Recollections from 25 years of psychiatric nursing

[marydc]

As of this month I'll have been a nurse for 25 years, almost all of which have been on the same psychiatric unit. It's not just me, most of my co workers have been there almost as long, and many longer. We are fortunate to be a close group that works well together.

We were discussing this today. Psychiatry is not considered "cutting edge" and not a field new nurses want to get into. I don't think many truly understand what it's like. I know my family and friends still don't quite "get" what I do or even why.

That sheltered, naive 21 year old girl has seen and experienced the worst of people. So much pain, sadness, anger, violence, suffering, poverty, addictions,... I have also seen the best of people. Enduring strength, hope, love, resilience, patience, gratitude, faith...

I have been challenged and blessed in more ways than I can count throughout these years. Have even experienced, at various times, what many patients do. Major depression, anxiety, chronic insomnia, even assault, PTSD and chronic pain. Certainly brought about growth in empathy and humility, which helped me to be a better nurse.

There are many who have crossed my path that I will never forget. I remember most with fondness, even a few with fear; but they have all played their part in my growth.

I am so grateful to have a job I love, with terrific co workers, at a hospital I'm proud to be a part of!

[MusicEMT]

Im interested in Psych nursing

as am EMT ive transported a TON of Psych patients, and I can tell you they are one of the most challenging (in a good way) ive had. id like to say: It takes the patience of Ghandi, The social skills as Winston Churchill and the strength of Arnold Schwartzenegger to help Psych patients

its really an interesting field and i hope i can get more exposure to it.

[Simply Complicated]

I recently changed paths and have become a psych nurse. I find that it is very sad because so many of the patients are there against their will. It saddens me that patients are treated like criminals. On the other side of the coin, I have been a nurse since 1986 and this is the main department that I have felt threatened. I have also been hit and cussed for every name in the book.

These patients are set up to fail and I want to help but do not know how. Any suggestions?

I think like any area of nursing, there are good facilities and bad. Our patients are no where near treated like animals where I work. I have been verbally screamed at and called names, sure, but I had that happen on a medical floor. I've been physically abused on the medical floors, but in almost 2 years working psych, I've never actually been physically assualted. I'm currently nine months pregnant and still working, I've worked without issue throughout my pregnancy.

[ctmed]

This is not the way it is supposed to be! If it is as you say, patients treated like criminals, you feeling threatened, and actually being hit, then things are not being done the right way. Where I work, there is enough staff support to keep other staff and patients safe. Patients are not to be treated like criminals! That is outrageous! If my environment were like yours, I would want to change it too.

How to change it: Staff education:Respectful Workplace, Non-violent Crisis Intervention, De-escalation Techniques. It will take a while to get attitudes readjusted. Just know in the meantime that you are the one who is right about how patients should be treated. You be the first to make the changes by treating everyone with respect.

You feel threatened because patients are out of control. They are no doubt upset about being treated like criminals. A lot of the irritable edge will resolve when that changes. There are still dangers involved in working with patients who are actively psychotic, or just antisocial. That is why you need staff who are trained in non violent crisis intervention who also know how to take a patient down if they have to without anyone getting hurt. You also have to have plenty of staff available and/or law enforcement standing by. Sometimes when you have to enforce a Treatment Override, you just have to wait until the next shift comes on, and then use the extra staff to get it done.

I am sorry that your foray into psych nursing is going like this for you, but there is a better way to do things, and you are right to be concerned about what is going on around you now.

I feel you on this, but let's get realistic. Sometimes you have to be firm with people. Sometimes you have to use physical and chemical restraints regardless of what some person with a Master's degree teaching CPI says for the safety of the patients and the staff. (who, BTW probably has NOT had to deal with patients in some time) Unfortunately, sometimes this is the only thing that will get someone who has in thier head they are going to try to go Rambo and knock everyone's head in to chill out because there must be real consequences to actions. Better they did it with us than the criminal justice system. I go hitting on folks out in the world, I am going to jail and losing my job (AND may be ineligible to work because of background checks) and probably will be homeless in short order. The real world does not care about any "issues" I would have had, only my actions.

Now, I do agree with you about some of the treatment. There was one psych tech at one facility I did agency at that issued patio restrictions, even threatened seclusion for petty stuff. But, this person was an empty, unhappy jerk. Unfortunately, that particular field can attract those kind of folks who have their own control issues. But, this is an exception rather than the rule and this person eventually had the "come to Jesus" talk and had to fly right.