About to start in a Psych Hospital..

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    Hi everyone!

    I've been a graduate of Nursing since 09, but just recently licensed. I am going to start my first job here in the US in a private psych hospital. Best to say that I am very excited, although on the other hand, and same amount of emotion, I am quite scared and nervous. This is my first real nursing experience, and I can't believe that I actually got in the hospital. Psych really isn't my first choice (sorry to those who love Psych), although I don't entirely hate it either. I accepted it because it was the first hospital to call back to offer me a job, and I figured it's a way to get my foot in the door, and if eventually I fell in love with it, then it's a good decision, or if not, then it's a lesson learned. I've always leaned towards critical care, although I think all new grads/inexperienced nurses are. My only exposure in a psych unit was for 2 weeks. I had fun, although I had a hard time understanding and connecting with my patient, literally and figuratively.

    Anyway, I just wanted to share what I'm feeling and I guess the question I want to ask is what advice do you give to someone who is newly entering the field? Was psych your first choice? What do you love/hate about it? How do you become an effective psych nurse, and what could I possibly expect?

    Thanks for all your input guys. I am totally open-minded to all your advice or criticisms. I am very eager to learn.
  2. 10 Comments so far...

  3. 0
    I started out in a private psych hospital, I enjoyed it. I then moved on to a regular hospital and I truly hate it. I want to get out of nursing all together. Maybe if I had stayed in psych I wouldnt feel the same way. Maybe if you are passionate about nursing on a whole you'll be fine. Good luck. I have only been a nurse for 20 months
    Last edit by astia on Feb 10, '12 : Reason: typo error
  4. 0
    Let your patients know that you really care about them (even if you don't feel that way yet). Always have an open mind and put yourself in their shoes. Without at least attempting to understand them you will never connect with them. They're people too, remember that and it should help with the scared feeling. Good luck, and congrats!!
  5. 0
    Quote from sapphire18
    Let your patients know that you really care about them (even if you don't feel that way yet). Always have an open mind and put yourself in their shoes. Without at least attempting to understand them you will never connect with them. They're people too, remember that and it should help with the scared feeling. Good luck, and congrats!!
    Thanks sapphire18. That's great advice! I already know that I will have a rough first few weeks (or even months) just like in any job, but I think I'll have a great time. The scared feeling, I guess is from not knowing what they will do. I mean, you grew up with your parents telling you to be weary of people, because there are a lot of "crazy" ones out there, but now I'm actually going to start taking care of them. Honestly, it's 2 emotions at one time. Scared because of what might happen.. but at the same time, excited and curious to see how the world is in their eyes. I've always wanted to know what the story is behind these people, and I think psych nursing will really open my eyes up to the world. I guess I should expect violent tendencies at one point or another. Lol.
  6. 0
    Quote from astia
    I started out in a private psych hospital, I enjoyed it. I then moved on to a regular hospital and I truly hate it. I want to get out of nursing all together. Maybe if I had stayed in psych I wouldnt feel the same way. Maybe if you are passionate about nursing on a whole you'll be fine. Good luck. I have only been a nurse for 20 months
    Thank you! Are you gonna go back to Psych nursing soon?
  7. 0
    Quote from jenmesh
    Thanks sapphire18. That's great advice! I already know that I will have a rough first few weeks (or even months) just like in any job, but I think I'll have a great time. The scared feeling, I guess is from not knowing what they will do. I mean, you grew up with your parents telling you to be weary of people, because there are a lot of "crazy" ones out there, but now I'm actually going to start taking care of them. Honestly, it's 2 emotions at one time. Scared because of what might happen.. but at the same time, excited and curious to see how the world is in their eyes. I've always wanted to know what the story is behind these people, and I think psych nursing will really open my eyes up to the world. I guess I should expect violent tendencies at one point or another. Lol.
    I used to work psych as an LPN about 3 years ago, went to a stroke unit, and then was hired at a state psych hospital this month. Needless to say, a lot is coming back to me, and I am having a lot of "oh yeah" moments.

