State institutions/hospitals

KYPsych · Jul 27, 2007

I'm researching a variety of mental health nursing jobs hoping to find a good place to start my psych nursing career. However, I'm having trouble finding out the subtle/obvious differences between nursing in an inpatient state institution vs. a private/hospital inpatient facility.
What can I expect??
Thanks!!

In private hospitals you're typically going to find patients with health insurance. In my experience, the diagnoses most seen in private institutions were depression, substance abuse, anxiety disorders, a few bipolars, and a couple personality disorders. Lengths of stay at private facilities are generally short and the facility itself is usually plush.

Now in a state instition you're typically going to see folks that have no insurance. At the state institution where I work, the diagnosis seen most often is schizophrenia. A lot of state run facilities are run down and these facilities truly look like asylums! (The hospital I work is 175 years old with some of the original buildings still in use and the newest building being a mere 60 years old.) You're going to find a rougher brand of patient here. Felons, the chronically homeless, hard core polysubstance abusers, violent MRs, habitual malingerers, and of course - lots and lots of antisocials!

Both state and private will be short-staffed, though private hospitals in general pay more...at least where I am. State hospitals will have a larger census. It is common on my ward to have 30 patients with 1 RN, 1 LPN, and 2 aides. Private hospital census is typically 10-17 beds.

I hope this helps!

allnurses Guide · Jul 29, 2007

In private hospitals you're typically going to find patients with health insurance. In my experience, the diagnoses most seen in private institutions were depression, substance abuse, anxiety disorders, a few bipolars, and a couple personality disorders. Lengths of stay at private facilities are generally short and the facility itself is usually plush.
Now in a state instition you're typically going to see folks that have no insurance. At the state institution where I work, the diagnosis seen most often is schizophrenia. A lot of state run facilities are run down and these facilities truly look like asylums! (The hospital I work is 175 years old with some of the original buildings still in use and the newest building being a mere 60 years old.) You're going to find a rougher brand of patient here. Felons, the chronically homeless, hard core polysubstance abusers, violent MRs, habitual malingerers, and of course - lots and lots of antisocials!
Both state and private will be short-staffed, though private hospitals in general pay more...at least where I am. State hospitals will have a larger census. It is common on my ward to have 30 patients with 1 RN, 1 LPN, and 2 aides. Private hospital census is typically 10-17 beds.
I hope this helps!

I too work in a state hospital, and I have also worked on a psych ward in a larger private hospital, so I second everything that KYPsych said. The private hospital that I worked at... I saw mostly diagnoses of depression, suicidal ideation, some bipolar, the occasional schizophrenic, and then we also had some elderly folks who had recently had a change of mental status and the docs were trying to, I guess rule out alzheimers. But where I work now, the three main dx's are schizophrenia, schizoeffective disorder, and bipolar. And yes, lots of homeless and lots of felons.

oignurse · Aug 4, 2007

My experience has been also in Kentucky. Like Realnursewitch, we had alot of schizophrenics and bipolars but these folks were treated longer term on different units. I worked on an admission unit where we saw everything- lots of dual diagnosis- substance abuse + depression- personality disorders, etc. Staffed really well with mix of state employees and temps. Temps are paid better than some of the new state employees but of course, no benefits. Felons and homeless are placed ASAP if no psych DX. Building is old but beautiful and well maintained. Hope this helps RNoholic.

studentforlife · Aug 5, 2007

Also consider this - the most common reason the clients do not have insurance (and are therefore in a state institution) is because their illnesses are severe enough that they are unable to hold a job.

If you can, consider volunteering for a week or so to see what it's really like before you make a decision either way.

drmorton2b · Aug 5, 2007

Generally State Hospitals (in accordance with what KYPsych said) are for long-term mentally ill. The ones that have 2 pages of Medications at least in the pharmacy. If these patients were general hospital patients they would be in the ICU (if there was one for psych problems.)

Some don't have insurance, but most end up on state insurance due to their disability.

In MA you have to be severely mentally ill and or be in and out of psych hospitals multiple times. Also most of the time court ordered medication and commitment. The key point about State Hospitals its to remember, long term care and like you read about insane (in some wards not all)

Weeping Willow · Jan 1, 2008

State hospitals probably pay less but you probably will get a pension, not just a 401k. Probably a little harder to get fired unless you abuse or neglect - then you're gone.

You also deal in State with MRDD, children, adolescents, INGP (insane, not guilty persons - the criminally insane or they would be criminals if they were sane).