Questions on Violence in Mental Health and Child/Adoles. Units ??

[sandlewood_nurse]

Hello there,

I am an OR nurse, but lately I have been considering mental health nursing. In school I really enjoyed learning about mental health and my rotation, which was at a community hospital (not too acute). Mostly they dealt with depression and schizophrenic patients. I also spent a couple days in the Child/Adolescent Psych Dept. I truely enjoyed it and felt as if it was my calling. Some things prevented me from going straight away into Mental Health However.

1. Was having a hard time finding a med/surg job at that time (in Ontario), and when I called HR I was told they were saturated with new nurses and needed more experienced people to ORIENTATE these new grads. Hmmmm.

2. I was told I should get experience in an acute setting FIRST !! It would be better in the long run for my career, and some acute experience was necessary. I ended up taking a course in the OR and am now working in that unit.

3. I was afraid of violence and how to deal with it. I truly care for my patients and I did not like the idea of having to restrain them unnecessarily or to feel as if I was in danger. I have been told by so many people that they could see me being an excellent Mental Health Nurse because of my patience and genuine caring. I see people with mental health issues as I would see patients with any type of medical condition. I empathize with them and would like to be part of their recovery, and helping them to cope better. Yet, being about 5feet tall, and not too strong, I worry about my physical safety. This is one of my bigger concerns.

4. I have heard that most Psych nurses have their own issues. I know thats a broad generalization, and I only heard it from two people but it concerned me. I was wondering what the long term effects of working in Mental Health Areas were. Does it change you, do you start feeling depressed or as if you are going crazy. One former Psych nurse told me she switched to OB because she got worried when the patients started making sense to her :uhoh21:.

Regardless of all these reasons Mental Health, especially in the Child/Adolesc. units have been in the back of my mind. I recently picked up a newer edition of my psych book (left my old one in Ontario ) and for the past week I have been reading it like I read novels. For years I wasnt' interested in reading because I felt so overwhelmed by the school workload and other stressors, yet I'm once again FASCINATED with psych. I am so tempted to start applying for casual or part time positions in psych, but I wanted to get some opinions from others who have worked in psych.

If psych does turn out to be as exciting for me as I think it might, I will follow my passion and eventaully work in child/adolesc. psych. What type of experience do I need, how do I get a job in this area, can I apply now with a years working experience (in the OR)?

I would like to persue a masters in psych nursing or counselling eventually. When I was younger I did want to get into psychology, counseling etc, but ended up doing nursing. Is pysch nursing a good alternative ?

Please share your experiences with me thank you so much.

[New2ER]

We sound very similar but with reverse experiences. I lagged behind on all my reading while in school EXCEPT when it came to my psych rotation, then I was always ahead of my professor. I've been out of school for a little over 1 year now and have been working in psych for almost as long. I was told by many people (including recruiters) that I should get med/surg experience before moving into psych. I did and hated it. Worked ICU for 2 months and ER for another 8. I started working inpatient acute psych about 3 months into my first year. Now I'm considering working per diem OR just to maintain my clinical knowledge.

I enjoy psych a lot. Currently I work fulltime in a moderately busy psych ED for a community hospital in Florida. I like being able to talk to my patients and make a difference in their viewpoints, or lives in general. Sometimes a little medication can turned the most crazed psychotic patient into a gentleman/lady. I love seeing that change. As far as psych nurses having issues, everyone has issues. Psych nurses may just be more willing to accept/admit them because that is what we deal with on a daily basis. We focus on mental health/crisis and therefore that's what we diagnose.

As for patients making sense, sometimes they see things with more clarity than the average person, they just don't have the insight/judgement to act on what they see. Sometimes the patients are intimidating, sometimes maddening, often funny - you definitely have to have a sense of humor when dealing with our population of patients. I hope you're able to follow your dream where ever it leads you.

[sandlewood_nurse]

WOW !! Thank you for sharing that with me :). I loved my psych rotation. I did read my psych stuff and was interested, but was busy with other stuff I couldn't savor it. Now re-reading the book I can actually savor it, and I love it!!

