Got fired twice this year, brother. Once for sticking up for patient ratios; once for being "discourteous" to a nurse I'd never had so much as a heated discussion with lol. Weird being essential and expendable.
Basically if you chose to give a patient additional medication you were out of your scope as a nurse. We can’t dictate how much a medication patient should receive . I think I would have told her I would give her the additional 1.5 medication dose once the prescription was brought in by her husband or consult the physician .They were probably afraid that this behavior would continue and cause grave outcomes. Although I understand you wanted the best for the patient we must act within our scope. I would look into the pmhnp program sounds like you would thrive .
I sought treatment when I was really manic (no sleep for ~4 days) and I begged for a higher dose. I pleaded my case, explaining how heightened my symptoms were and that the dose they wanted to give me was too low to help. They totally disregarded me and I had another awful night with only a couple of hours of sleep. Luckily the next day I had a nurse who listened to me and increased the dose, and I started to recover. We need more people like you who actually care about patients and listen to our needs. Health care companies are just sociopathic organizations who only care about liability since it threatens their profit.
I don’t necessarily feel those nurses didn’t care about your needs. I believe they had to follow guidelines because at the end of the day it is their job on the line if they don’t.
next time you have a problem with a dose size while you're inpatient , it's WAY better to ask the nurse to call the Attending On Call for a one-time dose to get you through the night and then tell the doc the next day how you felt with the increased dosage, because THAT is how you get your script adjusted legit so you won't have to wait for another "caring" nurse to be on staff that night... Now you know why the long term staff are so inflexible, by the way, because we are aware that you're asking us to put our license in harm's way, our license that we paid a fortune for AND suffered through nursing school to get. I know when you're drying out and your skin is crawling your heart is pounding and the voices are getting meaner you don't care about anything but feeling better,...but just putting it out there that in the long term you really gotta go through the right channels to get the treatment you actually need. Playing games with the nurses at best is a quick fix and you'll have to do it EVERY time. Just a heads up.
@spg1794 I totally agree. You need to go through the proper channels as should have this RUclips Nurse. He knows how to do things correctly but chose to go ahead anyway...
Thank you for being open about this. I am about the start my last semester of nursing school and my instructors really haven't talked that much about what happens if you make a medication error. All they said was to report it right away to the charge nurse. I feel like someone shouldn't be fired unless they are repeatedly making mistakes. I feel really worried about working as a new nurse soon and that I am going to mess up. Do you know if mental facilities train new nurses ? I am kind of worried because I want to work in the mental health field, but I want to be trained well because i have no experience. I feel like I still have no idea how to do anything and I don't feel like clinicals are enough.
Clinicals are never enough, but! You'll be fine and the way you're feeling is how we all feel right out of nursing school! also, you WILL have a med error, assuming you pass enough meds. . .it's really one of those not if but when things. Also, technically what I did wasn't an 'error' b/c I think 'error' implies something accidental, whereas my 'error' was intentional, and falls under the lines of misconduct. So yeah, when you have a legitimate med error (e.g., you accidentally give the wrong dose to the right patient), at a minimum you report it to the patient and the provider, monitor for any potential side effects, and fill out all the fun paper work that your institution will want you to fill out after the error.
What a cascade of mistakes you described... Okay first- openness about a med variance is only acceptable in the context of an ACCIDENTAL med variance. Being "open" about intentional misconduct only comes off as irresponsible and defiant. I was not present at that meeting with the big wigs, but it's so easy to imagine that you went into that meeting intent on rationalizing what you did on the off chance that they'd go easy on you if you made your case strong enough. That was the second mistake, because the higher-ups are responsible for making sure everyone is obeying the law, and your attitude said nothing to them besides that the chain of command is not mandatory when you yourself decide you know better. You do come off as smart enough to not try the "but lots of people do worse things" defense that you vented in the video , so there's no need to point out thats a waste of time and only makes you come off as minimizing what happened. "But they didn't get hurt" etc. Your last mistake is letting yourself feel betrayed over them doing their job of taking accountability for the actions of their subordinates, especially at a time when they're being scrutinized like you said. Other people getting away with bloody murder is always irrelevant, and also stating so actually pressures those in authority to make an example of you as a message to all the other offenders. I recommend taking a little time off and reflecting on what's worth risking your license for and what isn't...
