My thoughts on Mental Health Nursing

Specialties Psychiatric

Published

I posted this on my facebook wall a while back and thought I would share it here...

When I tell people I work in mental health, I almost always get a negative reaction. I get asked if there was nothing else left, am I scared to go to work and other questions that make no sense to me. I love what i do. I can't emphasize this enough. Everyday is different and challenging. I've never worked a "boring" shift. People ask if I'm afraid that I will lose my nursing skills. This baffles me. People with mental illness have physical illnesses too. I deal with diabetics, people with high blood pressure, clients with high cholesterol and many, many other illnesses. We handle cuts, bruises, stitches, casts, post-surgical care and all of the other things you see with a "normal" nursing job. We take vitals, assess clients and do ADLs. The difference is, I handle all of those duties, plus the duties of dealing with mental illness. My days are always interesting and never, ever boring. I have yet to work a shift that I look at the clock and think "is this day ever going to end?" Usually I look at the clock and think "it can't be that late already!" And no, I'm not afraid to go to work. The clients I work with are ill, not scary. I have far more pity for those that fear the mentally ill than I do for the mentally ill people themselves.

Yes, I am soo sick of people asking me are you afraid of losing your skills??... I have to say that I do get scared sometimes, not right away but have had a few aggressive/agitated/psychotic AVH patients who were escalating fast..and without proper staffing or no security.gets me a little worried in those moments.but I love psych! wouldn't do any other nursing!

I am really torn right now. I LOVE psych nursing, and even though I don't graduate until December, I've been offered a job at a state psych facility when I graduate. I think I would absolutely love working there, and I think I deserve to have a job that I love considering I've put so much time in to jobs that I pretty much hate. The thought of spending one more day doing something I don't love is painful!

On the other hand, I agreed to go in for an interview at a hospital for a med/surg position. Med/surg is on my list of jobs that I'm pretty sure I would hate. However, every time I'm looking through job postings, I come across post after post of jobs (that pay WELL) who want a nurse with 1 or 2 years med/surg experience. I think...what if I get tired of psych or just that particular hospital after awhile? What if circumstances beyond my control (family, health, etc) force me to look for another job? Will I be able to go back to a hospital or med/surg setting after being out of practice for so long? I feel like I can always go back to my first love which is psych. I don't know how easy it would be to go back to med/surg.

It really sucks having to choose between taking a job that you really want right now and taking a job that you really don't want, but would probably be beneficial to your overall career. I don't know what I'm going to do. It's such a tough call!

Specializes in Psych.

Yep, I pretty much always knew I wanted to be a psych nurse and I always got looked at like I had 5 heads when I told people that. I still get it now LOL. I took my first job out of nursing school on an ACT team and I love it, love working with our clients. And losing skills, nahhhh. Just did a dressing change on the most *awesome* chronic wound I have ever seen today.

You love your job and you're making a difference in someone's life, isn't that what nursing is about? I give you a :up:.

Unfortunately, a nurse also has to think about his or her own best interests and survival, too. Unless one enters Nursing via a religious Order and has his or her expenses paid by the Order, a nurse is going to have bills, retirement financing, and so forth.

Yep, I pretty much always knew I wanted to be a psych nurse and I always got looked at like I had 5 heads when I told people that. I still get it now LOL. I took my first job out of nursing school on an ACT team and I love it, love working with our clients. And losing skills, nahhhh. Just did a dressing change on the most *awesome* chronic wound I have ever seen today.

How about IV's, vents, titrating drips, knowing the latest emergency techniques and the newest M/S meds? It is hard to keep up with all of that while working Psych.

I am really torn right now. I LOVE psych nursing, and even though I don't graduate until December, I've been offered a job at a state psych facility when I graduate. I think I would absolutely love working there, and I think I deserve to have a job that I love considering I've put so much time in to jobs that I pretty much hate. The thought of spending one more day doing something I don't love is painful!

On the other hand, I agreed to go in for an interview at a hospital for a med/surg position. Med/surg is on my list of jobs that I'm pretty sure I would hate. However, every time I'm looking through job postings, I come across post after post of jobs (that pay WELL) who want a nurse with 1 or 2 years med/surg experience. I think...what if I get tired of psych or just that particular hospital after awhile? What if circumstances beyond my control (family, health, etc) force me to look for another job? Will I be able to go back to a hospital or med/surg setting after being out of practice for so long? I feel like I can always go back to my first love which is psych. I don't know how easy it would be to go back to med/surg.

It really sucks having to choose between taking a job that you really want right now and taking a job that you really don't want, but would probably be beneficial to your overall career. I don't know what I'm going to do. It's such a tough call!

Keep your M/S skills up. With the glut of excess nurses looking for work these days, no facility will update out-of-date RN's to come work for them. Work an occasional shift on Med/Surg - even 4 per year will help.

