What does a Psych RN do exactly?

  1. 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?
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  2. 48 Comments

  3. by   SandyB
    Depends where you work. I know some psych RN's who do awesome group work and one-on-one with patients...
    where I'm at is often feels like high pay babysitting...with occasional take downs!
    But even that beats med surg..i always get out on time and often have time in the shift for breaks and lunch...
    In fact, the pts are great most the time..it's the staff who need the meds..LOL
    Actually, it is a bit more intense than baby sitting cuz so many of them now seem to have medical problems to go with the mental illness; you gotta know both medical and psych!
  4. by   lucianne
    Hey, thanks for perpetuating the stereotype, except you left out sitting on our butts and talking on the phone all the time and gossiping about patients at the nurses' station.

    I don't know about other places, but I work my tail off providing a safe, therapeutic milieu for my young patients, leading recreational and therapeutic activities, developing therapeutic activities, dealing with and educating families, educating patients, de-escalating patients, doing therapeutic holds-often several a night or for extended periods, charting patient behaviors, doing physical assessments as needed, doing admissions which can take up to an hour and a half IF everyone is cooperative, providing support and nurturance to patients and families. Oh yeah, I pass meds too, which can be an ordeal in and of itself. The only time I spend on the phone is with doctors, pharmacy, and the hours I spend talking with distraught or belligerant family members. Did I mention getting cursed at, kicked, spit on, punched, bitten, having my hair pulled, 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). Then there's the support I provide to my fellow nurses and mental health techs who are often wrung out at the end of the night and need to process what went on during the shift. I have gone for a week at a time without a break and longer than that without a break off-unit. I don't get out on time because I usually don't have time to sit down and start narrative charting until the patients are in bed--and kids often escalate at bedtime. I do my very best to have everyone settled for third shift because they don't have enough people to deal with someone climbing the walls.

    "Pass meds and make small talk with patients." I wish.

    luci
  5. by   sbic56
    lucianne
    Phew! Good answer! I so remember those days in psych!

    But, I passed all that up to work in OB where I can just "sit back and rock the babies" ...

    FutureRNMichael, stereotypes abound in nursing! It is usually the individual and not the specialty that promote such a skewed perception. Also, I can see why you are thinking the way you are, as when in anything oher than med-surg, students aren't allowed to do as much and observing is just not the same as doing.
  6. by   sanakruz
    WHAT 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?
    Last edit by sanakruz on Jun 18, '03
  7. by   WorkingnPajamas
    ahhhhh lets see. You left out all the good laughs that you get in the midst of this because you cant read the discharge orders, there is no bed ready for the patient, the housekeeper is busy flirting with the mental health worker, your co-worker just gave tetanus insted of the flu vaccine, the CNA is asking you to look at someones red behind for the hundredth time, the paranoids are lined up ready to take pot shots at the new patient, the social worker is busy out buying sneakers because all the ones the patients have have been urinated on, two call outs for the next shift, attention seeking behaviors have been turned up a notch or two, the elevator is stuck between floors with 7 patients on it, yuo have to call and cancel doctors appointments because you have no staff or no transportation to rely on, someone just whipped off their colostomy bag and pitched it like VIda BLue, the MDS nurse brings you some work that was supposed to have been completed and hour ago, your coworker says, "I'm not staying late", your one good pen has been swiped by a patient, and the over head intercom is blaring nonstop. Yeah, you forgot to mention that stuff. Oh, yeah. Lets not forget empty supply room. That was 41 patients to 2 nurses, half with med conditions....(tried to fly, discovered they couldnt, blind, deaf, wheelchair wars and the like.) Oh, its swell! The only perk is that you get to self medicate with antibiotics when you get a UTI from never having a minute to pee!!!!!!!
  8. by   Gator,SN
    WorkingnPajamas,
    Only a nurse could laugh at what you described, then get up and do it all over again!

    Gator
  9. by   PsychoRN
    I am a psych RN and what I mostly do is conduct groups such as living skills training, functional skills training, coping skills training, leisure skills training, social skills training, cognitive skills training and illness management training. I also conduct a family support and education groups for patient's families.
  10. by   sanakruz
    , someone just whipped off their colostomy bag and pitched it like VIda BLue,

    or put a slice of pizza in the VCR instead of a movie causing a fist fight and near riot.
    Oh yeah SMOKE BREAK!!!!!:roll
  11. by   seewhiterabbit
    Do you all enjoy being Psych nurses? I can't really tell from these postings if you do. If you don't then would it be difficult for you to switch to other types of nursing? Do you get paid well for what you are doing as a Psych nurse?
  12. by   PsychoRN
    Originally posted by seewhiterabbit
    Do you all enjoy being Psych nurses? I can't really tell from these postings if you do. If you don't then would it be difficult for you to switch to other types of nursing? Do you get paid well for what you are doing as a Psych nurse?
    I 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.
  13. by   sanakruz
    Managed care is an issue in psych as well. This would be the main bug-a-boo for me. I work out pt now and its great to see people in recovery from thier illness and functioning in the community as opposed to being "locked up"
    I never complain about my salary. I have my own office as well.
    Sometimes I miss inpt; mostly for the commaraderie of other psych nurses!
  14. by   WorkingnPajamas
    Yeah, I cant always stay awake for comedy central, so I have elected to work in it.

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