@sph1794 this my assessment as well as to why he got fired. I would like to add he started off by saying they gave him an team lead type position. I think this made him think he had more clout than he actually had. A bit of hubris. That type of position doesn't allow you to break protocol or over ride the dr treatment plan etc. In fact it means that you are there to ensure protocols are being followed. Plus why didn't he request a call in to the resident Dr and make a request then follow whatever decision the Dr gives him?
dont get me wrong, I like this guy. Im a psych RN also who works CRC/High acuity, every shift one or more patients tests the fences with me. ive made mistakes too that have gotten me quietly transferred to another hospital or "encouraged" to resign, I watch my step super carefully now,....it's so easy to get in trouble in psych nursing without even doing anything wrong, there's absolutely no advantage to knowingly breaking rules, all the rules matter.
So sorry to hear that, such a silly reason to be fired ! man I wish you the best of luck. I just discovered your channel and I'm going to watch most of your videos since I'm planning to shift my career from an EMT dispatcher to a psychiatric nurse.
@@A_Psych_Nurse Hey may I ask if I'm not physically strong do you think that I have the chance? I do workout but I'm not that strong, But I do have high empathy and have my ways with patients. Do you know anyone who isn't strong but thrived in psychiatric nursing?
yeah there's a TON of people who fit the description. I just personally feel more safe knowing I can handle myself if need be, and I don't think it takes much to get in 'reasonable' shape (i.e., daily walks, + maybe 10mins of calisthenics)@@Arbiter902
As a student MHN it’s useful to hear this. Personally I follow procedure closer than most and don’t mix pleasure with work or care about making friends in the workplace, which may hold me back in some ways but your story holds water to my theory which is that in most cases people may feel liberties are being taken because of the perceived work relationship. apologies if this comes across as harsh, as I appreciate you sharing your experience. Are you able to find work still?
Respectfully, you can’t just go rogue and give medication outside the parameters defined by the script & doing so subjected them to legal liability if they didn’t fire you. Also, it sounds like you maybe worked in a facility where I worked (based on some terminology). And your lozenge story- I can totally see how that could happen, and you are correct that it was on her prn med list. You were fine on that.
I am sorry to say this but even if you have the best patient s interest at heart. You are not allowed to give someone more medicine, you don t make the treatment plan. Doctor s do. So that if any side effects occur, doctor s know what amount someone was taking, etc. Maybe a warning would be enough.
You should not give anybody double dose of this poison, let's face it. I am surprised you did sth like this. Maybe it is for the best so you can commit to spreading the truth instead. Take care. It is a wild world. I think it is a pity as you sound like you are a caring person and most in this profession are cold and indifferent.
thanks for your comments :). I tend to value patient autonomy, so for instance, if I think a patient is better off w/o some sort of PRN medication but they request it, I still give it to them.
Sorry this happened homie ... I don't personally work in healthcare, but I can empathize with seeing how something like this could happen. It's a shame but at least it looks like something like this won't happen again. Not sure if you've been able to get another job yet, if not I'm wishing you the best in that area :)
gainfully employed so far. . .as honest was prospective employers about my transgression and it thus hasn't impacted my ability to find a job. Thanks for stopping by!
That doesn't sound like a med error that sounds like deliberately and intentionally practicing medicine without a license. You can be reported to the board for that and actually lose your license, you should call to clarify with md before you give it to cya this is the whole reason you do a med reconciliation on admission and if there is a discrepancy to clarify. Such a poor choice to make with such major consequences upto and including losing your license your crazy bro hahaha
Wish you was dispensing the IDTS meds when I was in prison. I don't know if it was because my name starts with W but I often went to get my Meth in the morning and the nurse would inform me the Doctor hasn't rewritten your script, sorry you will have to wait until later on. Happened to me 3 times in 6 months nobody else though!
