What does it take to be a good psych nurse?

  1. 1 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 when...

    also, as a psych nurse, does it help to be the artsy, in touch with your feelings, emotional type? or is it better to be the opposite? or somewhere in between?

    in other words, is it better to be a little crazy among the crazies? or to be well grounded mentally, emotionally, and resistant to the craziness around you?
  2. Visit  paulschwinn profile page

    About paulschwinn

    Joined Jun '12; Posts: 30; Likes: 7.

    21 Comments so far...

  3. Visit  hakunamatataRN profile page
    2
    Definitely a dark sense of humor, among other things. And tolerance to sit and listen...for extensive periods of time.
    Davey Do and Hygiene Queen like this.
  4. Visit  xenogenetic profile page
    12
    I would say the traits below (...probably among many others) are important:

    1. Thick Skinned - it helps if you're not easily offended. You'll get swore at, get accused of raping people, spit at, threatened, be called Satan, at least once (probably multiple times) during your psych nursing career. It's the mental illess talking, don't take it personally.

    2. Have Emotional Intelligence - psych patients will have a roller coaster of moods and emotions (depression, mania, multiple personalities, paranoia, anger, sobbing) and you have to be cognizant to maintain your own emotions in the same, very narrow professional range. Don't get to wrapped up in their current mood and just be sure to keep the whole clinical picture for that patient in focus. The good psych nurses don't get in the same car on the mood roller coaster with the patient.

    3. Know Your Medical Stuff - just because you're caring for a psych patient does not mean they won't have potentially serious medical issues arise on your watch. Don't forget about your medical assessment skils when you're in the capacity of a psych nurse. Good psych nurses realize that medical ailments can and do arise when caring on a psych unit.

    4. Be Prepared For The Potential Of Violence - in no other area of nursing, other than correctional nursing possibly, will you encounter the possibility of witnessing or being the victim of violence. Be aware of your surroundings, your patient's triggers, acuity, and history, and your co-worker's personalities (because how your co-workers behave can lead to violence). Honing and using verbal descalation techniques can avert a large percentage of violence on a nursing unit. Good psych nurses are never caught with their guard down and don't get into verbal power struggles that more than likely will lead to a hands on situation.

    5. Check Your Baggage In At The Door - good psych nurses realize that bringing problems from your personal life to work will make you, your co-workers, and the patients miserable on any ordinary nursing unit. The ramifications are amplified greatly, like dropping an anvil on a trampoline, when done on a psych unit. You'll be labeled a "firestarter" on your unit amongst your co-workers with the whole nursing team having to "put out" the fire you started by setting off a psych patient. Your popularity and respect level will plummet among patients and co-workers.

    6. Incredible Level Of Patience - good psych nurses have a very high level of patience. Psych patients can be so in tune to the nurse's demeanor that a dismissive or curt comment can cause a cascade of overblown emotions (self-injurious behavior, violence, self-seclusion).
    Davey Do, Cougar1113, sharpeimom, and 9 others like this.
  5. Visit  tyvin profile page
    6
    You know you're a psych nurse when the first thing you do when you get to work is make sure there's lots of Geodon in stock.

    You know you're a psych nurse when you've met George Washington, an archangel named Lucifer and a whole host of famous people who are no longer among the living.

    Psych nurses are special people who love life and know how to handle themselves in an emergency. Advanced critical thinking skills are what keeps them safe...I don't know about a dark sense of humor; perhaps a dry one with the ability to believe the unbelievable. You see, the people who are mentally ill can sense a phony a mile away.

    The difference between a floor nurse and a psych nurse is when an emergency is called for "all hands" in the psych ward the psych nurse doesn't hesitate but responds quickly.. the majority of the floor nurses stand around and argue about who has to help answer the call. That's not a dig against floor nurses; just a fact with my past experience. It can be a daunting experience to face.

