But I Didn't Go To School For Psychiatric Nursing?

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Psychiatric Mental Health Nursing: You’re going to do it no matter what.

Hey everyone! It's David from ADPIE. This week I wanted to talk to you about mental health. This is one of my favorite nursing specialties! While I don't work in psych, it is such an important part of my nursing practice. Mental health has many connotations for people. Some associate it with taking care of yourself. Tea, warm baths, meditation, wine…

For others, it is a branch of medicine that is often thought of as last resort if you are trying to find a job in nursing. “The psych hospital is always hiring…”

This is so unfortunate because it is the most underutilized, but much needed branch of nursing. Nurses are so well equipped to be a valued part of mental health services.

Mental health and psychiatric nursing is its own nuanced branch of nursing with its own skills and challenges. Having said that, nurses always handle mental health in some way and students really need to understand the importance of that. Psychiatric nursing is usually covered after the first semester. If you have taken any psychology courses beforehand, they will really help you out.

One topic that is discussed and often dreaded is “therapeutic communication”. It is such a hard thing to teach someone if you don’t have a knack for it. A part of it is natural ability in reading someone’s body language, reading between the lines, asking the right questions, and no small amount of intuition. Many nurses dread having to really talk to their patient; preferring to just make them better and get out of the room.

You may not have wanted to go into mental health nursing, but no matter what specialty you choose, you WILL have to talk to patients. During this time, you have an opportunity to really make an impact on someone’s situation. If you are still nervous, here are some ways to get through a therapeutic conversation:

• Listen
• Truly listen. Some may call this actively listening. What is the quality of their voice? Do they have a tremor despite saying they are fine?
• Don’t try to offer advice right off the bat
• I’ve seen some nurses get the first little bit of information and fire off some advice. Wait for the patient to finish speaking. While we are trained to intervene in many ways, do not tell them what to do. It comes off as dismissive and you sound like a know it all.
• Keep the patient on track
• Patients like to wander; both in conversation and off the unit sometimes. Keep them focused on what is bothering them. If you need to, bring them back to the point.
• “Tell me more...” does actually work
• This is such a cliche statement that we learn in school, but it really does work. It makes you open to more information and tells the patient you have the time and attention to give them. Some of the greatest stories from patients or most insightful information came from me using this very phrase.
• Get on their level
• Sit with them. I got this from a physician and it works most of the time to make an angry patient much more amicable to conversation. 
• Keep your nurse face on
• No matter what they say, keep your “nurse face” on and remain professional. You are not there to judge them or make fun of their situation. Be open to any and all information. Most of the time, patients are scared and looking for help or information. They might say some weird ****, but we need to take it all in and help them process it.

If you are interested in mental health nursing check out the American Psychiatric Nurses Association. Most nursing specialties have an association and they are great resources for certifications or information on their specific specialty.

We’re looking forward to seeing you guys next week, but if you have any questions, please contact us.

As always, we’ll continue to monitor...

- David RN, BSN

How Do I Prepare For NCLEX?

It's Wednesday! This week, we want to talk a bit about NCLEX prep.

Once we graduate from nursing school the first thing we want to do is to never look at another book again. #wesurvived No one is at fault since we've really had multiple "date nights" with our book, writing out drug cards, and finishing our absolute favorite - care plans . Allow yourself the time to relax for a bit (give yourself a deadline), then get back to reviewing before sitting for boards, aka NCLEX!

Here at ADPIE, we firmly believe in using our time efficiently, so we recommend a few things before taking your exam. Here's a few tips we've like to suggest:

1. Study groups
They only work if you are honestly there to study. This means evaluating each other's knowledge in an effort to determine which content material you need to review. If you don't come up with a game plan, and find someone who is just as serious as you are about studying, then don't bother. You'll waste your time and may not have the best outcome. Keep the group small and remember this is not a social event! You can hang out later after you complete your tasks! We cannot stress enough the importance of limiting distractions!