Honestly stuff like this drives all of us nurse's nuts. Especially when we know an offender should be taking a medication but for whatever reason it hasn't been renewed or it's lapsed or expired whatever. Then again we got a lot of offenders who are slacking too lol and forget to submit their kites. 🤪
I know, double the dose. In all my life, I never had a psychiatrist just double my antipsychotics in one day. You need to gradually increase and be closely monitored during that process if you, like me, have schizophrenia or if you have Bipolar. Not a good idea.
I'm not sure there's a way to increase Invega much more slowly than going from 1.5mgs to 3mgs as I don't think there's an intermediary dose between these doses.
The amount of dumb, off the cuff comments in this video... and I was thinking that before the firing part. What nurse isn't comfortable with seeing, "The human naked form." The fact that you'd disregard an order and just give what you thought has dangerous written all over it. You have to be someone that falls in line and is a rule follower. Clearly not a good fit.
I know its not really an option in prison, but I recommend going on a diet. Eating lots of fruit and taking vitamins everyday did more for my mental health than 4 meds
@@silverdweller2809 An unmedicated individual with a psychotic disorder is likely to feel “malaise” regardless of their diet, even if they aren’t experiencing an active psychotic episode. I have an unspecified psychotic disorder. It doesn’t bother me unless I have no weed/antipsychotics
Got fired twice this year, brother. Once for sticking up for patient ratios; once for being "discourteous" to a nurse I'd never had so much as a heated discussion with lol. Weird being essential and expendable.
Basically if you chose to give a patient additional medication you were out of your scope as a nurse. We can’t dictate how much a medication patient should receive . I think I would have told her I would give her the additional 1.5 medication dose once the prescription was brought in by her husband or consult the physician .They were probably afraid that this behavior would continue and cause grave outcomes. Although I understand you wanted the best for the patient we must act within our scope. I would look into the pmhnp program sounds like you would thrive .
thx, I was recently accepted into an nP program and I think this will be the right direction for me :)
Rest knowing you are truly led by the patients best interest.
I sought treatment when I was really manic (no sleep for ~4 days) and I begged for a higher dose. I pleaded my case, explaining how heightened my symptoms were and that the dose they wanted to give me was too low to help. They totally disregarded me and I had another awful night with only a couple of hours of sleep. Luckily the next day I had a nurse who listened to me and increased the dose, and I started to recover. We need more people like you who actually care about patients and listen to our needs. Health care companies are just sociopathic organizations who only care about liability since it threatens their profit.
I don’t necessarily feel those nurses didn’t care about your needs. I believe they had to follow guidelines because at the end of the day it is their job on the line if they don’t.
next time you have a problem with a dose size while you're inpatient , it's WAY better to ask the nurse to call the Attending On Call for a one-time dose to get you through the night and then tell the doc the next day how you felt with the increased dosage, because THAT is how you get your script adjusted legit so you won't have to wait for another "caring" nurse to be on staff that night... Now you know why the long term staff are so inflexible, by the way, because we are aware that you're asking us to put our license in harm's way, our license that we paid a fortune for AND suffered through nursing school to get. I know when you're drying out and your skin is crawling your heart is pounding and the voices are getting meaner you don't care about anything but feeling better,...but just putting it out there that in the long term you really gotta go through the right channels to get the treatment you actually need. Playing games with the nurses at best is a quick fix and you'll have to do it EVERY time. Just a heads up.
@spg1794 I totally agree. You need to go through the proper channels as should have this RUclips Nurse. He knows how to do things correctly but chose to go ahead anyway...
I imagine it must've been hard to be so transparent about this. I'm very grateful 🙏 Wish you all the best going forward, love your videos
Thank you for being open about this. I am about the start my last semester of nursing school and my instructors really haven't talked that much about what happens if you make a medication error. All they said was to report it right away to the charge nurse. I feel like someone shouldn't be fired unless they are repeatedly making mistakes. I feel really worried about working as a new nurse soon and that I am going to mess up. Do you know if mental facilities train new nurses ? I am kind of worried because I want to work in the mental health field, but I want to be trained well because i have no experience. I feel like I still have no idea how to do anything and I don't feel like clinicals are enough.
Clinicals are never enough, but! You'll be fine and the way you're feeling is how we all feel right out of nursing school!
also, you WILL have a med error, assuming you pass enough meds. . .it's really one of those not if but when things.
