Behavioral Health Nurse- break from floor nursing?

Multicollinearity, BSN, RN · Sep 24, 2012

I just recently switched to inpt. psych. I wears you down in its own way. Lots of crazy/lazy staff. The pace is slower, but psych can just wear on you due to the behaviors and problems that present that are difficult to manage. I have moments were I just wish I could start an IV or give injections like I used to - more straight forward. Only way to know is by trying it. I will say since I switched to psych I am well-rested and don't experience all the job-related stress/physical ailments I used to.

Davey Do · Sep 24, 2012

Any behavioral health nurses out there that can give me the down and dirty on behavioral health nursing on the unit?

I find it interesting that a Hospital-based Behavioral Health Program can have Patients with no unresolved Medical Issues. Our units often have some of the same treatments on them as the Medical units. Perhaps not as involved, but on the Geriatric Unit, we have IV's, Tube Feedings, Catheters, and so on.

Psych Nursing is merely a Different Kind of Stress. There are Patient Behaviors which causes Staff Behaviors and Phreneticism and the like.

Psych Nursing is okay. In fact, there's times that I still love it. But the Important Thing is: What do YOU want to get out of your job, Redder? Easy or Satisfying?

The best to you.

Dave

gcupid · Sep 24, 2012

I find it to be more spiritually draining, and then it later becomes more physically exhaustive.... Because it is a different environment you may feel relief but it really depends on the manager, coworkers, and how acutely psych and/or medically sick the patient population your caring for at this particular place tends to be that will determine how long that burn out-free state of being lasts.

Meriwhen, ASN, BSN, MSN, RN · Sep 24, 2012

If you work inpatient psych, guess what: you are still in floor nursing!

Davey Do summed it up best. It's not without medical components: contrary to what some others believe, psych patients don't check their medical issues at the door when admitted. They may be controlled medical issues, but they will be there and will be unable to be ignored. And if a facility took only psych patients with no medical issues whatsoever, they'd have a very small census.

Inpatient psych nursing is not the "put up your feet and take a break" nursing that some think it is--if that is your mentality, turn around now because you will be eaten alive in your first week. It's a different speciality of nursing with its own skill set as well as its own stressors. Pace may be faster or slower. Plus it's actually more physical/hands-on than one may think. And there is an increased risk of physical danger to staff...not as bad as the risk of working in the ED IMO, but it's there. Staff are trained to handle such incidents, but that doesn't eliminate the risk entirely.

The best way for you to see what it's like is to experience it for yourself. See if you can get a per-diem job there, or at least shadow for a few shifts (you need to do more than one to get a truer picture of what psych nursing is like). You may find it's the change you seek, or you may find you've went from frying pan to fire. You won't know until you try.

Best of luck whatever you decide!

iluvtdybrs · Sep 24, 2012

My goal is to get away from the medical side of nursing for awhile. I am severely worn out when it comes to floor nursing. In some of the hospitals I have worked when we transfer people to behavioral health it is a locked floor and the patient can't have any unresolved medical issues. I have this idea that not putting up with a ton of cormobidities and just the mental health side of people would give me a break. Any behavioral health nurses out there that can give me the down and dirty on behavioral health nursing on the unit?

i have been a nurse in a psych facility for 26 years and i wouldn't trade it for active nursing - true there are different challenges and strengths that are used everyday . A person has to want to work with mentally unstable people because it is a very stressful job both with staff and patients- i would advise as MERIWEN said to take a temporary or try to do a few shifts to see if it is your cup of tea

LisalaRN99, BSN, RN · Sep 24, 2012

It depends on where you work. My current job is in a medical center, but nobody is transferred there until they are medically cleared. We have no IVs, no NG tubes, etc. We do wound care, ostomy care. Our patients are maintained on a medical floor until they are medically cleared, especially the drug overdoses or high (>250 blood alcohol levels). They have telemetry on that floor. The stress is a different type. The patients are psychotic, manic, suicidal, having withdrawals. We have legal statuses to be mindful of in terms of medication administration. You spend more time talking with patients, doing God-awful paperwork, and two or three very long med-passes at the med. window. Patients get loud and requiring redirection and sometimes seclusion and restraint (more paperwork). Plus side is very limited visiting hours! I've been a psych nurse for most of my 14 yrs career. I much prefer it to the regular med/surg or telemetry floors!

MSN Student · Sep 25, 2012

As much as I love my psych nursing job, I would never say it was not stressful or in any way easy. You have to be thinking ahead of your patients, some who are always looking for a sneaky way to kill or harm themselves, or someone else. You have to be on a constant state of alert and this can be incredibly draining. Physically, you have to be able to withstand the take-down of a patient who may be acting out in a dangerous manner. It can be terrifying at times, and the strict rules and policies can delay what need to be quick actions when a patient becomes violent. Just as any nurse needs to deal with mental problems in their unit no matter what unit that it, psych nurses have to deal with patient medical problems. Pain is huge, as it alcohol/drug related issues. We also have the geropsych patients who can be sicker than their peers. Give it a go and try it. You will love it or hate it. Perhaps more than any other specialty, psych nurses work best when they have a strong interest in psychiatry, and a passion for helping those with its demanding and challenging problems. No nurse should go into the field for a break from the demands of the med-surg floor. That would be a disservice to your patients AND your fellow nurses. Good luck. It is certainly not a boring field.

twinkerrs · Sep 25, 2012

In no way is it easier just different. You will still have noncompliant diabetics, htn patients who drown everything in salt.

Everyone else has covered the down and dirty stuff well. Here is the other piece to psych nursing. You are a teacher to your patient. Not just the med surg stuff but actually teaching them about their mental disorder, their Meds, how to navigate the system when necessary. You are also someone who will hear about all the problems that led them to this point. The abuse, the rough life etc. Some stories are just absolutely horrifying. All of this you have to do while being non judgmental and empathetic. When you work with kids you will grow to hate most parents and "the system" created to help them.

I have never done anything else but psych nursing it is where I knew I belonged and why I went to nursing school in the first place. From what I can tell it is a love or hate field. My cohorts in school are amazed at the joy I get from my job. As I tell all of them we all work with psych patients. Mine are just clearly identified.

angelkerri · Sep 25, 2012

I just started in psych nursing. I was first on an outpatient substance abuse program (methadone) and now I work on a small (10 bed) voluntary psych unit. The voluntary part of this is what makes it more manageable than maybe some other places...I love it. We do still have some medical issues, but with the nature of our unit, patients have to be medically cleared before we can have them here because we don't have the staff to do monitoring of heavy duty med issues. For me this is a fantastic change because I spent my first two years as a nurse in long-term care and you get the psych AND the crazy medical issues there.

So, I suppose the long and short of it is: it depends on what kind of unit you can find. Good luck! I'm glad I made the change!

Elladora · Sep 26, 2012

Psych nursing is medical/floor nursing, just in a different way. Psych can be physically and emotionally draining but it can also be extremely rewarding. I would encourage you to read some of the posts in this area. There are a lot of GREAT summaries of what psych nursing is all about.

Good luck to you!

Midwest4me · Sep 30, 2012

Our patients in the psych hospital have many medical issues too. However, primarily, we deal with strange behaviors, verbal/physical abuse from these patients. Sometimes they're hallucinating; most often they are not. It's a VERY CHALLENGING field and VERY EMOTIONALLY STRESSFUL. On my ward, there is not much physical abuse but there is an abundance of verbal abuse which can truly wear one down. Yes, it can also be physically stressful..as in when we staff have to restrain/seclude a patient while that patient is spitting at us, cursing, striking out. I have about 5 years left to work before retirement; I only hope I can make it through without pulling out my hair.