Adolescent psych and a NEW RN????

Jules A, MSN · Jan 6, 2009

Hey Tammy,

No real advice you will just have to see if its your niche. As a medic you are far more qualified than I was as a new grad. Have you done a share day to see what these kids are like? :) It sure is different but I just love the kiddos. Wish you well and please keep us posted.

Jules

felixfelix · Jan 6, 2009

I had no experience and am doing just fine in adol. psych. you're probably going to love it.

GooeyRN, ADN, BSN, CNA, LPN, RN · Jan 7, 2009

I started out as an RN in adolescent psych. I loved it. I moved, then worked med/surg. I will soon be working in psych again. :redbeathe

MentalRN74 · Jan 8, 2009

Hi Tammy!

I too went to work at a child/adolescent psych facility directly out of nursing school. I ended up going to work at the hospital where I did my psych clinical rotation. I just knew during my clinicals that psych was where I wanted to be. In the beginning, I related really well to the patients due to my own age of 21yrs--not much older than some of the patients. The experience can be both very rewarding and very emotionally disturbing at the same time. I have to say that working with the adolescent female population is probably the most difficult. The only thing predictable about them is that you can never predict what they are going to do. :banghead: Working with the younger, child population is usually the more disturbing and sad part of the job. But, I wouldn't trade my experience for anything.

I'm now a Weekend Nursing Supervisor at a 98 bed psych facility, but I still work one shift a week on the child/adolescent unit. It's almost a different kind of "stressful" than working on the adult or detox units. Mainly, it's just putting up with adolescent "attitude" and the hyperactivity and oppositionality of the little kids. I do like my time spent with the adult population. (My office is on one of the adult units with the higher acuity.) This is where you will see the truly psychotic, depressed, borderline, and often, quite entertaining bunch of patients. I'm not trying to be insensitive in saying this. Some are very humorous, witty, and even sarcastic patients. The other part of this is that sometimes you just gotta laugh at some of the situations to keep from losing your own mind.

I'm confident that if you enjoy working with kids, you'll do fine in this area. Just remember to set and enforce limits, and follow through with consequences. These kids can smell "new blood" the minute you walk on the unit. Never let them see you scared or emotionally out of control. They will test your knowledge of programmatics and rules--be prepared. They will attempt to split staff to work you guys against each other. And manipulation is the name of their game. I learned to initially rely on the experience (and often, expertise) of the Mental Health Techs who work with these kids day-in and day-out. Ask them for input and advise.

Good luck and keep us updated on your progress!

NeoPediRN · Jan 9, 2009

Hi there. I'm a recent grad (May) and also a per diem Charge Nurse in an inpatient pedi psych unit. We take ages 4-17 and when you're on you are the only nurse. It can be overwhelming knowing you're responsible for the entire floor, the patients and the MHCs! I love it so far, I had a six week orientation and have been on my own since mid November. The key thing is to keep the unit calm, identify early signs of crisis and INTERVENE. If you're not sure about something always keep safety the first priority and don't worry about the little details. I think my medical director hates me because I'm a new grad and female, but I don't let him intimidate me and if I have a question I am on the phone with him. I'd rather deal with his attitude than to put the unit at risk with a patient who has potential to escalate. On that note, my next piece of advice is MEDICATE MEDICATE MEDICATE. Psychotic adolescents have the strength of twenty adults and once they enter crisis it's very difficult to turn it around. I don't know about your unit but mine prides itself on being as restraint-free as possible, which basically means you have a lot of 'splaining to do if you have to put hands-on, especially with younger kids. Therefore, it's imperative to medicate when patients become agitated and efforts to diffuse the situation fail. My last piece of advice is that a little humor goes a long way, especially with adolescents. Kids respond well to people they feel they can relate to, and test people they feel they can break. Set firm limits to prevent staff-splitting but don't be so rigid with every contact that it's like you're running a boot camp. A lot of these kids are broken and fragile, and sometimes empathy and kindness work better power struggling, especially with angry teenagers in DCF custody that know the ropes inside and out and have nothing to lose. Pedi psych is a true balance of of skills, but if you have a strong backbone and a kind heart you will go far with stabilizing these patients. Good luck!!

tj_Medic_RN · Jan 10, 2009

Up date..