Also, technically what I did wasn't an 'error' b/c I think 'error' implies something accidental, whereas my 'error' was intentional, and falls under the lines of misconduct.
So yeah, when you have a legitimate med error (e.g., you accidentally give the wrong dose to the right patient), at a minimum you report it to the patient and the provider, monitor for any potential side effects, and fill out all the fun paper work that your institution will want you to fill out after the error.
@A_Psych_Nurse thank you this helps now I know what to expect lol
What a cascade of mistakes you described... Okay first- openness about a med variance is only acceptable in the context of an ACCIDENTAL med variance. Being "open" about intentional misconduct only comes off as irresponsible and defiant.
I was not present at that meeting with the big wigs, but it's so easy to imagine that you went into that meeting intent on rationalizing what you did on the off chance that they'd go easy on you if you made your case strong enough. That was the second mistake, because the higher-ups are responsible for making sure everyone is obeying the law, and your attitude said nothing to them besides that the chain of command is not mandatory when you yourself decide you know better. You do come off as smart enough to not try the "but lots of people do worse things" defense that you vented in the video , so there's no need to point out thats a waste of time and only makes you come off as minimizing what happened. "But they didn't get hurt" etc. Your last mistake is letting yourself feel betrayed over them doing their job of taking accountability for the actions of their subordinates, especially at a time when they're being scrutinized like you said. Other people getting away with bloody murder is always irrelevant, and also stating so actually pressures those in authority to make an example of you as a message to all the other offenders.
I recommend taking a little time off and reflecting on what's worth risking your license for and what isn't...
Thanks for this comment, I think you have a lot of valid points here.
@sph1794 this my assessment as well as to why he got fired. I would like to add he started off by saying they gave him an team lead type position. I think this made him think he had more clout than he actually had. A bit of hubris.
That type of position doesn't allow you to break protocol or over ride the dr treatment plan etc.
In fact it means that you are there to ensure protocols are being followed.
Plus why didn't he request a call in to the resident Dr and make a request then follow whatever decision the Dr gives him?
dont get me wrong, I like this guy. Im a psych RN also who works CRC/High acuity, every shift one or more patients tests the fences with me. ive made mistakes too that have gotten me quietly transferred to another hospital or "encouraged" to resign, I watch my step super carefully now,....it's so easy to get in trouble in psych nursing without even doing anything wrong, there's absolutely no advantage to knowingly breaking rules, all the rules matter.
Thank you for sharing!
So sorry to hear that, such a silly reason to be fired ! man I wish you the best of luck. I just discovered your channel and I'm going to watch most of your videos since I'm planning to shift my career from an EMT dispatcher to a psychiatric nurse.
awesome! best of luck in your endeavor.
@@A_Psych_Nurse Hey may I ask if I'm not physically strong do you think that I have the chance? I do workout but I'm not that strong, But I do have high empathy and have my ways with patients. Do you know anyone who isn't strong but thrived in psychiatric nursing?
yeah there's a TON of people who fit the description. I just personally feel more safe knowing I can handle myself if need be, and I don't think it takes much to get in 'reasonable' shape (i.e., daily walks, + maybe 10mins of calisthenics)@@Arbiter902
@@A_Psych_Nurse Your words are very assuring! I'll be careful of course, Thanks!
As a student MHN it’s useful to hear this. Personally I follow procedure closer than most and don’t mix pleasure with work or care about making friends in the workplace, which may hold me back in some ways but your story holds water to my theory which is that in most cases people may feel liberties are being taken because of the perceived work relationship. apologies if this comes across as harsh, as I appreciate you sharing your experience. Are you able to find work still?
yeah I'm good, working at a local prison :). Not harsh at all, appreciate the comment.
I am in a big shock with this story !
They don’t value your honesty…
Respectfully, you can’t just go rogue and give medication outside the parameters defined by the script & doing so subjected them to legal liability if they didn’t fire you. Also, it sounds like you maybe worked in a facility where I worked (based on some terminology). And your lozenge story- I can totally see how that could happen, and you are correct that it was on her prn med list. You were fine on that.
