November 30, 2010

Life on the depressive unit

The most recent BSN class is drawing to a close...after the hell that was Informatics, Diversity was a breather:  1/4th the weekly workload and only two main projects.  Though I will admit that I didn't get as much out of Diversity as I did the other class...because I didn't have to do as much work.  Go fig.  The next two semesters will be fun:  two classes at the same time for each.  Plus at one point, I need to figure out how I'm going to squeeze one of my two remaining liberal arts classes in there. 

I'm back to floating.  It's not my idea, though I don't mind it.  But whenever a nurse is needed somewhere and they look at our unit to provide it, I'm the one who gets sent .  It gives me experience and cheers me up, because I get to see different patient populations...which is nice when I'm feeling a bit down on psych nursing and wondering if I should attempt to break into med-surg.   The experiences remind me why I like psych in the first place.

Speaking of first places, the first place they always send me:  the depressive unit.  This is where all of the "sad" people go.  It's mostly depression, SI with or without a plan, actual suicide attempts, and the temporarily detained.  Lots of drama.  Lots of personality disorders.  Lots of tears.  Lots of medication seekers who are after the benzos and Schedule II/III narcs. 

Floating is definitely a good chance to keep the therapeutic communication skills sharp.  Whereas in detox I can be blunt, use the word "why", and break half of the rules in the communication book because most of our patient population are frequent flyers and we've been through this dance several times before. 

I have to admit it can be hard.  I guess that's because sometimes I expect it'll be like the textbook:  have a 1:1, talk to them, teach them a bit and boom, patient is 20 times better and no longer depressed/suicidal/crying.  It's amazing what can be accomplished in the world of textbook nursing.  For the most part, the patients do feel better after the 1:1...but their problems aren't solved and they're not all cured.  And I know this.  And I know I can't solve all of their problems and say some magic words and boom, all happy.  But sometimes I do wish it was that easy. 

Even though the depressive unit isn't really a place for psychosis, occasionally some sneaks in.  I got to see a couple of psychotic issues I haven't seen in a while.  Audio hallucinations (more of the background commentary type than the "kill them!" type), thought blocking, paranoia, and mania.  Good opportunity to refresh my skills in dealing with those issues too. 

I dug the psych textbooks out, and I'm making it a point to read up on at least one thing a day...both to help me at work and to help me start preparing for the board certification exam.  Granted, I have several months to prepare, but with the BSN and everything else going on, best I start some of it now.

November 19, 2010

Schoolwork doldrums

Have to do a paper over the Thanksgiving day holiday...going to try and see if I can whack most of it out the Wednesday before.  Then all I will have to do is proofread and tweak as needed.  I hadn't wanted to take schoolwork with me on the holiday trip but life's like that.  Oh well.  I also need to get my paperwork over to the office before the holiday.

November 18, 2010


I need 30 psychiatric CEUs for my certification.  I also need to actually be working for two years, but I figure that if I start knocking the CEUs out now, I can test as soon as I cross the big 0-2.  Also, I'm starting so soon because I'm trying to find as many free CEUs as possible.  The APNA is hooking me up with a few, and I'm sure I can dredge up a few free ones through the ANA and other sources.  I have a feeling that even with my best efforts I'll have to pay for a few of them.  Oh well.

November 16, 2010


Being a nurse and BSN student keeps one rather busy.  These last few months had me up to my neck in classwork.  What really gets me is that the fewer credits the course is, the more demands the instructor puts on us and the more work I have to do.  One of my courses was only a 2 credit course, and we needed to make 9 posts a week, with the final project being a term paper and accompanying slideshow.   The 3 credit course I'm in now seems like an absolute break.

I occasionally get twinges whenever I hear from classmates that went into med-surg.  While I'm loving pysch and have no regrets, for that brief second I feel like a failure.  Not that I am a failure in any way:  med-surg is not the only area of nursing, and there's many nurses that have successful careers without even going anywhere near the area.  I guess it's because that everyone pushed (pushes) it as the area that you must start off in to have any measure of nursing success.   Yet I seem to be doing rather well as a nurse without it.   Plus my unit gives me enough medical issues to keep it exciting.

Maybe I feel like that because of all of the rejections I got when I was hunting in med-surg.   I think that's the case, because if I was truly unhappy then I'd have kept looking for the med-surg job and not carved out a full-time niche.

Or maybe it's an occasional resentful twinge, since I chose the psych job over the PCU because of the hours.  I knew I couldn't be away from my child for 14-16 hour days.  It's hard enough that my better half's days are at least that long, neverminding all of the underways and deployments.  But you know what?  I didn't want to put my child through that.  We're fortunate enough in that if I didn't want to, I didn't have to work and we'd be OK financially.  Not great, but we'd make it.  I don't have to take a job with hellacious hours just to make ends meet.  And frankly, when I look at his face, I don't want to work those hours.

And I definitely don't miss the blood, guts and demanding patients.  If my patients come at me saying they need new sheets on their bed, I get to say "I'll get you clean ones so you can change them" and I won't get into trouble.  Hell, I'm expected to say that :)

Oh well.

Work is going well.  Still have staffing issues but since no amount of yelling and screaming will change it, I've pretty much adopted a zen attitude.  I'm trying to get my supervisor to do the same.  She gets so worked up over them and it's really stressing her out.