I have had one week on the unit and so far so great!! Of course I am still in orientation... but things have gone well. .. SarahBeth you are right about the restraint free as much as possible, this facility only admits 12-17 year olds. It is a fairly new facility in the area and has only been open for 7 months, there is alot of one on one and close observation but so far the little darlings have behaved this week.. probably because they are testing me. I look forward to the rest of my orientation and I start orientating on the adult psych unit next week at a different hospital. It will be part time. .. and so I don't lose my IV, and cardiac skills I will still be ridin the ambulance when I can.. I think in my heart I will always be a medic, but I am enjoying the nursing side of it as well... like today is an ambulance day... and what a day it has been.. looking forward to the psych unit on Monday!!

I want to thank everyone for their words of wisdom, it has really helped me to understand you have to start somewhere.. and where better to start than with something you like.. Not many people I know can say they really Love their Job..I know with time I will feel as comfortable in my nursing role as I do in my paramedic role.. but it will take time..

Tammy

Quilter0225 · Jan 11, 2009

Tammy, I am following this with interest. I am also a new grad. I start orientation on Feb. 2 for a psych unit serving kids 8-13. I have 8 years of experience with elementary school age special ed. (I was an assistant) specializing in kids with behavior problems. I am a little concerned that starting as a new grad in psych will lock me into psych forever. I want to keep up my med surg skills in case I want to do something else down the road. Good luck in your new job!

jprn05 · Jan 14, 2009

Hi!

I have worked in pedi psych in a residential facility now for over 2 years. It was and still is a great learning experience for me. I still use all my med surg skills except for IV's. We are constantly assessing the kids for physical as well as mental issues. Psychotropic medication has many side effects that warrent constant monitoring. We have many children with diabetes, chronic gastro issues, many children are returned to us post surg within hours, we even are responsible for daily neuro checks on many of our kids. We take orders, we give medications, vaccines, and even do heights and weights and vital signs. Pedi psych should be a separate speciality as far as I'm concerned. It is good that you have experience dealing with children with behavioral and emotional issues. You will laugh, you will cry and you will learn just how strong children really are. I wish you good luck, and welcome to a great nursing speciality. :saint:

dynoboy · Jan 24, 2009

Hi There,

Good to see this post. I have been working with kids off and on, mostly as a professional guide, for the past 11 years. I recently challenged the NC state CNA test and passed and was just offered a FT (3/12's) Psych Tech/CNA postition on an Adolescent Psych floor. Very excited, they could potentially pay for my Nursing degree. I do have concerns of not gaining some of the typical CNA/Nursing skills, I guess time will tell. Cheers,