2. Timeline
After you've received your authorization to test (ATT), schedule your test date and put a plan together. You probably have a planner but if you don't already, look into Inkwell Press (We use them with ADPIE and love them)! Getting organized is what will keep you on track and a key to your success. Some people need a detailed schedule to remain organize, which is great but this plan has to be realistic too. Set yourself some scheduled breaks. You can't exactly cover 2 years of nursing content in one week if you don't already know the material by heart. Tailor your study plan to meet your needs; perhaps you can take a test to get a baseline and compose a study plan based on the subject you'll need more time on. Treat this like a full time job. Study an hour at a time and walk away for a new minutes. Take a lunch break and hydrate yourself. Don't rush yourself but also don't  think you have to score 100% on your practice test.  Research encourages graduate nurses to take their boards sooner rather than later. Not many ever feel ready to take the test. After all, it is a defining moment in your career. Think of it this way...you survived nursing school! You're a beast! You can and WILL pass your boards!

3. NCLEX resources

• Sara- For content, I attended a live Hurst review. I had access to online videos, NCLEX prep questions, and was provided with a notebook for note taking that is specific to the review. I felt that the material was presented in a way by the educators that I can confidently recall the information. I was drawn to their southern accent, they even tied a story or catch phrase to the topic they were covering. Three full days of review left me feeling confident in my study plan. I recommend this review for individuals who feel they need a crash course. Another resource I used was NCSBN (National Council of State Boards of Nursing) I absolutely loved NCSBN. They are the makers of NCLEX. I took my boards 5 years ago and I can confidently say this review helped me tremendously. I took a pre-test and was able to focus on the subjects I need to improve on the most. I purchased a membership a few times. If you're short on funds, suggest this membership as a graduate gift! I promise you all, you won't be disappointed in the content provided or the question bank! I cannot say enough great things about it.
• David- I was required by the school to use ATI and its products for my classes; I can't say for certain if they helped or not. Honestly, it just felt like something I had to do and didn't take away all I could have. We also had to attend a Live Hurst Review. I did not enjoy this. I felt it was long, boring, and the book was fill-in-the-blank. What I do recommend is NCLEX RN Mastery! There is a free version with plenty of questions, but if you blow through all those there is a paid version that is inexpensive. I got in the habit of doing a few dozen questions every day and I did feel this was very helpful. 

4. Eliminate your distractions
Whatever that means to you, do it. Your IG, FB, and Netflix account will still be there for you once you're done studying! Also, for those that like to study at work, that doesn't work! You have to establish a designated area for studying, remember we're treating this like a full-time job!

5. Relax!
When you are done studying for the day, don't pick up any material. Do something therapeutic, something that you enjoy. We certainly understand the pressure of taking this test but you have to trust that whatever happens; it will be ok. Allow yourself 24 hours before the exam free of nursing material, I know it sounds insane but information overload will not help. If you don't know the information by now, then just keep moving forward and take the test!

We want to know what are some tips that you have for graduate nurses? So new grads, good luck and please continue to monitor...

What are Nursing Unions?

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Welcome back! This week we are focusing on nursing unions.

Do nurses need a union?

We took a poll on our Facebook and Instagram accounts and a majority of our voters were pro nursing union. Let's take a look into what it means to be a part of a union.

Overall, the nursing union looks out for their members. This is either in a financial or legal aspect.We were fortunate enough to speak with a nurse that gets to take full advantage those benefits from what nursing union has to offer in California.

What type of benefits are we looking at with unions?

From what we've gathered, the union's goal is to:

• Assure their members are compensated
• Guarantee employers provide growth within their organization
• Improve work conditions

They also believe in strength in numbers, therefore you may hear on the news about nurses going on strike in an effort implement changes for their work conditions. Often times strikes don't last long, but they are effective. Union nurses get paid approximately 20% more than non-union facility employed nurses. Unions have influenced nurse-patio ration. In fact, California is mandated by law to keep patient ratios low to provide the best care by nursing. Sadly, hospitals may decrease the number of ancillary team members in order to abide by the law.

We are fortunate to know a few people were employed by unionized hospitals and they were extremely pleased with the unions' work. According to our resources, they were guaranteed fair wages, great working environments, yearly raises, and most importantly they felt like someone had their back!

