Going into psych after 15 yrs of hospital nursing

pandora44 · May 8, 2011

There are lots and lots of greats posts on the psych pages for nurses new to the field. Spend some time reading through the posts.

Here is what I wish I'd known:

You will become strangely close to many of your patients as you work with them over the months and sometimes years. You will see them at their worst, and daily hear intimate details of pain and heartache. This creates a bond that is difficult to describe but none the less real. I think of it as a cross between an older sibling and a distant cousin.

Your patients will make poor decisions. Not always, but frequently, and sometimes fatally. However much you may lament their choices, you must always remember that they are still responsible for them. Keep your boundaries firm, but never lose your compassion.

Know yourself. I cannot stress this enough. Being a good psych nurse requires a strong sense of self. What types of manipulation are you especially susceptilbe to? Most psych patients are master manipulators and some like to split staff. Watch out for phrases like, "No one understands me like you do" and "You're the best nurse here."

Leaning to set appropriate limits on patient behavior can be daunting. I think it is one of the least addressed aspects of the job but one of the most important. You must address inappropriate behavior in a timely manor. Sometimes that means addressing it immediately, such as a when a patient is harming themselves or others, and sometimes it can wait until you sit down with the patient to have your 1:1. On the other hand, pick your battles.

The mental health care system will make you want to bash your head against the wall. Lack of services, extremely long waiting lists for every type of assistance, and the almost daily loss of mental health beds mean more frequent hospitalizations for everyone.

Despite all I've said above, psych nursing is actually fun. I spend every day engaged in my job, challenged intellectually and emotionally. I love what I do, and I have the time to make a difference in the lives of my patients.

Davey Do · May 8, 2011

I can really only echo what pandora44 wrote: There are some great threads on Nurses getting started in Psych who enquired on what it was like. Pandora44 also gave a good, sound general perspective on Psych Nursing.

I would like to reinterate something pandora44 referred to in my own words: Thes people are Mentally Ill. Expect irrational behavior from them. So, in essence, always expect the unexpected.

And the best to you in your new position.

Dave

Whispera, MSN, RN · May 14, 2011

I agree with the above. Sometimes I have to step into bizarro world where all my thoughts of what's real don't fit. I have to get into my patients' world (way of thinking) so I can help them sort through it and come into the non-bizarro world. I also have to remember when I'm in bizarro world that it IS bizarro world.

You'll have to develop a self-support system too, so you can leave things at work rather than taking them home with you. Sometimes that takes awhile. Be as gentle with yourself as you are with your patients. Do things for yourself that help you smile and stay healthy. You can't be a helper if you don't remain emotionally and physically strong.