Excited for psych clinical!!

  1. 0
    I'm getting ready to go into my FIFTH semester of my BSN program (Hallelujah, right?!) and it's psychiatric nursing and public health. While I like public health, I'm absolutely in love with the idea of psych nursing, and I've always been more drawn to that population. I was the nursing student that got in trouble for talking to my patients for too long in the room during med-surg clinicals. And whenever possible, I requested patients that had a psych background because I was fascinated to see how the connections played out to their physical health.

    Anyone that has been through psych clinicals - I'd love to hear your thoughts. Did you feel like it gave a good experience? Were you ever frightened by your patients or the milieu? What about paperwork? What kind of interventions were you allowed to perform?

    Thanks!
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  4. 1
    I would like to know too. I also have my psych clinical next semester.
    decembergrad2011 likes this.
  5. 2
    Is that all you do is talk to them?

    We don't have clinicals for psych next semester. I'm glad.
  6. 2
    My psych clinicals were all interviewing and chart reading, no meds or interventions except a tiny bit of teaching. It was interesting and sad. It wasn't scary. Our assigned patients tended to be stable.

    Paperwork was hx tool, drug cards, process recording, care plans, and a worksheet about the axis dx.
    MyNameRN and decembergrad2011 like this.
  7. 1
    My psychiatric clinical was 3 weeks long. Before I started, I was concerned about being physically attacked. My group had orientation with the unit director who stressed we must remain striking distance away from patients. We were also advised if a patient grabbed our hair not to pull away- just yell until staff comes to help.

    As for what my group did, we each got one patient. We weren't permitted to pass out medications. The patients would line up in the hallway and one nurse would pass out meds to everyone. We led groups, performed rounds, attended hearings, took vitals, and charted. There were other things some of us were able to do too, depending on the individual needs of the patient. As for school work, we had to do a major care plan, a process recording, and drug cards.

    The patients on the unit it loved it when we came (there were a lot of us). Things would get very chaotic and there was a lot of attention-seeking behavior. There was never a boring moment except when we had post-conference.

    My psychiatric clinical was a good experience and I found most of the nurses friendlier and more open to students. I've never been interested in psych, but after this experience I"m more open to working on a psychiatric unit.
    decembergrad2011 likes this.
  8. 0
    Quote from tokidoki7
    My psychiatric clinical was 3 weeks long. Before I started, I was concerned about being physically attacked. My group had orientation with the unit director who stressed we must remain striking distance away from patients. We were also advised if a patient grabbed our hair not to pull away- just yell until staff comes to help.

    As for what my group did, we each got one patient. We weren't permitted to pass out medications. The patients would line up in the hallway and one nurse would pass out meds to everyone. We led groups, performed rounds, attended hearings, took vitals, and charted. There were other things some of us were able to do too, depending on the individual needs of the patient. As for school work, we had to do a major care plan, a process recording, and drug cards.

    The patients on the unit it loved it when we came (there were a lot of us). Things would get very chaotic and there was a lot of attention-seeking behavior. There was never a boring moment except when we had post-conference.

    My psychiatric clinical was a good experience and I found most of the nurses friendlier and more open to students. I've never been interested in psych, but after this experience I"m more open to working on a psychiatric unit.
    This sounds like a fantastic experience. I hope mine is similar. I believe that our clinicals are split up to be half of the semester in a community setting, and the other half in an in-patient facility. Either way I am very excited to interact with this population.
  9. 3
    My Mental Health clinical was the best one thus far. The facility we were at has both inpatient and outpatient services and is the largest facility for our state. I worked in several different units. The first was PICU (Psychiatric Intensive Care Unit). Generally clients in this unit are unstable and need 24-hour watch. Some are suicidal, others are in withdrawal, and a couple who experienced their first metal episode. I was not scared in the unit. I was more like, “wow I cannot believe these things happen to people.” The second unit I was on was addictions. The folks on the unit were stable. They were required to attend individual and group meetings all day while on the unit. I was able to attend an AA/NA meeting. I hope you get to experience it. The format is truly an interesting and effective one. I also was assigned to the adolescence unit. This was hard. The kids there were so nice and willing to talk. I just felt so bad that they were having such a difficult time with life that they were severely depressed and suicidal.
    So, what did I do? Everything. I was able to assist the nurse with several admissions and discharges. I was able to participate in the group meetings. I also engaged in conversation with the clients. I was interested in learning their story. My experiences encouraged me to pursue a position with the facility. In fact, the facility manger told me to contact him after I graduate.
    Maybe I liked Psych so much because I am mental myself J
  10. 1
    We went to a lot of the group meetings for our Psych rotation. It was 4 10.5 hr shifts. We were encouraged to interact with the patients a lot. We didn't really do much outside of that. My favorite was the teen area. I have a soft spot in me for troubled teens. It was very disheartening as well though.
    decembergrad2011 likes this.
  11. 4
    Since you're students, pretty much all you will be allowed to do with patients is interact with them. Lest you write this off as "just talking" to the patients, therapeutic communication skills are very important in psychiatric nursing as it is one of the primary nursing interventions we perform (the other big one being medications). Not all the psych patients you will meet are going to be AO4 and just depressed: you're going to encounter a wide spectrum of psychiatric conditions and you need to know how to be able to communicate with these patients...and how these patients will communicate with you.

