Nurse Emicat

Where I work, there is a number you can call if you suspect abuse or neglect against a patient. I work in a state psychiatric facility.

This number is mainly used by three different kinds of people

1. Paranoid Schizophrenics

2. People with BPD who didn’t get their way

3. Disgruntled Staff

Never in my time here has it been used for a substantiated case of abuse or neglect. It wastes time and displaces people from their units for nothing.

Sometimes it gets to a point if the same patient keeps calling they get their own caseworker and the reports get thrown out, but that’s rare.

I didn’t place a client on a 1:1 observation who asked to be on one. This client is attention seeking, and when other clients are getting 1:1 observations or being put in restraints or are otherwise not giving her attention, she acts out. As a nurse, I can’t even put her on a 1:1. Her record shows that she will act out for attention. The doctors know her pretty well because she tries to manipulate them to get around rules I’ve set. I refused to feed into that. I put her in her place by stating she just wanted attention. Thats also known as a “reality statement.”

She destroyed all her belongings and cried to the next shift that I ordered my staff to do so.

The next day, I found myself kicked off my own unit and under investigation for abuse.

How is that fair?

Nurses of tumblr, has there ever been a time when you questioned whether you had made the right decision when you chose to become a nurse? I’ve been questioning myself lately. I feel like I did make a good choice, like nursing is the only thing I wanted to do, and other nurses say I’m miles ahead of where they were when they first started as nurses, and I always hear that I’m a good nurse, but I don’t know. Perhaps it’s a feeling that all new nurses get.

I love psych. I’ve worked in psych for 9 months and I honestly can’t picture myself working in any other area of nursing. The facility I work in is part of the state, which means really good benefits and a pension. I adore my patients and the staff that I supervise.

I still am not happy where I work.

I know work isn’t supposed to be fun and games all the time. It really isn’t WHAT I do or WHO I work with that is bothering me. It’s the way things are run. You’ve got to do your job but there are policies that prevent you from doing your job. We still do basically everything on paper and there are forms to fill out when you fill out forms. You get dinged by Quality Management if they can’t read your signature on something but they know that that signature is yours. We don’t have enough staff, and the few staff we have keep getting mandated to the point where they get injured. We have patients here who are not appropriate for the inpatient psychiatric care setting. My facility makes me feel like the only thing that makes my presence worthwhile is my RN license.

I basically got thrown to the wolves. They didn’t care that I had just come from nursing school. They just saw “RN” on my resume and hired me. They expected me to know everything and provided me with no coaching whatsoever. I know how to do the things within the scope of my practice but I didn’t know how to do them within the policies of my facility. They didn’t show me how to be an RN. They just made sure I knew how to pass meds because a license is a license. I can do assessments and can even straight cath. They didn’t teach me how to run a unit like an RN is supposed to. I figured it out with help from my aides, but then I got spoken to by an administrator about being too friendly with them and being too impressionable. I figured they knew how the unit worked the best, and made things work that way. I get told all the time about how I need to be more assertive. I don’t know how. Nobody has given me any advice.

Nurses of Tumblr, please add

1. How to deal with being abused by a patient

2. How to tell your poor tired aide that they have been mandated

3. How to deal with facility politics

4. How to deal with staff splitting patients

5. How to maintain patient safety while working short

6. How to get psychotic patients to take their meds

7. How to call the provider to clarify an order