I am thinking after another few months in the OR I will go casual and pick up a job in psych provided I can get one. I loved how you described being able to talk with patients. That is one thing I really miss, since working in the OR. I don't get much actual contact with patients except during the brief interview we do just before their surgeries. The best part about psych was being able to talk with the patients and developing the therapeutic relationship with them. There was some of that in M/S too during my rotations. I enjoyed long-term for the same reason, but I wanted to work in a hosptial. I look forward to working in the Psych dept.

We sound very similar but with reverse experiences. I lagged behind on all my reading while in school EXCEPT when it came to my psych rotation, then I was always ahead of my professor. I've been out of school for a little over 1 year now and have been working in psych for almost as long. I was told by many people (including recruiters) that I should get med/surg experience before moving into psych. I did and hated it. Worked ICU for 2 months and ER for another 8. I started working inpatient acute psych about 3 months into my first year. Now I'm considering working per diem OR just to maintain my clinical knowledge.

I enjoy psych a lot. Currently I work fulltime in a moderately busy psych ED for a community hospital in Florida. I like being able to talk to my patients and make a difference in their viewpoints, or lives in general. Sometimes a little medication can turned the most crazed psychotic patient into a gentleman/lady. I love seeing that change. As far as psych nurses having issues, everyone has issues. Psych nurses may just be more willing to accept/admit them because that is what we deal with on a daily basis. We focus on mental health/crisis and therefore that's what we diagnose.

As for patients making sense, sometimes they see things with more clarity than the average person, they just don't have the insight/judgement to act on what they see. Sometimes the patients are intimidating, sometimes maddening, often funny - you definitely have to have a sense of humor when dealing with our population of patients. I hope you're able to follow your dream where ever it leads you.

[psychnurse37]

response from a psych nurse of 37 + years:

JCAHO has a goal of ZERO restraints and seclusions and most hospitals are trying to meet this goal. We have made tremendous progress since I first became a psych nurse in 1968. We seldom have to resort to seclusion and/or restraints because of the meds available and the education to staff on early recognition and early interventon to prevent acting out or assaultive/aggressive behaviors. In the old days it was like tag team wrestling. Now we use any alternative that we can to prevent physical intervention. Very seldom do staff get injured, there are programs taught that help you learn to protect yourself from harm and how to therapeutically deal with aggression.

Psych nursing isn't for everyone, but then again, no specialty is for everyone. Only a few choose psych and stay, but at my facility, many of the nurses have been there since we opened 18 years ago. Many of the psych techs also have stayed for years. We have little turnover, and are probably more like a family than most other areas of the hospital because we do care for others and know how to interact and relate to people. we listen to each other and use each other as a sounding board. "We know when to hold them and when to fold them" and we know when to back off and get help (sometimes in the form of a prn)

I agree that some med surg experience prior to psych nursing is good, although I have hired nurses just out of school. The main pre-requisites for working in psych are: 1. A desire to make a difference in the lives of those with a mental illness, 2. Being able to listen with your eyes as well as with your ears, 3. Great communication skills (which includes listening skills), 4. Caring for someone as you would want someone to care for you or a loved one, 5. Being able to deal with people of all ages, religions, races, alternative life styles, IQ's, illnesses (including medical problems), 6. Being able to manage your own emotions and not over-react or take things personnaly, 7. being able to act professional with patients, family members, co-workers and doctors, and perhaps the most important 7. being able to leave your work at work and not take it home (in other words, have a means to relax and reduce the stress in your life. I may have left a few of the pre-requisite out, but you get the idea.

I love psych nursing and can not think of any other field I would care to work in. Psych patients are everywhere... in every firld of nursing. They are in the ER, having babies, in OP clinics, on med surg floors, etc.

We have patients from age 5 to 99. Each unit is different, each shift is different, some days are fun and some days aren't. No one can predict what will happen from minute to minute, a new admit can change the melieu, a staff member can make any situation better or worse, families can help or hinder to healing process.

We get to know our patients because the recidivism rate is high in psychiatry. We get them stable and send them back to the same environment that was unhealthy to start with, they can't afford or think they don't need the medication, there are few resources for the indigent, they have burned a lot of "bridges" with family/friends due to past mental problems, there is still a horrible stigma associated with the mental patient

I wish you well in your nursing and hope you give psych nursing a chance. When you interview, ask to talk with some of the nurses or techs on the unit so you can find out how they like it there and maybe get a feeling for how you think you would fit in.