[normj]

Hello, I am a recent ADN grad, studying for NCLEX ...

I got into this thinking I wanted to go straight into Psychiatry as an RN ... I have worked as a Psychiatric Tech/Mental Health Specialist. Instead, I am going to start out in Medsurg/Onc until I learn a few things, then switch if I am still interested ...

My questions are these:

1) If you are happy in your current situation, why? What about your unit makes it safe, well-run and a good place to work?

I ask because the places where I have worked are unsafe, non-therapeutic pits of misery for patients and staff, with crappy management who literally should be imprisoned, or at least de-licensed, for their horrific mismanagement.

2) How do you recommend that I "shop around" for a good, safe, therapeutic milieu in which to work? What are the hot-buttons to look for when interviewing?

All of the psych jobs I have had seemed like a good deal until I had been there about a month or so ...

3) How do you deal with incompetent, counter-therapeutic, just plain mean, or sick coworkers?

It is a cliche in nursing that we who work in psychiatry are all nuts ourselves, and in my admittedly limited experience, that stereotype is grounded in truth ...

Anyway, I really want to work in psychiatry, but with the decline of funding and diminishing quality of care in I have seen, I don't want to be a rat jumping ON a sinking ship ...

All replies appreciated ...

Norm

[PRNMEDS]

1 What about your unit makes it safe, well-run and a good place to work?

Well I don't think I or many of my co-workers would describe our hospital this way, yet I do enjoy my work. It can often be very frustrating dealing with mentaly ill patients, not to mention anadministration that has an eye on finance. However it is rewarding to work as part of a team, espcialy when it leads to a patient (in my case adolescents) showing improvement and doing well. The days are busy, hectic and move fast and I like it.

2 Not sure how to "shop around" all places have good and bad and you just have to try it to find out.

3) How do you deal with incompetent, counter-therapeutic, just plain mean, or sick coworkers?

Again there are good and bad in all disciplines. I have not met any just plain mean or sick coworkers - presumably these have all been fired already. As for the incompetent and counter-therapeutic I try to educate them on proper way to work with patients. Its far better to light a candle then to curse the darkness.

[Spazzy Nurse]

You're smart for getting a little med surg experience under your belt first. I didn't and I knew I'd lose so many skills, but I loved psych and didn't care.

Don't forget--- a hospital isn't the only place to practice psych nursing. There are psychiatrists that have a nurse working by their sides, homecare psych nursing, and treatment programs. I work in a residential treatment facility. We usually get people from the hospital. Sometimes they're ready to be out, sometimes not. It's very rewarding, very interesting, and just plain fabulous. I am the only nurse there--- all of my coworkers have psych degrees. It's usually a bit more low key than a psych unit in a hospital, and I don't have to deal with mandatory OT, being short, and cruddy things that poor floor nurses have to deal with sometimes.

So explore your options. There are quite a few.

[nurse lala]

My questions are these:

1) If you are happy in your current situation, why? What about your unit makes it safe, well-run and a good place to work?
I ask because the places where I have worked are unsafe, non-therapeutic pits of misery for patients and staff, with crappy management who literally should be imprisoned, or at least de-licensed, for their horrific mismanagement.

Norm,
How many places have you worked?
What kind of facilities have you been working in?
Why do you say they are poorly managed and non-therapeutic?
It makes me wonder why you want to go into a field in which you have not had good experiences beyond the first month!

2) How do you recommend that I "shop around" for a good, safe, therapeutic milieu in which to work? What are the hot-buttons to look for when interviewing?

Ask to see their records regarding restraint and seclusion use. That will give you a pretty clear idea of the team-working ability of the facility.

3) How do you deal with incompetent, counter-therapeutic, just plain mean, or sick coworkers?

You gently confront and teach proper clinical skills by using them yourself.


Norm[/quote]