Well, after months of phone/email tag, we have met up.
I have now signed with a nurse staffing agency. I filled out the forms, took my competency tests, and pending a successful background check and urine drug screen, I will now be an agency psych nurse.
The agency provides staffing services to a couple of local psych places, all inpatient shifts on locked units. The salary is somewhat lower than what I'm getting, but there's no minimum shift commitment other than they'd really like me to work two weekends a month, and even that is a soft limit. Very flexible about shifts. They said I should have no problems picking up 40 hours a week...then again, my current job said that and that hasn't really happened.
I will be going to a union facility with a higher psychiatric acuity then where I am now: think 5150s and lots of them. This doesn't really matter to me. I'm used to 5150s from my time on the ICU at my last facility. My recruiter just wanted to warn me that because they're union it's hard for them to get fired and that sometimes means they get away with doing a crappy job. That also means that as an agency nurse, I will probably get the crap assignments. But I'm not after anyone's job there, nor am I there to be the nursing police. And I'm used to crap assignments from my first job. I'm just there to take care of patients and that's all: they have nothing to fear from me.
The facility I am going to is legitimate. I recently met the DON and ADON at an event...this was before I signed on with the agency.
I'm not giving up my current job...but to be honest, nothing has come down the inpatient per-diem pike there that would work with my schedule. Plus, with censuses dropping as the weather gets warmer (not an unheard of phenomenon in psych), I'm getting called off more. So I figured I'd keep the outpatient per-diem as I wait for inpatient per-diem, but diversify a bit and look at another facility.
And it's a chance for me to try out agency nursing. If it doesn't work out, I'll resign or work as little as possible. The only restriction I really have on me is that I can't work directly for the facility they're sending me to, not until 365 days have passed since my last shift there. But that's not an issue as I'd rather get in inpatient at my current facility anyway.
If all goes well with my screening and UDS, I should start orienting at this facility next week.
April 11, 2012
April 9, 2012
So starts the 35 Days of Terror
That is, the concurrent taking of Health Assessment and Health Promotion during the same session.
Day 1 begins. First thing that I did was log into each class, download the syllabus, and note every single due date for each course into iCal's task list. I find that by keeping track of what's due and when, as well as being able to check them off as I complete them, I can stay on top of all my coursework. Of course, since I'm Pacific time and the class is Central time, deadlines were adjusted...so a lot of assignments are--at least for me--due one day earlier than printed in the syllabus.
Second task: download all readings, presentations and assignments. I set up two new class folders and I downloaded everything that I could. Of course, things can change weekly, but at least I have material on the hard drive.
Third task: take a deep breath and keep telling myself that I can do this, that I've done far more difficult things.
Fourth: order equipment for assessments. *sigh* The costs of this course are beyond ridiculous...on the brighter side, the equipment is a tax write-off.
The assessment teacher decided to be sneaky and not post the materials on reserve until the first day of class--today--so I was not able to get a start on the readings. Actually, both course instructors decided to be sneaky and state that the classes will not be ready until today and not to download or submit anything prior to today as things may change. Which was understandable but annoying.
It's too late to bail now so here I go!
Day 1 begins. First thing that I did was log into each class, download the syllabus, and note every single due date for each course into iCal's task list. I find that by keeping track of what's due and when, as well as being able to check them off as I complete them, I can stay on top of all my coursework. Of course, since I'm Pacific time and the class is Central time, deadlines were adjusted...so a lot of assignments are--at least for me--due one day earlier than printed in the syllabus.
Second task: download all readings, presentations and assignments. I set up two new class folders and I downloaded everything that I could. Of course, things can change weekly, but at least I have material on the hard drive.
Third task: take a deep breath and keep telling myself that I can do this, that I've done far more difficult things.
Fourth: order equipment for assessments. *sigh* The costs of this course are beyond ridiculous...on the brighter side, the equipment is a tax write-off.
The assessment teacher decided to be sneaky and not post the materials on reserve until the first day of class--today--so I was not able to get a start on the readings. Actually, both course instructors decided to be sneaky and state that the classes will not be ready until today and not to download or submit anything prior to today as things may change. Which was understandable but annoying.
It's too late to bail now so here I go!
