Psych Specialty--The Red-headed Stepchild of Nursing?

[Meerkat]

I am just wondering how many of you encounter the attitude that mental health nursing is not 'real' nursing. A co-worker said something the other day about the med-surg part of our hospital 'where the real nurses are'.

Do you personally ever feel that mental health nursing is somehow 'less' than traditional med-surg? Do you find that other people do?

[kadokin, ASN, RN]

Well, psychiatric nursing IS very different from "regular" nursing - notice I didn't say REAL nursing! There is a much different focus - at least in my hospital. Our mental health center nurses FREAK out if a pt. comes up accidentally with a saline lock in. I am a PCT while in school, and transported a pt. w/ an AC lock in, which was forgotten about by the RN, and not noticed by me. Well, we got to the door at the lockdown MH unit, and the nurse flat out refused to let the pt. in the door with the lock in. I asked if one of the RNs could come out and take it out before we went in if she felt that strongly about it. She said, "I am an RN, and neither I nor any of the other RNs who work up here would ever touch an IV - you take it out, you work in the ER." Of course, I had to explain that I am not allowed to take out an IV, as I am a PCT - and that an RN or LPN must remove the lock. Well, after discussing this issue for a while, the RN refused to budge on the issue, and the pt. had to be transported back downstairs to have his saline lock d/c before heading back up to the MH unit. Now maybe it's just the psych nurses I have had experience with, but it seems that a lot of psych nurses have decided they like wearing street clothes and still calling themselves RNs, but not doing anything but pass meds and write assessments. Who knows what else they do up there, it's a locked unit - but my point is, they refuse to do anything requiring needles unless it's an injection. They will not touch an IV or draw blood. The house phlebotomist has to come in to do that.

And then, knowing all of this, the staffing coordinator has a psych nurse that got called off because they were over staffed, and calls the ER to ask if they can float her down to us because she needs the hours!!!! Like psych nurses (the ones like I've described above - I know you are not all alike!) would have any idea what to do floating in the ER!!! Sorry for the rant... didn't mean to go off.

Basically, my point is, even considering the kinds of rude people we have working on our psych floor, I don't think of psychiatric nursing as "the ugly redheaded step-child of nursing." Just something VERY different from a lot of areas of hospital nursing. That's all.

It is not like that on the inpt psych units where I work. We flush iv's, give iv meds, change dressings, give tube feedings, draw blood, many things. The only things expressly forbidden on our units are blood transfusions and telemetry. We aren't equipped to pick up the telemetry signal and we don't have a crash cart to deal w/severe prophylaxis. We have an emergency cart that includes a back board, ambu bag, setups to start ivs and a few other things, but no meds. We, of course, can not give certain cancer meds that require special certification or other push meds that require cardiac monitoring, etc. A few wks ago, I had 2 recent post-op (less than 48 hours) pts and a 42 hour post-partum pt. We frequently get transfers from med/surg floors that can not be managed on a traditional unit d/t acute psych problems. I guess what I'm saying is the nurses on your psych floor are being very unrealistic, because, guess what, psych pts are people, and sometimes people have very real physical problems. As a matter of fact, chronic physical illness can lead to or exacerbate such things as depression and anxiety. Also, chronic mental illness can lead to or exacerbate certain physical conditions such as copd, diabetes, cad. Red-headed step-children, I think not.

[kadokin, ASN, RN]

This quote bothered me. I am not a psych nurse, but I don't work in Med/Surg either. I am an outpatient educator. I do work with inpatients in my job, but when I am there I will not touch their IVs or pumps or anything else, I'm qualified, but I do not work in that department. I am still an RN. The great thing about being an RN is that there is room for us all. We all have our own tasks, duties, and focus, but we are all RN's and I still call myself an RN, I earned it, and I pay for it every year on my birthday. I have the piece of paper to prove it.

D**n straight!