Psychiatric emergency nursing

Jules A, MSN · Jun 8, 2016

Aren't you going to be diagnosing? I'm not sure how that would work for someone with no psych or ED experience. What kind of nursing have you done? There aren't many CNSs in my area any more but we had them in the psychED at a hospital where I used to work. Unfortunately in addition to diagnosing and recommending disposition they were stuck doing all the secretary and social work things like calling to locate inpatient beds and insurance authorizations. They tried to get NPs in because they can prescribe also but they quit shortly after they realized they were doing so many administrative tasks.

Ladysin21 · Jun 8, 2016

Hi Jules, thanks for the response. I worked as a nurse supervisor in a family health clinic. Lots of admin work as well. I really wanted bedside to get away from the admin. Work. My whole interview and hiring process was a bit strange. I first though it was for medical emergency room. When HR called and said I was accepted for the Behavioral health job, I was confused. Found out it was CPEP. It is just too had to get into a hospital without hospital experience where I live. Been trying for 2 years. So I accepted the offer.

Jules A, MSN · Jun 8, 2016

Be very careful especially if you think they might have pulled a bit of a bait and switch on you. Something people often forget is that just because you are hired for a position doesn't mean you will be competent and practicing within your scope. No joke my hospital would have me performing brain surgery if they could get reimbursement and I lacked the insight to say no. Definitely check with your board of nursing to ensure you are practicing within your scope. I would email to have it in writing. Again do not for one minute trust your employer when they say it is ok. In some states, Maryland for example, to work exclusively in psych you need to be board certified in psych. Best of luck to you and consider posting in the NP section if you have clinical questions.

Ladysin21 · Jun 8, 2016

Thanks for the insight. I will take your advice into consideration.

elkpark · Jun 8, 2016

OP, I notice you're posting in the CNS forum. Are you a CNS? If so, in what specialty? Or are you a generalist or another advanced practice specialty? Is the position for which you've been hired an advanced practice position, or a generalist psych ED nurse position? The background you describe doesn't sound like you've been working in an advanced practice role. It does seem odd that someone with no psych or ED experience would be hired for a psych ED position. That sounds to me like an employer that is mostly looking for warm bodies (which would be a big red flag for me, personally).

Trauma Columnist · Jun 9, 2016

In looking at this poster's history, they appear to be an RN?

Ladysin21 · Jun 12, 2016

Hi, I now see that. I am a RN. This is the first time I initiated a post and some how, it was done in this forum. Lol. Thanks for the comments everyone.

Trauma Columnist · Jun 12, 2016

I will move to emergency nursing for you - best wishes in your new position.

Altra, BSN, RN · Jun 12, 2016

I have worked in hospitals that had a separate "psych ER". In one, it was organizationally a sub-unit of the emergency department. In the other, it was a program operating under the psychiatry service. So I don't necessarily see a bait & switch, although it is something to consider.

Both of these were staffed with RNs who assessed and reported findings to a psych provider, provided ongoing monitoring and reassessment, and implemented orders as needed. In one, insurance auths/bed searches were also completed by the RN ... in the other, there was a social worker who handled those functions.

Kooky Korky, BSN, RN · Jun 18, 2016

In working Psych ER, I encountered a pt who had a knife in his boot. The blade was about a foot long and had been missed on initial intake. Fortunately, he was asleep when I encountered him. Security came and took the knife. Nothing came of it, but could have. Pretty scary.

Once had a pt who had a razor secreted on her person and she began cutting herself, despite being monitored by staff every minute. Very scary also.

Best wishes, it isn't always like this. These are 2 encounters out of hundreds I've had with Psych patients. Most of the time, it's reasonably mellow. Treat people well and they will generally be nice to you in return.

Ladysin21 · Jun 29, 2016

Thank you Kooky for your response. I haven't started as yet. I have 8 more days at my old job.