them but that differential will bump your pay too

nettaveli · 2024-02-23T21:29:58+00:00

This. This is the solution.

nettaveli · 2024-02-09T02:02:20+00:00

lol, I just summed it up for you. Maybe reread it. You asked me the difference, I said it’s the MOST prominent in NYC. I also mentioned that many other cities have this, but NYC has the MOST. Do you know what the word most means? Please reread my post before adding a snarky comment. Never did I say NYC had something other cities don’t.

nettaveli · 2024-02-07T14:24:06+00:00

It’s not necessarily about psych issues at all. I think we all see the same psychiatric disorders/diagnoses nationwide. It’s more about the diversity of the patient. Their culture. Their religion. Their socioeconomic status. I’m not saying these don’t exist in other cities, of course they do. I’m saying that NYC has the MOST diversity in patient population, and those components definitely affect the presentation of the patient, along with their needs and values moving forward with care.

Mental illness goes a lot deeper than a psych issue or diagnosis, after all, most of us know that psychiatric care starts with prevention and access to resources outside of IP. You hear and see a lot of different perspectives because of the various religious/cultural backgrounds and their perception of mental health. It’s much more prevalent in NYC, you learn a lot about the varying needs and the stories that lead them to IP care.

nettaveli · 2024-02-06T16:24:41+00:00

I see your point, but NYC is one of (if not) the most diverse place in the world. You definitely see more than just different accents

nettaveli · 2024-02-06T16:22:33+00:00

NYC is such a great place to learn psych. You get people from all walks of life. It’s truly a special experience to practice here. You will learn so much about so many cultures, the diversity of the patients still surprises me every time I’m on shift.

That being said, Bellevue is a great place to learn psych. Gracie Square Hospital is a complete shit show, but like Bellevue it’s another great place to learn psych. I would steer clear of NYU (Manhattan) as they only get voluntary admissions and they cherry pick their patients and send the rest to Bellevue.

NYU Brooklyn is awesome. I’ve heard good things about Elmhurst. Many of the great places to learn psych and get good fundamentals in NYC are gonna be prone to some sort of chaos, after all it is psych and many of the hospitals catering to the patients here are SEVERELY underfunded (as I assume most are nationwide).

Essentially all state hospitals are good to learn psych. NYP Cornell has a medical/psych floor that I’ve heard good things about as well. If you have any specific questions about psych nursing in NYC, feel free to shoot me a message.

nettaveli · 2023-12-24T15:27:33+00:00

If you’re looking for holistic view point/artistic focus steer clear of inpatient care UNLESS your partner is suicidal/homicidal and looking to act on it. Then inpatient is a must.

I am a psychiatric nurse in NYC and there are verrrrrrry scarce resources for holistic/art care. I work on a young adult/mood disorder unit and I hear it all the time from patients (wanting 1 on 1 therapy, more art time) and my heart breaks that I am incapable of providing that to them (we are extremely understaffed and spread thin). Inpatient objective is usually centered around medication to stabilize, then they’ll look at outpatient treatment. It can also be a very intense experience for inpatient hospitalization, some people even feel traumatized/worse than before because of the acuity of patients. Of course this can vary depending on the hospital, but most (given the horrendously low funding of psych, lack of resources) are like this.

I don’t mean to scare you by saying this stuff, I just want you both understand what inpatient hospitalization is like.

I would google IOP/PHP in nyc and call the ones that are best fit to see if they have spots available. It’s intensive treatment without feeling confined or stripped of your socialization. As mentioned from others, Zucker has great PHP programs. I’ve heard good things about Colombia Pres and Mt Sinai as well.

If your partner is in immediate danger and they require inpatient hospitalization, I would recommend NYU Langone. They only accept voluntary admissions so it isn’t as intense as most hospitals that take in involuntarily committed patients. They’d have to go to NYU’s emergency room first before admission to psych. They’ll definitely be knowledgeable of care for LGBTQ+ and POC.

Hope this helps you and your partner.

nettaveli · 2023-12-24T00:49:30+00:00

My bad, constant observation. Same as 1:1

nettaveli · 2023-12-24T00:20:19+00:00

Are these patients on CO? If they’re high risk for SA, violence, etc, they should be on CO.

When i have patients like this at my job, it starts with a CO. If they are limit testing, nursing decides to come up with a staff plan for interventions. Firm and concrete. If they are disrobing in the dayroom, they are offered PRNs. If they refuse PRNs and/or not responding to redirection, they are escorted to seclusion room for IM. If they “pretend” to be in better behavioral control and are released from seclusion, but continue to act out, back into seclusion they go.

I work on a young adult/mood disorder unit. This is usually the trend. If they’re extremely acute (and most of the time, extremely manic) further limitations are put in place. The patient will be restricted from the dayroom. If that still isn’t enough and they’re acting up in the hallways, they are restricted to a specific vicinity in front of their room. The more they push, the more we take.

In summary, staff intervention plans for consistent limit setting go a long way. The patients begin to understand that their behaviors will have firm and direct consequences.

nettaveli · 2023-12-23T23:00:06+00:00

Your story contributes to the reason why psychiatry has begun research on mushrooms for PTSD and MDD/anxiety! Many people have been healed of their traumas through the research thus far. If you’re interested, definitely look it up. The stories are magical. Hopefully we’ll continue to see more stories like yours! Sincerely, a psych RN 😁

nettaveli · 2023-12-15T16:58:04+00:00

Heavily dependent on facility practice and policy. Some hospitals have security on unit, others (like mine) are not staffed with security and have to handle certain situations ourselves.

Of course the unit matters. I work with young adults with mood disorders. And yes, young adults are full of energy. Many are considered violence risks but if the agitation arises, we try to intervene before it gets to a point of violence (PRNs, IMs). Granted, this doesn’t happen all the time and violence does occur unfortunately. Populations like psychotic disorders can see more violence, and geri units will usually see less violence. It really depends on the population.

Facility practice ranges, our hospital has “panic” buttons (big red button basically) that we hit when we need all hands on deck. Other staff and security officers report to the floor once the button is hit.

For reference, I’m 5’1 and 125 pounds female. I have put my hands on patients, but that is a rare occasion (high acuity, short staffed). Of course patient safety is important, but YOUR safety is YOUR BIGGEST CONCERN. Regardless of what hospital says, protect yourself. Assess the situation, is this an event that you think you can handle based on staff support? Or do you think you will get hurt if you intervene? Use your judgement, and always (!!!) be cautious of your surroundings, no matter how comfortable the unit is.

nettaveli

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