April 6, 2012
If we hadn't moved, I would be graduating in May with my RN-BSN, instead of graduating next year.
Then again, given Former RN-BSN's uncertain status regarding the CCNE accreditation, I suppose it's not a bad thing that I had to transfer.
Still, I'd like to be done with being a student, at least for a while.
Oh well.
Rx: Repeat Serenity Prayer PRN.
Then again, given Former RN-BSN's uncertain status regarding the CCNE accreditation, I suppose it's not a bad thing that I had to transfer.
Still, I'd like to be done with being a student, at least for a while.
Oh well.
Rx: Repeat Serenity Prayer PRN.
April 5, 2012
*sigh*
So, I need to purchase about $200 worth of books for this assessment class, PLUS have access to basic medical tools. Though why the tools if actually hitting a knee with a hammer and other related tasks are only worth a small fraction of the grade? And of course, I already have two assessment textbooks at home…and of course, the syllabus specifically states that for assignments I MUST use the assigned textbook. I wondered if I've registered for the right section, so I shot my advisor an email to ask before I gave Amazon my money. And yes, it is correct.
All this for a 5 week class that is supposed to be 100% online? Feh.
On the brighter side, the school bookstore actually had a cheaper price than Amazon for most of what I needed, even the new versions…how rare is that? So I ordered used anyway since I'm rather peeved I have to buy yet another set of assessment and care planning books. I saved about $50. Sweet.
Pity the program didn't accept the last RN-BSN assessment class for credit though.
I read the course syllabus…at least I WILL be reading this textbook, and often: the first week's reading assignment is so large, it reminds me of the days of Nursing Fundamentals. So knowing that I will actually use this textbook takes away some of the sting of having to buy it. I'm starting on the reading as soon as possible: the teacher kindly posted the first week's readings online, in case people have a delay in receiving their books. I'm also glad that i'm taking this during what looks like to be a famine stretch in the per-diem front, as I will have my hands full.
I've been using some of the tips I learned yesterday to deal with our histrionic patient. So far, so good. I never thought in a million years I would say this, but I am far more comfortable handling patients with borderline personality disorder. But practice makes perfect, right?
Maybe it's because at 2 years on, I'm still relatively a baby in the world of psychiatric nursing and perhaps my elders are really actually wiser, but I do think about what follows and question this at times:
I fully understand the importance of limit setting and enforcement. I do. I also understand the importance of self-assessment and how I need to handle myself in an emphatic yet neutral manner towards them. But if a patient comes in to see me about something, I am going to talk to them if I can. I may not make them tea and cookies, but I'm going to take the minute or three to listen. Or I may tell them to come back later when I am free. I'm not going to say, "it's nothing, you're fine, go back to group," at least not without hearing the patient out first to see if it is nothing. And if it's nothing, then I'll tell them they're fine and go to group.
But sometimes I feel like the some of the staff takes things to the extreme—they seem so quick to brush off a patient or set rigid limits that seem to be over the top. Or they treat a patient on the cool-to-cold side. Or they downplay the patients' concerns as just being part of their Axis II-ness and don't seem to listen or even question if there is something really behind their behavior or concerns. They're very quick to do that once they learn it's an eating disorder patient, no less.
And maybe they are. And maybe they're not and they really listening and being therapeutic and it just doesn't seem like it. I don't know.
My supervisor said that the skills in handling different populations comes with experience. True that. I have to remember that eating disorders is not the usual population I deal with. I have to learn not a whole new language (since essentially psych is psych is psych), but just a different dialect.
All this for a 5 week class that is supposed to be 100% online? Feh.
On the brighter side, the school bookstore actually had a cheaper price than Amazon for most of what I needed, even the new versions…how rare is that? So I ordered used anyway since I'm rather peeved I have to buy yet another set of assessment and care planning books. I saved about $50. Sweet.
Pity the program didn't accept the last RN-BSN assessment class for credit though.
I read the course syllabus…at least I WILL be reading this textbook, and often: the first week's reading assignment is so large, it reminds me of the days of Nursing Fundamentals. So knowing that I will actually use this textbook takes away some of the sting of having to buy it. I'm starting on the reading as soon as possible: the teacher kindly posted the first week's readings online, in case people have a delay in receiving their books. I'm also glad that i'm taking this during what looks like to be a famine stretch in the per-diem front, as I will have my hands full.