I have to say, I've only been a nurse for a little less than a year and I feel that my experience in psych LTC has enabled me to use my skills and be extremely resourceful. I have up to 50 patients by myself (sometimes they give me a second nurse if staffing allows) and not only do I have to manage to medicate all of these people, I'm making phone calls to doctors to relay labs or report any acute illness as well as any treatments that I have to do during the day. Sure, none of my patients get IV meds round the clock, but there have been times where I've inserted IV's for rehydration purposes. I have a patient that, until recently, I was straight cath-ing every day for post void residual. I have quite a few patients with wounds and pressure ulcers. A few of my friends that have gotten nursing jobs in acute care give me the "poor you" look when I talk about work, but these people have Med Surg AND psychiatric illnesses and I have to be able to recognize and articulate both to physicians over the phone, because these docs come to the facility once per month.

The skills we can always pick up. But today one of my patients who has schizophrenia and bipolar d/o who has been institutionalized for 40 + years and whose family lives states away told me today "You're everything that I have in this world" with a huge smile on her face. That made my day...and I think that's what real nursing is all about.

Love this comment!!! I work in LTC as an lpn, and I feel the same. It's a satisfying career!

I asked an experienced psych nurse about this. He said that when you really think about it, everyone who comes into the hospital is having some kind of mental health crisis, whether it's depression, anxiety, paranoia, hostility or whatever. In order for you to deal with this person, and before you can even get to the point where your "skills" are going to make a darned bit of good, you're going to need to get through this barrier. Patients don't remember how awesome your mad IV skillz were as much as they remember how you made them feel.

Specializes in Post Acute, Home, Inpatient, Hospice/Pall Care.
How about IV's, vents, titrating drips, knowing the latest emergency techniques and the newest M/S meds? It is hard to keep up with all of that while working Psych.

Depending on the facility you will have psych patients on IV's, vents, and deal with emergencies as well. Psych patients can need O2 and desat quickly, they can have wounds, heart issues etc. Some people don't want to work in a M/S position, they want to be in a psych facility of some sort, some may not need to keep up with the latest and greatest in the med surg. world. Not all nursing skills are med surg. First and foremost a good nurse needs to be able to build a therapeutic relationship in any setting. The psych nurses are generally masters at this. Any one can take refresher nursing skills if they so desire, there are courses offered all around. There is nothing wrong with not working in a hospital setting. There are so many different nursing roles to choose from. Your skills are what they need to be for what you are doing. Not everyone wants to do trachs, vents and IV's. I feel bad for the M/S nurses who say they dislike psych because there was not one day on my clinical rotations on M/S that I did not see at least one psych patient-ETOHers in the DT's, severe anxiety r/t hospital stay, dementia patient who fell. Psych is everywhere that is what people forget.

Specializes in Post Acute, Home, Inpatient, Hospice/Pall Care.
Unfortunately, a nurse also has to think about his or her own best interests and survival, too. Unless one enters Nursing via a religious Order and has his or her expenses paid by the Order, a nurse is going to have bills, retirement financing, and so forth.

I don't even understand your response here...the person posts an upbeat response about nursing being about caring and you are talking about bills...

Specializes in Hospice, corrections, psychiatry, rehab, LTC.

My first job after graduating nursing school was as evening shift charge nurse on a hospital adult mental health/chemical dependency unit. This hospital had never offered mental health services before. I literally opened the unit, taking in the first three admissions we ever got. In the beginning, many ancillary hospital staff were fearful of coming on the unit, not knowing what they were going to run into. Sometimes on the elevator nurses from other floors would make disparaging remarks, one stating that we "couldn't be real nurses, because you don't wear uniforms" (my unit preferred casual street attire for work).

The tide began to turn when there was an incident on our telemetry unit. One evening we heard a code called overhead for a mental health emergency - only it wasn't for my unit or our companion gero-psych unit next door. The gero charge nurse and I went to the unit, and we saw an elderly woman in a virtual fist fight with a floor nurse. I told the other charge nurse "We had better take this over." We talked the woman into her room, talked to her for a while and found that after waking she was confused and she believed that someone had moved her to another hospital. After taking some time to reassure her and calm her down, we started to leave the unit. Tele nursing staff was astounded that we were able to resolve the situation without medication or restraints. From that point forward, we didn't hear the nasty remarks anymore, and we were often called when situations developed on other units, to check for proper restraint placement and so forth.

As someone who has been in the psychiatric ward multiple times as well as starting school in April to be a mental health nurse, I love your attitude! I think all LMHN's should have the mindset you do! In my stays, I experienced some cruel and insensitive nurses. I was having such a bad panick attack that I couldn't feel my arms or legs while laying in bed. It took almost an hour to have a nurse come check on me. The nurse told me it was all in my head and walked out without checking my vitals or anything. I've also experienced some nurses that are so compassionate, one broke the rules and we keep in contact to this day.

Anyways, as a future LMHN myself, there are alot of people in this field without the heart and compassion for it. I love the thought of being able to help even just one person. Keep on rocking!

And btw, I get all sorts of weird looks and rediculous questions when I tell people I am going to work in mental health. It's my heart and my passion, so I ignore their ignorance and keep on smiling :)

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