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- May 29, '12 by chevyvThat is real advice you're getting from Merlyn! They will see you coming a mile away and will absolutely try to manipulate you. If they can't get you that way, some will try to get you out of there. It's a great experience though and you'll know within a short time if its for you.
Wait until the diabetics try to get you to get them chips/candy. That can get pretty nasty too
I still remember the 1st time I found myself in a corner with no where to go to get away. The pt knew it too so I had to fake the confidence and be much more assertive than I felt. Worked out well but it could have really gotten ugly quickly. I've never ever put myself in that situation again. I am always aware of my way out/around a pt, always. I swallow my fear because they can smell it on you. Seriously, I swear they can.
- Aug 11, '12 by HappyAppleI agree with all the above posters. I was lucky enough to be a CNA in a hospital when I became an RN. Resultantly, I easily & luckily got a job there. It was a med-surg floor in a big hospital. We dealt with pts from 20->100 , predominantly geriatric. In this pt population I cared for plenty of pts with medical problems who also had anxiety attacks, depression, bipolar disorder, schizophrenia, PTSD, etc. While we concentrated mainly on the medical issues, we also had to deal with the psychiatric issues. It is challenging but I really enjoy it!
Good luck in your future endeavors & do whatever is right for you. While I do recommend a med-surg job initially, take a good psych job if you have the opportunity. The job market is pretty tight in a lot of places currently.
I recently moved to another state and "fell" into great job at a small geri-psych hospital. I have worked there only a very short time but I love it. The fact that I work with a great group of people & not back-biting gossipers makes a world of difference. I feel my previous experience in med-surg has given a solid foundation upon which to build in dealing with this pt population, & has also allowed me to hone & utilize my nursing skills. Learning to practice therapeutic communication with psychiatric pts is a special nursing skill all it's own. It is however a whole different world from med-surg. I have learned to become more relaxed & not let my anxiety or fear show as they transfer onto the pt. I have not had an opportunity to deal with the more manipulative type of pts in the geriatric population, but I certainly did in clinicals.
As previous posters stated, you always have to keep your guard up, be aware, be assertive, be confident, don't ever give personal info to pts. Tell them, " I am here to focus on you & to help you." Develop a thick skin. Always leave an escape route for yourself when dealing with a pt. I have given more IM injections here in a week than 4 years on a med-surg floor, excluding flu shots. It has been a real learning experience.
At this hospital I am responsible for staffing, giving meds, doing staffing with another nurse, communicating with drs, taking orders,assessing pts, dealing with behavioral problems, assessing pts, dealing with families & much more.
- Aug 12, '12 by BentleyJazzieGreat information, Mer....
- Aug 14, '12 by ElladoraThere is some great advice in this thread! I found myself nodding (and smiling) a LOT while reading these posts.
I started in psych as a new grad and I loved it (still do). I think you will be surprised at how many skills you will use. Psych isn't "just" treating the mind, it's also treating the medical.
Good luck to you! You are in for a very interesting career!
- Aug 15, '12 by 2bLVNmeHaaHAAHa, I compleatly agree. I work in acute Psych. If the floor staff tells u to back up, you had better. Or be willing to participate in the code. At that point there is NO "therapizing" the.. Just be reAdy for the S&R paper work. Keep them smoked, hydrated and medicated and u will have a good shift...
- Aug 25, '12 by emptyboxcarsThank you for all of the great advice! Albeit, I must say some of you have made me a little fearful! LOL. I think geropsychology sounds like a good possibility for me. It's been wonderful hearing from all of you about your responsibilities and your experiences. Thanks again, everyone! And I'd love to hear from more people if anyone else has anything to add!
- Sep 20, '12 by docpsychrnHi there! I've been a psych nurse for over 23 years...I love psychiatric nursing! I too worried about my medical skills but I took a 2 year break to work on a step down unit/med surg to get my skills back up to par. I have no problems with drawing blood, starting IV's or giving IM's. As for the harder skills like chest tubes, trachs, traction etc...psych will never take those kind of patients because of their medical status. If you could work PRN medical unit while working psych, this would allow you to gain skill in medical yet keep your job in psych. Also, be the first one that is willing to float to medical when your unit is overstaffed. As for being a psych nurse, it's what you make it. The main thing is to listen and observe. It takes many years to learn the many aspects of mental health and when a patient is in crisis etc. Always remember safety is the most important part of your job. Whether it's your safety or the patients safety. Never feel bad if you call for help and always have someone with you when you have to talk to a patient and you feel it's going to upset that pt. If you are lucky, you have electronic charting if not, most of your time your nose is stuck in the chart charting everything by hand and revising treatment plans etc. Don't ignore your patients as this is a critical time in their illness. Set a specific time that you can talk to them so that they know upfront you are not going to sit there for the next 8 hrs. This is most useful with your borderlines. Never show your fear. You can be scared to death...just don't show it. YOU are the one in control, they aren't. YOU are the one that decides what the game plan is going to be and YOU offer that pt the choices he has vs him going off and hurting someone. I wish you all the best and if you love it, stick around it gets better!!! Take care!!