100%
I am sorry to say this but even if you have the best patient s interest at heart. You are not allowed to give someone more medicine, you don t make the treatment plan. Doctor s do. So that if any side effects occur, doctor s know what amount someone was taking, etc. Maybe a warning would be enough.
You should not give anybody double dose of this poison, let's face it. I am surprised you did sth like this. Maybe it is for the best so you can commit to spreading the truth instead. Take care. It is a wild world. I think it is a pity as you sound like you are a caring person and most in this profession are cold and indifferent.
thanks for your comments :). I tend to value patient autonomy, so for instance, if I think a patient is better off w/o some sort of PRN medication but they request it, I still give it to them.
He didn't follow the 5 rights of med administration. Dangerous practice
Sorry this happened homie ... I don't personally work in healthcare, but I can empathize with seeing how something like this could happen. It's a shame but at least it looks like something like this won't happen again. Not sure if you've been able to get another job yet, if not I'm wishing you the best in that area :)
gainfully employed so far. . .as honest was prospective employers about my transgression and it thus hasn't impacted my ability to find a job. Thanks for stopping by!
Thank you for sharing. I don’t think firing you was appropriate for that scenario. ❤
That doesn't sound like a med error that sounds like deliberately and intentionally practicing medicine without a license. You can be reported to the board for that and actually lose your license, you should call to clarify with md before you give it to cya this is the whole reason you do a med reconciliation on admission and if there is a discrepancy to clarify. Such a poor choice to make with such major consequences upto and including losing your license your crazy bro hahaha
Sweet heart I recommend you to always follow the doctor medication order and never trust the patient. You will be fine.
Its not an error when you did the right thing.
You know best if you did the right thing.
😢 That sucks. Red tape politics.
Wow 😮
Wow bro!
Wish you was dispensing the IDTS meds when I was in prison. I don't know if it was because my name starts with W but I often went to get my Meth in the morning and the nurse would inform me the Doctor hasn't rewritten your script, sorry you will have to wait until later on. Happened to me 3 times in 6 months nobody else though!
Honestly stuff like this drives all of us nurse's nuts. Especially when we know an offender should be taking a medication but for whatever reason it hasn't been renewed or it's lapsed or expired whatever. Then again we got a lot of offenders who are slacking too lol and forget to submit their kites. 🤪
why give double dose intentionally? 😅
she said she had a script for the dose I gave her :)
I know, double the dose.
In all my life, I never had a psychiatrist just double my antipsychotics in one day. You need to gradually increase and be closely monitored during that process if you, like me, have schizophrenia or if you have Bipolar.
Not a good idea.
I'm not sure there's a way to increase Invega much more slowly than going from 1.5mgs to 3mgs as I don't think there's an intermediary dose between these doses.
@@A_Psych_Nurse😅
The amount of dumb, off the cuff comments in this video... and I was thinking that before the firing part. What nurse isn't comfortable with seeing, "The human naked form." The fact that you'd disregard an order and just give what you thought has dangerous written all over it. You have to be someone that falls in line and is a rule follower. Clearly not a good fit.
Get a job as a bus driver instead mate. Less risk to the general public. Drink a glass of water & try not to make videos stoned. Painful.
I'm a big fan of Mr. Shulgin. Glad to see he's finally arrived at my channel! But yes, probably not the best idea to make videos stoned. . .
I think you fired due to those pharmaceuticals companies, which you were exposing and telling truth.
People don't need medication for mental health
He worked as a prison nurse. Probably no chance for alternatives
I know its not really an option in prison, but I recommend going on a diet. Eating lots of fruit and taking vitamins everyday did more for my mental health than 4 meds
@@reddbenddthat may be for a relatively healthy person but schizophrenia is not going away with vitamins and fruit.
@@silverdweller2809 thc has antipsychotic properties
@@silverdweller2809 An unmedicated individual with a psychotic disorder is likely to feel “malaise” regardless of their diet, even if they aren’t experiencing an active psychotic episode.
I have an unspecified psychotic disorder. It doesn’t bother me unless I have no weed/antipsychotics
I would be pissed off if you gave me a double dose of an antipsychotic drug. Akathisia SUCKS