    You will probably also be taking vital signs and assisting patients with some of their ADLs, though you will not be allowed to be alone with patients in their rooms. Depending on the policies of your school and/or your clinical site, you may do blood sugar checks, give medications and help with other procedures. Honestly, I wish my facility would allow students to do medications, as in no other setting will they get so many opportunities to practice IM injections

    As far as being safe...we're not going to put students in unsafe conditions. Don't feel like you have to act macho/tough there: just be yourself. And it's OK to be a little frightened...if anything, a little anxiety will help keep you on your toes.

    But the biggest thing about safety is that students need to pay attention to what the staff working the unit is telling them. If a situation may look safe to you but staff tell you it's not, LISTEN TO STAFF. Don't think we don't know what we're talking about and you know better...we often notice the subtle warning signs of trouble that you as students may miss. We know how to rapidly deal with an escalating situation and can deal with trouble before it gets out of control.

    And no matter who the patient is and how nice/calm/sane they seem, never ever EVER go into a patient's room without a staff member. This is for two reasons. The first is that their could be a risk of physical harm to you if you are entirely alone with a patient. The second and sometimes more likely event to happen is that the patient may claim you did something to them. It'd be your word vs. theirs...and psych patients have rights too: any claims they make are taken seriously and would be investigated. Even if nothing actually happened and you are found innocent, such an event could shoot your nursing career in the foot before it even starts.

    Don't expect to be involved in any sort of codes or restraint procedures, as almost all facilities as a rule won't let students do so for liability reasons: there's too much risk that students will get hurt. I tell any students on my unit that the best way they can help me during a code is to go to the staff lounge so I don't have to worry about them as well as the patient.
    Last edit by Meriwhen on Dec 21, '10
  12. 1
    I honestly hated psych AND public health!

    Psych lecture was somewhat interesting though it could be boring at times. I enjoyed learning about the different psychiatric disorders because I didn't have much knowledge on them prior to taking the course.

    While I enjoy talking to patients, I also love all of the technical hands-on/skills stuff related to nursing. Psych didn't really have any of that :/ I know psych RNs get to do stuff but for our clinical, we were only allowed to communicate. Sometimes we were lucky and would get a patient that would love to talk; others would talk to us for maybe 15 minutes or not at all and then all of us would just be sitting in the day room with nothing to do. I didn't like my perception of the nurses at my site, either. They would just sit in the nurses station all day and provide little to no client interaction. Basically just pass meds.

    We had the opportunity to sit in on team meetings, too. They would bring in the patient and talk to them about how they were doing that day, etc. and talk about goals for the patient. Team meetings included the primary RN, pharmacist, MD, and social work, maybe some other individuals but I can't remember (it's been awhile since I took psych!). Sometimes they were interesting; most of the time they were boring and I had to fight staying awake.

    Everyone has their place in nursing and for me, psych definitely is NOT the place. Maybe you will love it and this will be your niche, but not for me.

    Public health was very boring for me, too. I took mine over the summer and thankfully it was only 5 weeks (regular semester is 8 weeks) and we only had "real" lecture 3 times (I think I would have died if we had lecture for all 5 weeks!) We had clinical 3 days/week and all of our assignments were different. For two days I was with hospice and for one day I was with a home health infusion nurse. The hospice days were pretty boring, tbh. I got really good at taking manual blood pressures and other vital signs and then I would listen to heart/lung/bowel sounds. Of course, while I did all of this, the RN that I was following would ask all of the questions and address all of the problems. I would then have to sit there and watch her chart everything because we weren't allowed to. For home health I did more than just vitals/assessments; I was able to do dressing changes (wound and central lines), draw labs (mostly off central lines but sometimes peripherally) and initiate IV infusions. I got a better sense of what a home health nurse does and got to ask the questions.

    Lecture was boring and the information was useless (we got tested on a lot of statistics!!! who uses those??? ) and overall I didn't learn very much in that class.

    I hope it will be different/more exciting for you!
    decembergrad2011 likes this.


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