    Cougar1113, Mr_DEF, sharpeimom, and 3 others like this.
  6. Visit  crazyoldnurse profile page
    0
    Being well grounded is always important in nursing. Psych nurses need to have a terrific support system. It really helps to have a good team to work together. Unfortunately psych nurses often do meds all day and bed checks repetitively. Important functions to say the least and often clients will act out so you can have drama on the unit.There are many responsibilities usually in job descriptions outlined for each discipline.Good luck in your career and remember boundaries are there for a reason
  7. Visit  chrissypsychRN09 profile page
    1
    I think it helps to be able to drink the kool-aid sometimes. You know, jump on the boat or the crazy train and accept things that you wouldn't normally accept outside of the psych ward. I don't know of any better way to explain it. Tolerance and acceptance, I suppose.

    As far as personal madness, I'm mentally ill myself but stable and grounded most of the time. I check my baggage at the door. I set strong boundaries with patients. It helps to be in touch with your feelings in situations of transference or counter-transference, and in having patients that push your buttons and knowing not to push back.
    Last edit by chrissypsychRN09 on Jul 3, '12 : Reason: i a word
    Meriwhen likes this.
  8. Visit  paulschwinn profile page
    0
    i think everyone has a little bit of mental illness hiding inside them somewhere. i think i'm somewhere between schizoid and schizotypal. what kind of mental illness do you have?

    does having an understanding and appreciation for abstract art, or the art of mentally ill artists (louis wain, francesca woodman, etc...), indicative of someone that would make a good psych nurse?

    Louis Wain - Wikipedia, the free encyclopedia
    Francesca Woodman - Wikipedia, the free encyclopedia
  9. Visit  psychRN319 profile page
    0
    One of the most important traits of a good psych nurse is compassion. Of course, all nurses should be compassionate, but it's a different thing in the psych world. A good psych nurse truly believes that mental illness is just as serious a medical problem as heart failure or diabetes. As care providers for this population, we need to have a non-judgmental attitude and an understanding that psych patients are people with feelings who deserve our respect. We need to be in tune with the sometimes very subtle cues that our patients convey. Recognizing these cues can give us the opportunity to intervene for the best outcome for the patients and staff members. Above all, we need to really WANT to listen to our patients. Our patients won't always remember which nurse brought them their medicine or took their vital signs, but they will remember which nurse took the time to hear what they needed to say.
  10. Visit  elkpark profile page
    3
    Quote from paulschwinn
    i think everyone has a little bit of mental illness hiding inside them somewhere. i think i'm somewhere between schizoid and schizotypal. what kind of mental illness do you have?

    does having an understanding and appreciation for abstract art, or the art of mentally ill artists (louis wain, francesca woodman, etc...), indicative of someone that would make a good psych nurse?

    Louis Wain - Wikipedia, the free encyclopedia
    Francesca Woodman - Wikipedia, the free encyclopedia
    I second everything xenogenetic and psychRN319 said, and would add that a necessity for success in psych nursing, IMO, is a cool head -- the ability to stay calm and react therapeutically in crisis situations. Also, if someone expects (or needs) a pretty steady routine and expects (needs) things at work to work out the way s/he was expecting at the beginning of the shift, psych nursing is probably not a good choice. Flexibility and adaptability are key attributes.


    In my experience, there's no connection whatsoever between an appreciation of art, by the mentally ill or anyone else, and psychiatric nursing. Some of the best psych nurses I've known couldn't know or care less about art, music, etc., and I've known (worked with) some very "artsy" and cultured individuals who were terrible psych nurses (did more harm than good at work). I'm not suggesting that there is a negative correlation (that knowledge of and appreciation of art means someone will not make a good psych nurse) -- just that there's no correlation at all, either way, that I've observed over the years.
    Mr_DEF, paulschwinn, and Meriwhen like this.
  11. Visit  Meriwhen profile page
    4
    Quote from chrissypsychRN09
    I think it helps to be able to drink the kool-aid sometimes. You know, jump on the boat or the crazy train and accept things that you wouldn't normally accept outside of the psych ward.
    Sometimes that is the answer. As long as the patient and the milieu are safe, sometimes the better option is the, shall we say, less-than-normal one. I had a freshly-arrived patient who would spend most of his day on the patio talking to the crows. Wasn't bothering the other patients at all, but my tech kept reporting this to me.

