New psych nurse, advice please!

Specialties Psychiatric

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Hey everyone, I could use some advice. I graduated in may, boards early June, forensic psych position first week of July. I am VERY new. I wanted psych and love it however I need to know how to keep myself from being pushed around by other staff without being overbearing. I know that pretty much everyone there has more experience than I, however, there is a lot of passive agression and "slight" misdirection. I need to figure out how to let people know that I respect what they have to offer but at the same time I am not there to do what they want, but what I believe is best for the patients and myself, and our safety. There was a pt today that was angry and overly focused on me. I have not been there long enough to build a rapport and could not even speak to the pt without eliciting an extreme response. I was put on as primary one to one when the pt went out of control and was agressive and making suicidal gestures. I felt that it would be better for someone with a relationship with the patient to attempt to verbally de-escalate them. When I voiced this, I was at the end of quite a bit of outright hostility from some of the staff. I don't know if I was out of line and ignorant, or if I should have handled it a different way or what? I did not ask to leave, I simply was ineffective as a primary negotiator and I knew that at least. I want to be effective. I want to do what is right. I would like to be a team player as much as possible while also staying true to my gut. Very lost. How do I establish my footing? I love this job and want to stay that way. So.....please, point me in the right direction?

Congratulations on your new job! There is a great thread on psych nursing. You will be a great psych nurse, just pace yourself and remember the problems on the floor have evolved over time and will take time to resolve. My opinion on the patient you mentioned is he/she was manipulating you with his/her emotional outburst. Find a buddy, a nurse who does not eat her young and is interested in being a mentor. Good luck! :)

I'm a new psych nurse as well, been working for about 7 months. I feel out of place and not experienced enough at times to handle certain situations especially with aggressive patients. Sometimes when I see more seasoned staff step right in and de-escalate the sitatuion so well it makes me feel inadequate like I will never be able to accomplish that. Just the other day I had a patient target me and take his anger and aggression out on me, using personal jabs. I realized talking to him myslef was only making him angrier but thankfully I work with a great crew who have my back and knew it was more appropriate they speak with him since his anger wasn't directed toward them. I went back to work the next day, on the same unit and delt with whatever was to come. It's hard, but I tell myself with time I will get to where my more experienced staff are. The key is confidence and having a good crew to support you. If staff are targeting you and not treating you as an equal maybe you should try bidding on another unit or moving to another psychiatric hospital. Maybe giving it some time and gaining more experience might earn their respect. Good luck and I hope it works out.

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

I'm sorry you are having such a hard time. It makes working a new job so much more difficult when you have non-supportive coworkers. Have they ever voiced specific concerns with you? Or do they seem to just be hostile for no apparent reason? Maybe try talking to each individually, and let them know you are trying to learn, and respect what they have to offer. But you do need to try and learn on your own as well. Ask them to elaborate when they disagree with a decision you make.

I am relatively new to psych as well, have been there just under a year. Luckily I have very supportive coworkers who are always willing to help out. I have learned so much from them.

Thanks, I appreciate the support. I actually talked to some people, including my lead nurse and hashed some of this out. The behavior is really not targeted towards me, but towards my position and being new. There is, and has been some strife going on for quite a while and a whole lot of changes happening right now, so there is an "old guard-new guard" type situation. I thought about this the other night after I wrote that post and made some decisions. I am responsible for what I do, and at the end of the day that is what I have to look at. I am going in every day and doing my best and looking around for those staff members that are supportive and dedicated. There are actually quite a few of them. That's one of the reasons I was so attracted to this facility in the first place. I am not going to let the negative personalities take up my time and energy. I love my job and it is exactly where I want to be, so if someone doesn't like that it is their problem and I don't intend to make it mine. I figure my best defense is to learn everything that I can every day and keep helping our patients work towards there goals and stay safe. So needless to say, I feel a lot better about things. Knowing that I can vent, b*tch, and get advice and support here helps a lot! :) Sometimes just looking at what I've posted helps me to sort things out. Hope everyone has a great day

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
Thanks, I appreciate the support. I actually talked to some people, including my lead nurse and hashed some of this out. The behavior is really not targeted towards me, but towards my position and being new. There is, and has been some strife going on for quite a while and a whole lot of changes happening right now, so there is an "old guard-new guard" type situation. I thought about this the other night after I wrote that post and made some decisions. I am responsible for what I do, and at the end of the day that is what I have to look at. I am going in every day and doing my best and looking around for those staff members that are supportive and dedicated. There are actually quite a few of them. That's one of the reasons I was so attracted to this facility in the first place. I am not going to let the negative personalities take up my time and energy. I love my job and it is exactly where I want to be, so if someone doesn't like that it is their problem and I don't intend to make it mine. I figure my best defense is to learn everything that I can every day and keep helping our patients work towards there goals and stay safe. So needless to say, I feel a lot better about things. Knowing that I can vent, b*tch, and get advice and support here helps a lot! :) Sometimes just looking at what I've posted helps me to sort things out. Hope everyone has a great day

Good to hear! There are going to be negative people anywhere you work. Some who have a grudge for a specific reason, others who are just grumpy to be grumpy. Like you said, you just have to learn the ones who will be helpful, and use them as your resource.