Is it a perk to be a member?

Contrary to belief, there are some disadvantages to unions. Seniority has a big part in requests for time off or switching positions. This means if multiple nurses are requesting the same time off, the more senior nurse will be granted the time off. The same thought process is applied with nurses seeking professional growth within the organization; the union guarantees the employer will provide opportunities, but the most senior nurse seeking the position will have dibs on it. Another disadvantage is compensation, if a contract states a fixed rate, therefore incentive won't be expected. In addition, if the union decides to go on strike, those nurses will face some difficult times. Ethically, they are not allowed to care for their patients as they will "cross the line". They will also not receive financial compensation while they were on strike.

Should every nurse join?

Research suggests a positive correlation between successful unionization, safety, and satisfaction; implying unions are beneficial when they run successfully.  It would be each person's choice whether they would join the union. As far as we know, obtaining a membership is not mandatory. So we wonder, is the union way the future of healthcare employees? We are sure we will find out soon or later as things continuously evolve in healthcare.

 Thanks for joining us for another topic and be sure to subscribe and follow us on social media. We hope you continue to monitor...

Disclaimer: ADPIE headquarters is located in FL and unfortunately, we have do not have first hand participation in a union as FL is not a union state. All information has been obtained from online resources and the personal anecdotes of others.

Oh @$^% I'm Charge!

Welcome back! This week we are discussing charge nurses.

What is a charge nurse?

Why would I want to become one?

If it is right for me, how can I get this position? All these questions will be answered!

Charge nurses (CN) are viewed as a resource. Ideally, they are the first “go-to” person in the chain of command. Every facility may have different responsibilities for this role, however, across the board it is considered a leadership position that carries great responsibilities. CN may be appointed for the role for their:

• Positive team player attitude
• Fairness
• Team building behavior
• Knowledge base
• Leadership skills (This might be the most important)

This role will not always be appointed to a seasoned nurse, contrary to some beliefs. Nurses displaying potential will be sought after and groomed for the role in some cases. Ideally, CN should hold a BSN or higher since BSN prepared nurses learn leadership and management. However, ADN nurses are not excluded as their experience can hold great value.

We can expect charge nurses to be involved in the following:

• Assist with hands-on care at the bedside
• Communicate with physicians
• Coordinate transfers in or out of the facility
• Meet with staff for their annual evaluations
• Assist with the hiring process
• Handle service recovery
• Round on patients on the unit
• Assist with composing schedules
• Make the staff nurses’ assignments

Needless to say, CNs are just a tad bit busy! Their roles are not necessarily standardized between day and night shift, or other departments, nonetheless, this role has quite the shoes to fill. It is a privilege to be a charge nurse as it is a highly coveted and respectable title.

As new grads, it is vital to keep your CN aware of your day in an effort to maintain open communication and also allow the charge nurse to suggest some clinical pearls. David and I are charge nurses at a small community hospitals, sometimes were are in staff and assume care for a full load of patients. At times it can be challenging, but it has allowed us to maintain our skills and excel on our time management and multitasking.

If you’re interested in becoming a charge nurse, talk to your leader about the role and suggest a day to shadow a charge nurse on your unit. Expressing interest in this role is a great way to be considered for it. If you do not meet the qualifications, then set some goals! The new year is here and it’s time for some new goals for growth. We owe it to ourselves and our patients. Depending on where you work, you may need to interview for the position, don’t panic! The fact that you got the interview is a good sign. Maybe you can start as a PRN charge and eventually become a full-time charge? The key is to keep challenging yourself.

As a new CN, take deep breaths! We were all novices at one point or another in our career and look you’ve made it to charge nurse! #boss Remember, you too have a resource, so feel free to phone a friend. You CAN do this! Management believes in you and will support you! You have shown potential and this role is just the beginning of what you’re capable of! Be the leader you yourself would want to follow! Be fair, be patient, be ready! Now go on fearless leader!

Stay tuned for next week’s post! We’d love to hear from you all and encourage everyone to leave a comment below for suggestions of topics you’d like for us to discuss. Until then, please continue to monitor...