What does it take to be a good psych nurse? - page 2
what are some personality traits that make a good psych nurse? how do you pick out the good psych nurse from the average floor nurse? complete the sentence: you know you're a psych nurse... Read More
Jul 19, '12Quote from Orcaso true...Not all of the nut cases are on the other side of the desk.
Jul 25, '12Some excellent replies here! Not sure I can add much other than to second most of what's already been said. For me, a sense of humor and the ability to remain calm are probably the two most important things.
When I first started, a co-worker said to me "Think of the most offensive thing anyone can say to you. What really pushes your buttons or hurts your feelings? What cuts you to the core?" Now picture how you will react when you have that thrown in your face. The psych patients I work with have an almost uncanny ability to pick up on weaknesses and will try to use them against you. Remaining calm and never, ever letting them know you are bothered is crucial.
Jul 28, '12I think a lot of it lies in getting rid of the power differential between the patient and the nurse. Patients see the nurse as a powerful figure who can dictate a lot of their behavior, can punish or reward, give or take privileges, etc. I see a lot of nurses do that kind of thing. I don't know, maybe it works for them. It's never done anything for me but give me a headache.
I try to push the power and control back on the patient and make them decide what they want to do. I let them know there's only a certain amount of time that the hospital is going to allow them to stay, and then they're going to get spit back out on the sidewalk. How are you going to learn how to deal with stressful situations on the outside if you don't practice it now? At least here, there are people who are supportive of your goals and will look out for your safety. Put on your training wheels here and take it for a spin and see how you like it. It's not like you're going to leave here, go back to your apartment, and suddenly change into a new person. Right? Unless you get a running start at it now, nothing's going to happen.
I guess it's about giving a patient a reason to change, giving them motivation to take an opportunity and make something of it.
Aug 7, '12This is a great thread, I love these answers!
I think you have to have ingenuity not necessarily artsy but being creative, resourceful and flexible in your ability to deal with potential crisis situations.
The ability to dodge a punch or insult rather than fight back.
Aug 7, '12You are taught into reorient the patient to reality whenever the patient says something outrageous or implausible to you. Experience has taught me that the textbook response is not always wise, and when you use it you need to be tactful in how it is done. Sometimes you can further agitate a patient with a firmly-entrenched delusional system, to the patient's detriment, by insisting that what he/she "knows" is right actually isn't. If a patient says that he sees or hears something that isn't there, a non-judgmental response might be, "I don't see/hear that." This way you aren't dismissing or trivializing that patient's reality, simply saying that you don't perceive what the patient does. I have seen staff set patients off by being less tactful. You can also ask the patient to explain more complex delusions, which may give you insight into the patient's thought processes.
Aug 10, '12everything i've read so far is excellent advice! i have worked addictions, general locked
psych dept, a little forensics, and, within the community, a mental health clinic.
things that have served me well are:
1. listen carefully, not just to the words, but to the feelings too.
2.sometimes going along with a delusion is ok. good example is the crows.
one warm afternoon, i overheard george washington, ben franklin, and thomas jefferson
discussing the constitution as i passed the dayroom. everyone was calm and the discussion
was lively. the only one becoming progressively more agitated was the tech. i told him that
until someone suggested a duel, (or something) just to keep an eye on them.
3.never assume because a patient has a particular diagnosis that they will behave a certain
way. don't bring preconceived assumptions to work with you. because your sister-in-law
is bipolar, that your bipolar disorder patients will behave/react like she does.
4.if some idiot cut you off, your spouse angered or frustrated you, or whatever, let it go.
just hang it on a branch of the tree beside the door where you go in.
5.right now, after his family just left, may not be the best time to get something resolved
with your patient.
6. never ever turn your back on a psych patient -- no matter how pleasant she seems.
7.i never wore any jewelry except my wedding ring, which is a wide, domed, heavy gold band.
they can, and do grab and pull at bracelets, earrings, necklaces... my watch pinned to the
front of my top.
8.never go into a patient's room alone.