I've been using some of the tips I learned yesterday to deal with our histrionic patient. So far, so good. I never thought in a million years I would say this, but I am far more comfortable handling patients with borderline personality disorder. But practice makes perfect, right?
Maybe it's because at 2 years on, I'm still relatively a baby in the world of psychiatric nursing and perhaps my elders are really actually wiser, but I do think about what follows and question this at times:
I fully understand the importance of limit setting and enforcement. I do. I also understand the importance of self-assessment and how I need to handle myself in an emphatic yet neutral manner towards them. But if a patient comes in to see me about something, I am going to talk to them if I can. I may not make them tea and cookies, but I'm going to take the minute or three to listen. Or I may tell them to come back later when I am free. I'm not going to say, "it's nothing, you're fine, go back to group," at least not without hearing the patient out first to see if it is nothing. And if it's nothing, then I'll tell them they're fine and go to group.
But sometimes I feel like the some of the staff takes things to the extreme—they seem so quick to brush off a patient or set rigid limits that seem to be over the top. Or they treat a patient on the cool-to-cold side. Or they downplay the patients' concerns as just being part of their Axis II-ness and don't seem to listen or even question if there is something really behind their behavior or concerns. They're very quick to do that once they learn it's an eating disorder patient, no less.
And maybe they are. And maybe they're not and they really listening and being therapeutic and it just doesn't seem like it. I don't know.
My supervisor said that the skills in handling different populations comes with experience. True that. I have to remember that eating disorders is not the usual population I deal with. I have to learn not a whole new language (since essentially psych is psych is psych), but just a different dialect.
April 3, 2012
Just when I feel like a Competent nurse, I encounter something that brings me back to Beginner
Or at least back to Advanced Beginner.
It was in dealing with a patient with histrionic personality disorder. And while I know about it, I haven't actually encountered a patient with it. Lots of experience with the borderline, antisocial and obsessive-compulsive personality disorders, but this patient was a first for me.
And try as I might, I was on the losing end of this battle...fortunately the team rescued me.
I admit, I feel like I let everyone down since I wasn't able to deal with her. But I'm trying not to be too hard on myself--after all, as a per-diem, I don't always get to stick around long enough to really form good relationships with patients. And it's not often that one gets to see personality disorders that aren't borderline...even with all the time working inpatient, I can't recall working with a patient with histrionic personality disorder. Borderline, antisocial, OC, dependent, avoidant, paranoid, schizoid (really!)...and of course, lots of NOS, which usually ended up having more of borderline flavor than anything. Now I can add histrionic to the list.
Since we haven't really had any of these patients before and I wasn't the only staff member that was feeling off-balance with her, the staff ended up having an impromptu in-service on the care and feeding of the histrionic.
And I plan to do a little more reading up on it...a coworker recommended an excellent treatment planning book that had practical advice and interventions, instead of just the basic theory and the neatly wrapped up ivory-tower case study of my psych nursing textbook.
Oh well. It's a reminder that even though I've learned a lot, I still have a lot to learn.
It was in dealing with a patient with histrionic personality disorder. And while I know about it, I haven't actually encountered a patient with it. Lots of experience with the borderline, antisocial and obsessive-compulsive personality disorders, but this patient was a first for me.
And try as I might, I was on the losing end of this battle...fortunately the team rescued me.
I admit, I feel like I let everyone down since I wasn't able to deal with her. But I'm trying not to be too hard on myself--after all, as a per-diem, I don't always get to stick around long enough to really form good relationships with patients. And it's not often that one gets to see personality disorders that aren't borderline...even with all the time working inpatient, I can't recall working with a patient with histrionic personality disorder. Borderline, antisocial, OC, dependent, avoidant, paranoid, schizoid (really!)...and of course, lots of NOS, which usually ended up having more of borderline flavor than anything. Now I can add histrionic to the list.
Since we haven't really had any of these patients before and I wasn't the only staff member that was feeling off-balance with her, the staff ended up having an impromptu in-service on the care and feeding of the histrionic.