tj_Medic_RN · Jan 24, 2009

WEll ... after several shifts of orientation, I love the Job itself... but as our nursing instructors told us "Nurses eat their YOUNG" referring to new grads. I have this one particular nurse who "has seen it, done it and no matter what you ask her it is always her way regardless" I could not chart v/s, meal %, or even wether or not they had a BM. She told me that was her job and I was mearley there to observe. Mind you this was my 6th day of orientation and not all of them were with her. On day 2 with another nurse I was documenting assessments, v/s, just about everything, she would just review it and suggest a change or tell me what to add if I missed anything. After 4 shifts of doing NOTHING with the first nurse I went to administration and asked not to be scheduled with her for the rest of my orientation, and gave examples of my treatment. They told me that they knew she was that way and if I could survive working with her than they knew I was a keeper??? What the heck?? why would you want to treat your new employee's like that? I have taken a full time job elsewhere and will finish my orientation and stay PRN, but I resent being treated like a absolute fool, by one nurse and administration knowing she was treating employee's like that. I want to also say that she didn't mind sitting in the roll around chair all day and not getting out of it to accomplish anything she made the kids come to her. I love the kids and the job is really not that hard physically but mentally it is a challenge, one must be very strong to work with the children who come to this facility and the things they have endured. I just don't understand the reasoning behind putting a new employee with a nurse who treats them like they are a door mat. I was a gopher for her and that was it, go.. for this... go for that... I am not her personal servant, I was there to learn a job and that is what I am doing now.. working with a different nurse who wants to teach and knows they need help and is willing to take the time to show me things I need to know. They are so short staffed that the RN's are all in overtime everyweek, and I was told that they have lost a lot of nurses because of this one nurse who seems to feel that new nurses are not worth training... Sorry I know this was long but I just think that I deserved better treatment from her. And yes I did tell her how I felt and she just said "typical of new nurses, we could not handle the pressure," not really sure what she was meaning by that but that was all she could say. I kept asking her "WHAT PRESSURE" all I did was stand around all day and go get things for her...I have been treated well by most of the rest of the staff but my full time job pays me $4 a hour more and is 15 miles closer to home, downfall is it is med surge but I am keeping my prn slot at the adolescent psych, I just love the kids... and maybe one day the old nurse will move on and I can get her slot.. LOL joking.. we need all the nurses we can get around here..

Tammy

GooeyRN, ADN, BSN, CNA, LPN, RN · Jan 24, 2009

WEll ... after several shifts of orientation, I love the Job itself... but as our nursing instructors told us "Nurses eat their YOUNG" referring to new grads. I have this one particular nurse who "has seen it, done it and no matter what you ask her it is always her way regardless" I could not chart v/s, meal %, or even wether or not they had a BM. She told me that was her job and I was mearley there to observe. Mind you this was my 6th day of orientation and not all of them were with her. On day 2 with another nurse I was documenting assessments, v/s, just about everything, she would just review it and suggest a change or tell me what to add if I missed anything. After 4 shifts of doing NOTHING with the first nurse I went to administration and asked not to be scheduled with her for the rest of my orientation, and gave examples of my treatment. They told me that they knew she was that way and if I could survive working with her than they knew I was a keeper??? What the heck?? why would you want to treat your new employee's like that? I have taken a full time job elsewhere and will finish my orientation and stay PRN, but I resent being treated like a absolute fool, by one nurse and administration knowing she was treating employee's like that. I want to also say that she didn't mind sitting in the roll around chair all day and not getting out of it to accomplish anything she made the kids come to her. I love the kids and the job is really not that hard physically but mentally it is a challenge, one must be very strong to work with the children who come to this facility and the things they have endured. I just don't understand the reasoning behind putting a new employee with a nurse who treats them like they are a door mat. I was a gopher for her and that was it, go.. for this... go for that... I am not her personal servant, I was there to learn a job and that is what I am doing now.. working with a different nurse who wants to teach and knows they need help and is willing to take the time to show me things I need to know. They are so short staffed that the RN's are all in overtime everyweek, and I was told that they have lost a lot of nurses because of this one nurse who seems to feel that new nurses are not worth training... Sorry I know this was long but I just think that I deserved better treatment from her. And yes I did tell her how I felt and she just said "typical of new nurses, we could not handle the pressure," not really sure what she was meaning by that but that was all she could say. I kept asking her "WHAT PRESSURE" all I did was stand around all day and go get things for her...I have been treated well by most of the rest of the staff but my full time job pays me $4 a hour more and is 15 miles closer to home, downfall is it is med surge but I am keeping my prn slot at the adolescent psych, I just love the kids... and maybe one day the old nurse will move on and I can get her slot.. LOL joking.. we need all the nurses we can get around here..
Tammy

I am sorry it isn't working out for you there.