Hello everyone,

I have been offered a job at a psych hospital in my area. I just need some advice before I accept the offer. The facility accepts many patients who have violent tendencies from children to adults. One of my nursing colleagues states that it can potentially be very dangerous, and that many patients spit, kick, bite etc. I understand that like all nursing careers, there are risks. I'm just nervous about potential violence and exposure to HIV and Hepatitis due to IV drug use. How do people deal with environments where violence is possible? Thank you so much for your help!

Most patients DONT spit, kick, or bite; but it could happen.

many clinicians who aren't in psych make it sound much more dangerous than it is likely to be. Most non-psych clinicians have little idea of what it's really like.

Assessing your patients, developing a therapeutic relationship, showing respect & allowing choices, practicing the principles of CPI, setting appropriate limits, and medicating properly, all go a long way.

You may want to call back the manager and ask how manage potentially out of control patients.

Good Luck.

Many have followed the Path you are about to take, grasshopper... a... er... chickadee...

Do a Search. Bottom of Forum Page.

Good Luck to you!

First of all, PLEASE KNOW that "violent" patient and exposure to HIV, hepatitis or other exposures can occur at ANY department, had it be ER, Med Surg, OB, ICU etc,

Second, in dealing with patients in general, not only in violent or patients with behavioral problem, you will need to develop a therapeutic and effective communication, like MrChicagoRN previously mentioned..

Psych nursing is not for everyone, What is your passion? It's normal to feel nervous because of the unknown and unexpected, but know that psych patients are everywhere regardless of which specialty you choose.

Good luck to you nonetheless!

All things said, it will happen. It happens less often when the healthcare team collaborates to assure a therapeutic environment is maintained. Part of the challenge of being a successful psych nurse is facilitating this collaboration.

I too was anxious when I heard about biting, kicking, and all the other possibilities. Well, because of genuine empathy and caring I tried to communicate, I have never been assaulted. I worked inpatient psych for years filling in on adolescent, child, and adult units. Never was I hurt in any way. Psych clients know who is trustworthy on some level. Most want to get well and look for caring trustworthy professionals to connect with. Learn a bit about getting too close physically....arms length personal space body language. Have a sense of humor and connect regularly with clients to remind them you are available and want to assist them in their recovery.

Psych isn't that violent and if it is you have so many people having your back more on any floor. Though with an acute unit sometimes your like banging your head against the desk, ha. Psych is awesome just enforce limits and boundaries. Rely on your team rely on your team!!! Be quick on your feet. A lot of times you will meet patient's that tug at the heart strings. Being emphatic and understanding at times you'll develop good rapport with the patient's.

Also some nurse's think psych isn't medical will loose your skills. You'll have codes and not security codes. Have a lot of seizures, high or low blood sugars, and some odd medical occurrences.

I've worked in a state psych hospital for 2 years. I've been slapped, kicked, punched in the face (resulting in a concussion), spit on, bit twice, hair pulled, pinched, scratched and had body fluids thrown at me. I also have a high acuity female unit with 1/4 of the patients having a personality disorder diagnosis. It's not for everyone. This doesn't happen every day but when it does it can be bad. Especially when you don't have experienced staff to back you up.