What does a Psych RN do exactly? - page 3
From what I have seen(little), all I really saw the RN do was pass meds and make small talk with patients. I am sure this is not the case... So what exactly do you Psych RN's do?... Read More
Sep 1, '03Well, FutureRNMichael. I don't know if you are yet, or soon will be an RN, but if you are interested in Psych nursing, then you will be good at it if that's what you want to do. I have worked as a Psych nurse for 12 years and became credentialed through the ANCC a few years ago. We do, during slow days, sit and make small talk with the patients and pass a few meds. Maybe you didn't get to see a busy day! It sounded to me like some of the responses you got were from nurses working in psych that don't enjoy what they do. You do have to be alert to a lot of body language and be able to difuse a pending crisis at a moments notice. You won't use all of your nursing skills like you would on a med surg floor. But if your heart is in it, a good psych nurse is worth a fortune to a suffering patient who just tried to commit suicide because she was gang raped at a graduation party.
Or to a child who has been so severely abused that he doesn't trust anyone to come near him because he still has the bruises and cigarette burns all over his body from the last episode.
Or to the schizophrenic patient who hears voices and needs someone who isn't judgemental that understands that to him, the voices are real.
It takes a special person to work in psych nursing. You may have seen a nurse having an easy shift, but there are a lot of things you have to live to experience.
Sep 2, '03Work under cover. (at least I do) to seperate the malingerers from the needy.
Next we promote psychological comfort throughout the unit. (yep, no gossip here)
Then we sit and chat and chart what went on and go home.
That is in adult inpatient care. Adolescent care is a sure place you will get hurt physically.
Sep 6, '03There is a lot more to psych nursing than just sitting and having small talk. I have been in the field for many years.There has been many changes and the days of babysitting are over.Groups ,assessments ,treatment planning,documentation are all part of it besides just sitting and talking to the client,offering support as needed. If you like the field it's for you.The wages depend on where you are at and who you are working for as for every nursing job.
Sep 6, '03I work at a non-profit school for children ages 5-18 with mostly behavior disorders, alot are also abused children. As soon as all 70 kids get to school my day consists of literally running around the school until 3pm or later if a kid can't go home on the bus and has to be placed in crisis stabilization. On a slow day I usually only get kicked a few times or spit on once or twice while I am trying to get an 8 year old escape artist papoosed. My pay is not very good but I really like my job especially when I know that the 8 hours the kids spend at school are probably the only stable thing they have in their lives.
Sep 7, '03I'm a second year nursing student in Canada and I've just found out that my clinical this semester (12 hrs a week for the next 14 weeks) is on the psych ward at our local hospital... I keep hearing that we're going to be pretty bored from people at school! I was ok with doing this rotation but now I'm worried, I have no idea what to expect and if my nursing skills will be practiced at all. Any advice/suggestions for a worried nursing student???
May 8, '04Quote from lucianneSame thing seems to happen with geriatric patients who are getting lorazepam ... I once had a 78 year old woman in the midst of a thyroid storm proposition me on the tele floor (i am a 34 year old man). ativan should not be used as a chemical restraint, it is pretty much worthless for that purpose (imho, ymmv, my $0.02, yada yada yada)cleaning up urine when some idiot doc writes an order for a kid to have ativan (which disinhibits younger kids and they often wind up taking off all their clothes and peeing in corners).
May 8, '04Quote from Fox88wow, i wish we in the US had that long of a rotation on psych ... we had one night a week for 4 weeks ... totally lame.I'm a second year nursing student in Canada and I've just found out that my clinical this semester (12 hrs a week for the next 14 weeks) is on the psych ward at our local hospital... I keep hearing that we're going to be pretty bored from people at school! I was ok with doing this rotation but now I'm worried, I have no idea what to expect and if my nursing skills will be practiced at all. Any advice/suggestions for a worried nursing student???
May 8, '04I also take referrals, deal with staffing problems, act as a social worker, and deal with any thing else that happens, (and something usually does), do inservices, orient new hires, etc.
Quote from sanakruzWHAT AN RN DOES
1. Assess and admit pt to acute inpt psychiatric unit.This task will take about 2 hours including documentation(...And remember not all pts are visiting on a voluntary basis.)
2. Obtain appropriate orders from MD. Many units have standing orders for things like blood and urine specimens to be obtained ECG ,detox protocols etc. Most units admit 24/7. Each patient will need individual care. Many will be admitted with chronic illness such as DM, lupus,or HIV. Orders will need to be obtained to continue pt. on any med already prescribed. Often these orders will be obtained by phone and the MD will not see this person for 24 hrs. ASSSESSMENT SKILLS ARE CRUCIAL.You will see plenty of pts that need total care, at least until they are stabilized.
3.Delegate tasks to the rest of the team- meds to pass safety checks to do on all pts as often as q15 minutes,groups to run,(2-3 a shift except on NOCS
4.Co- ordinate care with other team members- Social workers to start discharge planning, physician to do H&P.(The MD that you call for orders will be the attending psychaitrist;however every one wil need to see a physician for history and physical),lab techs to draw blood(may have to draw your own, however) housekeepers to make the beds for new admit, order tray from the kitchen...
5.Obtain consent (or not) to speak with the patients signifigant other. (We in psych have always been very careful with confidentiality, prior to HIPPA.) Often one will find that the identified pt. is not the sick one
6.Keep the unit SAFE and running. "Safe" means no drugs, no weapons, no sexual activty, no gambling ,no pill cheeking, no fighting, limited verbal abuse, limits on demanding pathological behavior, somewhat like a cop with a heart of gold.
7.1:1 with assigned pts. A good way to achieve this is divide the number of clients by number of staff. Each staff will be assigned to spent quality time talking one on one with each patient assigned and documenting said conversation. The RN/ charge nurse will be assigned the most acute individuals. This can be a most therapeutic intervention, even at 3am.
8.Give report to the oncoming shift.
9.Complete an acuity assessment tool of some type, often thought of as a cruel joke.
10.Try to relax- it will all start again tomorrow.
WHAT DID I LEAVE OUT LADIES AND GENTLEMAN?
May 8, '04I love my job! I have worked in many areas of nursing, and I have enjoyed everything I've ever done. The satisfaction of knowing I made a difference, far outweighs the negatives.
Quote from PsychoRNI love being a psych nurse!!!!!! I have never worked in any area of nursing except psych and I have been doing this for 20 years! I have no desire to do anything else but psych nursing. My pay is the same as nurses who work in other areas.
May 8, '04That RN you observed really made a difficult job look easy!!!!!!!!!!!!!!!:chuckle
Quote from FutureRNMichaelFrom what I have seen(little), all I really saw the RN do was pass meds and make small talk with patients.
I am sure this is not the case... So what exactly do you Psych RN's do?