Too Many Nurses in the Kitchen: CNA, LPN, RN, APRN, PHD, DNP

Back in 1990 when I was fresh out of my initial nurse training program, for a LPN, the word in the hospital corridors was that LPN jobs would soon be obsolete. Go back to school and “get your RN” was the buzz. Since rising through the nurse ranks I’ve paid attention to the demise of the LPN and it’s not just alive and well, it’s thriving, in 2014.

I’ve got some analogies: movie ratings — G, PG, R, and X. And places to receive healthcare. (more…)

Psychiatry’s Stigma In The Medical Profession

The stigma of becoming a psychiatrist.


Today’s GML (Great Medical Link) has my brain wheels turning, so here’s my first 2014 post:

While working one of those long 12-hour shifts I used to pull while on staff at a university teaching hospital in SC as a registered nurse back in 2001, I found myself once again sitting with my patient/client/charge (nomenclature dilemma is fodder for a future post) just… talking. Excessive talking with patients isn’t smiled upon by the bean counters.

“You know?” my RN colleague said to me then. “Have you ever thought about becoming a psychiatric nurse? I think you’d be really good at it.” Hmm. No, not really. (more…)

How A Patient’s Suicide Changed A Doctor’s Approach To Guns (NPR)

How A Patient’s Suicide Changed A Doctor’s Approach To Guns : Shots – Health News : NPR.

The link above is to a story about one psychologist’s recent experience with a suicidal patient who shot himself soon after their last office visit. The psychologist had not fully incorporated a standard practice of asking specifics about whether or not there are guns in the home. Now he’s changed his opinion and firmly believes that all clinicians need to be asking that question.

Psychiatrists and therapists regularly ask their clients who suffer from depression if they’ve thought about suicide and do they have access to guns. But given the lack of access to professional mental health care for many Americans this responsibility often falls to primary care doctors who literally don’t have time to ask their patients this question. Primary care doctors may see anywhere from 15-20 patients a day and there’s no time built into that schedule to get into a conversation about suicide and guns. It’s a Pandora’s Box that stays shut, not infrequently with dire consequences.  Having a full-time psychiatric RN on staff at every primary care medical practice would allow the time for proper screening and improved outcomes. That’s an example of “Integrative Medicine” practice.