Just curious, where do you work that it's a forensic psych position?

Okay, that was all well and good but today I just wanted to rip somebody a new one!!!!!!!!! OMG how rude can people be? Then to top it off a PATIENT asked to speak to me and wanted to let me know that I shouldn't let those particular coworkers get to me. When I said I had no idea what that meant, the patient let me know that several of them had heard these two coworkers talking about me out on the unit and they didn't agree with their comments. I didn't discuss it with this pt but said that if they needed to talk to somebody about it I was probably not who they should go to. I don't talk about coworkers with patients but damned if I didn't want to say a LOT of things. I was so angry that by the end of the shift I could barely speak. Gonna have to find somebody to mediate and deal with this asap. I have no tolerance for this crap. I hate these type of games. I don't understand the mindset and it frustrates the heck out of me that people treat each other this way. AAAARRRRGGGHHHHHHH!!!!!!!!!!

See, now I feel better already. Seriously am going to at least, (calmly and professionally), speak my peace and then at least it is out on the table. I can't stand to waste the energy on this stuff. Sigh....can't we just work together? Heading to bed. This whole mess has just made me tired. Thanks for letting me vent yet again.:flamesonb

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
Okay, that was all well and good but today I just wanted to rip somebody a new one!!!!!!!!! OMG how rude can people be? Then to top it off a PATIENT asked to speak to me and wanted to let me know that I shouldn't let those particular coworkers get to me. When I said I had no idea what that meant, the patient let me know that several of them had heard these two coworkers talking about me out on the unit and they didn't agree with their comments. I didn't discuss it with this pt but said that if they needed to talk to somebody about it I was probably not who they should go to. I don't talk about coworkers with patients but damned if I didn't want to say a LOT of things. I was so angry that by the end of the shift I could barely speak. Gonna have to find somebody to mediate and deal with this asap. I have no tolerance for this crap. I hate these type of games. I don't understand the mindset and it frustrates the heck out of me that people treat each other this way. AAAARRRRGGGHHHHHHH!!!!!!!!!!

See, now I feel better already. Seriously am going to at least, (calmly and professionally), speak my peace and then at least it is out on the table. I can't stand to waste the energy on this stuff. Sigh....can't we just work together? Heading to bed. This whole mess has just made me tired. Thanks for letting me vent yet again.:flamesonb

Wow. I don't even know what to say to that. Sounds like these people are probably just bitter backstabbers.

Well, got through today. I spoke with the psychiatrist, psychologist, and my lead nurse before I spoke to my coworker. (the other one called off) I gave her the benefit of the doubt and asked what it was that I was doing that was making her so angry. I expressed my belief that all members are vital to the team. I told her that if there was something that she was having a problem with in respect to my performance she should come to me. I reiterated the fact that with all her experience that I hoped that she would be a valuable resource. I also let her know that I could not accept verbal abuse in front of the patients or elsewhere. That she had been overheard several times on the floor speaking about staff in a derogatory manner and that I didn't understand that. What I got back was....I should not question anybody, that I should do as I am told, that the patient's are not to be trusted to tell the truth, and that the only difference between RN's and other staff is that we can call doctors on the phone and get an order. Not one offer of cooperation or conciliation was accepted or acknowledged. So it's on to a mediated situation. I so wanted to be a b*tch. Fortunately for me I have a safety valve that shut my mouth off before I can say anything that would do damage. So not what I would have liked, however, I left work today without a headache so that is good. Y'all have a good night! Be safe.

Blakse, my first caution would be to not listen to patients. They are on the unit for a reason, and staff splitting is rampant. My second caution would be to be certain that you have administration on your side. When I spoke to MHW's about their use of cell phones while sitting on 1:1's and the use of facebook while doing 15" safety, and 30" census checks, two went running to the DON. Long story short, "I am obviously not aware of the culture in our hospital." I came very close to loosing my job. The fact that these two issues are written clearly in our policy/procedures did not/does not matter. I go to work, do my job as a RN, do the MHW's job, and concern myself with the patient, and have very little interaction with the MHW's due to the above, and what you have shared. Best wishes to you.

man, Blakse, if we still had a forensic unit, I would think that we work in the same hospital!! I can totally relate to everything you just wrote, 100%, and have had similiar told to me. And, here, I thought this mentality was only at my psych hospital!!

Thanks Jennay. I do agree with caution as far as the patients go. The first patient actually got a 1:1 on the repercussions of trying to cause trouble with staff. I didn't believe it at all. (feel like a bit of an ass now) With the second patient I had to give it some thought. Then the third patient kind of capped it off. They don't hang around each other either. Barely any interaction at all. I honestly think I have backing of higher ups. I am also careful to not be alone with this coworker. If it turns out that I have management turn on me then I do not want to be there as sad as that would be. I also have tons of documentation to cma. I am sorry that this happened to you also. How do you stay motivated?

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