    "Is he doing anything dangerous?" I asked.

    "No," said the tech.

    "Then let him get his bird on," I told her.

    I knew that trying to redirect him from doing that, especially since he was agitated from the moment he was brought in to us, would just escalate him. The milieu was quiet, he was content...and subsequently a little more cooperative later on.

    Is the "crazy" or less-than-normal option always the better one? No. Sometimes it is, sometimes it isn't. It's a true judgment call.

    And you know you're a psych nurse when you can recognize most benzodiazepines and psychotropics by sight. Hand me a filled psych medicine cup and I can name almost of the medications in it without looking them up.
    Cougar1113, Mr_DEF, Hygiene Queen, and 1 other like this.
  12. Visit  paulschwinn profile page
    2
    Quote from elkpark
    I've known (worked with) some very "artsy" and cultured individuals who were terrible psych nurses (did more harm than good at work).
    yes! this is what i wanted to know! i didn't want to make the mistake of thinking i could do psych simply because "i like art blah blah blah". thank you for the honest feedback! i think you're right, that flexibility, adaptability, and a cool head are more important attributes to have.


    Quote from Meriwhen
    I had a freshly-arrived patient who would spend most of his day on the patio talking to the crows.
    personifying and talking to an animal when you're agitated? what's crazy about that? i'm sure everyone that has a pet does this...
    Last edit by paulschwinn on Jul 8, '12 : Reason: consolidating replies
    whichone'spink and Meriwhen like this.
  13. Visit  Meriwhen profile page
    2
    Quote from paulschwinn
    personifying and talking to an animal when you're agitated? what's crazy about that? i'm sure everyone that has a pet does this...
    My point exactly. In the grand scheme of things, communing with the crows is pretty low on my crisis scale. If letting him talk to the crows calmed him down, then IMO bring the crows on...as long as the crows aren't telling him to hurt himself or anyone else, that is.
    Hygiene Queen and elkpark like this.
  14. Visit  Orca profile page
    6
    Some things I have found to be of great help:

    Have a calm demeanor. When a patient is spiraling out of control, the last thing he/she needs is to see the same thing happening to the caregiver.

    Keep a nonjudgmental attitude. No matter how outrageous anything a patient says to you might be, there is a good chance that is reality to them.

    Be an active listener. Listen to what the patient says, and pay attention. Watch body language to see if it matches the message. Reflect back what they have said, so you know that you didn't misunderstand ("What I hear you saying is..."). Don't be so focused on what you're going to say next that you miss something important. Some patients don't even care whether you believe them, just that you took the time to hear them out.

    Check your rank at the door. When something happens, just because you are in charge doesn't mean that you are necessarily the best one to handle every situation. If a patient is getting agitated and another member of the staff has a good rapport with that patient, let that employee take the point.

    Remember that you save lives all the time, you just don't always know it. In mental health, you don't get the immediate gratification that comes from seeing a patient respond to a life-saving procedure. The life saving is more subtle. Something you say to a patient that seems relatively insignificant at the time can have a profound impact on how that person responds to future situations, and it may make them think that self-harm is not a solution.

    As far as nurses who have mental health issues themselves, that can work both ways. On one hand, they may be able to understand a problem in a way that someone who has not experienced it first hand cannot. Patients may appreciate a caregiver who can relate to them where it hits home. I have also seen nurses so keen to self-disclose and "fit in" with the patients that it becomes more about them than the people they are caring for. It can be unsettling for patients to believe that the person caring for them is no better off than they are.

    I have a saying that I developed early in my career, and it still rings true: Not all of the nut cases are on the other side of the desk.
    Davey Do, sharpeimom, Hygiene Queen, and 3 others like this.


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