And I plan to do a little more reading up on it...a coworker recommended an excellent treatment planning book that had practical advice and interventions, instead of just the basic theory and the neatly wrapped up ivory-tower case study of my psych nursing textbook.
Oh well. It's a reminder that even though I've learned a lot, I still have a lot to learn.
April 1, 2012
Darn darn darn
Playing with the course map for my RN-BSN program...because I've missed the history class that started last week, I was trying to come up with new combinations of courses over the next year to keep me on schedule for enrolling in the capstone (final) class in January 2013.
So far the only definite answer I have come up with is to take two history classes concurrently during the summer semester: the missed one and a state history one. Anything else pushes my completion date back even further...most have me taking the last class in May, and one combination even pushed it back as far as August 2013. I figured I could make up for lost ground by taking two nursing courses concurrently in the next cycle, but no.
Bah!
I'm not sure taking two history classes concurrently is a good idea as I'm worried I may confuse material between the two (it's a federal government class and a state government class). On the other hand, it's not impossible...and could be done...might not be the easiest thing though. But I have three months to think on it.
In the meanwhile, doubling up on history means that I don't have to take the two nursing classes together in the next cycle. I'm debating about still doing it anyway. Right now I only have one per-diem job and this WOULD be the best time for me to double-up on something. It would free things up in the fall. It won't let me graduate any earlier because of how history classes #3 and #4 fall on the calendar, and these two classes are sequential so I can't take them concurrently.
Perhaps if I were to take history class #1 and #3 over the summer...then I could double-up on #2 and #4 in the early fall...and if I did take the two nursing classes together this next cycle and adjust the rest of the schedule, then I could start my final class in November 2012.
But then again...why am I thinking about killing myself in the rush to get this done?
Well, a lot of it is because I've been working on this BSN since 2009 and I just want to finally wrap up this chapter of my education. And...that's really it. No other real reason than I'm starting to get tired of being a RN-BSN student. I'd like to have the degree and start working on the next chapter in my education, which will be a nice little break while I decide what I want to do for graduate school.
Busy week of work ahead, so no time at the Y this work week. I'm trying to find out if my manager will let me take a couple of classes at the hospital: PPD (apparently at my job, one needs to be facility-certified in order to give and read PPDs) and EKG administration. (I've done EKGs before, but I would like to have a class under my belt). Plus there's some rumors going around that I want to investigate...but more on those later, when I know some more.
So far the only definite answer I have come up with is to take two history classes concurrently during the summer semester: the missed one and a state history one. Anything else pushes my completion date back even further...most have me taking the last class in May, and one combination even pushed it back as far as August 2013. I figured I could make up for lost ground by taking two nursing courses concurrently in the next cycle, but no.
Bah!
I'm not sure taking two history classes concurrently is a good idea as I'm worried I may confuse material between the two (it's a federal government class and a state government class). On the other hand, it's not impossible...and could be done...might not be the easiest thing though. But I have three months to think on it.
In the meanwhile, doubling up on history means that I don't have to take the two nursing classes together in the next cycle. I'm debating about still doing it anyway. Right now I only have one per-diem job and this WOULD be the best time for me to double-up on something. It would free things up in the fall. It won't let me graduate any earlier because of how history classes #3 and #4 fall on the calendar, and these two classes are sequential so I can't take them concurrently.
Perhaps if I were to take history class #1 and #3 over the summer...then I could double-up on #2 and #4 in the early fall...and if I did take the two nursing classes together this next cycle and adjust the rest of the schedule, then I could start my final class in November 2012.
But then again...why am I thinking about killing myself in the rush to get this done?
Well, a lot of it is because I've been working on this BSN since 2009 and I just want to finally wrap up this chapter of my education. And...that's really it. No other real reason than I'm starting to get tired of being a RN-BSN student. I'd like to have the degree and start working on the next chapter in my education, which will be a nice little break while I decide what I want to do for graduate school.
Busy week of work ahead, so no time at the Y this work week. I'm trying to find out if my manager will let me take a couple of classes at the hospital: PPD (apparently at my job, one needs to be facility-certified in order to give and read PPDs) and EKG administration. (I've done EKGs before, but I would like to have a class under my belt). Plus there's some rumors going around that I want to investigate...but more on those later, when I know some more.
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