    You'll learn to notice when a patient is escalating, and your training (I'm assuming you'll receive some) will help you de-escalate using verbal techniques. Plus, if you're techs are good, they will be proximal to the patient and will/should begin de-escalation techniques. Hopefully, you are amply staffed. It's a tough job, but in a different way from critical care.

    Trust your preceptor, rely on the experienced nurses and techs, and your experience will grow. Soon, it'll be "old hat." For me, and I'm new again the hardest part has been figuring out where the supplies are, and revisiting paper charting.

    If your team is unsupportive and you don't have enough staff, that is what makes a psych facility dangerous. If there's a "Nurse who eats his young" type on the unit, that also compromises safety. Be weary of that situation. Otherwise, a good team makes psych the best specialty to work IMO!


    Enjoy the ride! You'll love it.
  8. 1
    Quote from mingez
    I used to work psych as an LPN about 3 years ago, went to a stroke unit, and then was hired at a state psych hospital this month. Needless to say, a lot is coming back to me, and I am having a lot of "oh yeah" moments.

    You'll learn to notice when a patient is escalating, and your training (I'm assuming you'll receive some) will help you de-escalate using verbal techniques. Plus, if you're techs are good, they will be proximal to the patient and will/should begin de-escalation techniques. Hopefully, you are amply staffed. It's a tough job, but in a different way from critical care.

    Trust your preceptor, rely on the experienced nurses and techs, and your experience will grow. Soon, it'll be "old hat." For me, and I'm new again the hardest part has been figuring out where the supplies are, and revisiting paper charting.

    If your team is unsupportive and you don't have enough staff, that is what makes a psych facility dangerous. If there's a "Nurse who eats his young" type on the unit, that also compromises safety. Be weary of that situation. Otherwise, a good team makes psych the best specialty to work IMO!


    Enjoy the ride! You'll love it.
    I'll find out more about the facility when I have my orientation, hopefully everything will turn out fine. I can't wait, and I'm so excited!
    mingez likes this.
  9. 0
    Hi everyone! I started last week, and it's definitely an experience. Although I believe that there's not much orientation time (2 weeks, including the floors), I had fun. I had Handle With Care, and have been in the adolescent unit for 2 days. They say that adolescents are usually one of the harder ones, even more so than adults. Tomorrow, I will be in their "intensive care" unit, and hopefully, I will be able to practice what I have learned in Handle With Care. I'm still confused as to what to do, and need a lot of supervising, but I guess I just have to learn it as I walk through it. How did you guys feel during your first few days in a psychiatric hospital?
  10. 0
    Psych nursing is more challenging because you are observing human behavior... much more difficult than physical problems.

    Yes.. adolescents can be more difficult to manage because..

    1.) They have not developed the adult brain structure yet. This leads to increasing compulsive behavior.
    2.) There is another level of bureucracy you must deal with.. parents/custodians. You will need to triple check if it is legal to administer Tylenol!
    3.) The adolescent years of 5 to 17 involves a huge range of treatment modalities and nursing intervention.

    I hope this is a bonafide facility and not privately owned.

    They just house the psych patient for 3 to 7 days... take the insurance money and stick you with the work of documenting ... why they deserve the cash.
  11. 0
    My quickest words of advice....Learn your psych meds! Nothing feels worse then when a patient starts questioning the meds you are giving them and you don't have the words to explain things. Trust me, the quizzes your instructors threw at you are nothing compared to an upset patient who is paranoid about the meds you are trying to give them. Medication teaching is a vital part of your role, so you may as well get a head start and just get comfortable with the meds. Also, if a patient tells you that the meds are wrong, suck it up and go recheck them. It's hard to do as a new nurse, but we all make mistakes and it's well worth the time if you catch a mistake.

    Trust your gut for any safety issues and learn from your patients and co-workers. Psychiatry can be so much fun and people dealing with mental illness can teach you so much. I really hope you enjoy yourself and get to experience some of the great things I have working in psychiatry.


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