What keeps you going? Why do you stay?

  1. Greetings fellow psychics

    I work on the Acute side of a psych hospital that is going through a major turnover. Nurses are leaving to go to larger hospitals in the area, most staying in Psych.

    Our ratio is 1:6 and that includes nurses and mental health workers. So with a 31 patient bed unit divided into 3 groups (teen boys, teen girls and under 13 kids) we usually end up with 3 MHW and 2 nurses. It's not the nursing I signed up for, more like herding kids and managing bedlam. It's very difficult to keep up with the charting, rounds, discharges, admissions, and med passes and you rarely get to know your patients.

    That said...what keeps you at your hospital. We have an awesome nurse manager that is always open to suggestions. We probably can't change the ratio. We are owned by a larger corporation and the ratio is set by them. I want to help administration come up with some creative ways to help keep the nurses we have.

  2. Visit NCindasun21 profile page

    About NCindasun21

    Joined: Mar '10; Posts: 50; Likes: 30


  3. by   Hygiene Queen
    Well, besides money (ahem) I would have to say I am intrigued by the stories behind my pts. and bizarre behaviors. Fascinating.
  4. by   Hallows_Eve
    I am a float LPN at a BH program that includes about 10 different units. You didn't mention how safe you felt at your workplace, but I can say in ours that safety is a factor in our turnover rate- not just physical safety (although that is huge) but license safety too- the likelihood of being disciplined or suspended for whatever reasons.

    Often how this plays out depends on the Unit Manager's interpretations of Administrator's set of rules. Where one unit manager just needs to make sure bodies are on the floor and all the charting is correct because 'that's what the Director expects' , another may be more concerned about patient to nurse interaction and not as focused on dotting the i and crossing the t 'because the Director wants more one to one interaction'.

    One unit manager will have a true zero tolerance for violence on the floor, while another may initiate disciplinary actions against staff for not being theraputic enough when a violent incident happens on their unit. Whether or not all violent incidents can truly be diverted and how differs from unit to unit, as well as whether our hospital can give itself a 'no restraints necessary' brag, which to some managers and admins is like the Grail of Mental Health achievements.

    For a while we had security guards on every unit- then suddenly they were replaced by plain clothes 'Security Assistants'- one per every two floors, or about 1/3 of that original security.

    Each unit manager saw this administration decision differently, one stating that it was because patients were too intimidated by police looking folks hovering around and therefore contradicting a theraputic environment (particularly those with ODD, or police centered paranoia). Another UM stating it was a state thing having to do with medicaid- as soon as a uniformed officer touches a patient, medicaid is said to stop payments on their treatment as it becomes a criminal justice issue. (About 75% of our pts have Medicaid). Yet another UM stated is was a budget cut, pure and simple, and that the replacement panic alarms overall saved the hospital money.

    Overall thing to ponder would be how comfortable the nurses and staff feel about their security, whether they feel that they have each other's backs during escalated situations, and whether they feel the nursing is a priority over charting where you are.

    Last edit by Hallows_Eve on Aug 24, '12
  5. by   Elladora
    Every great once in a while, we have a client that makes it. (Goes out into the "real" world, beats their addiction and/or successfully manages their mental illness, becomes a contributing member of society, etc). THAT'S what keeps me going.

    Plus whenever I get frustrated I remind myself of this (and I say this to myself a LOT - even have it hanging in my locker at work): Every person here at one time meant something to someone. They are someone's loved one. If they aren't, it's all the more reason they need 100% from me.

    It's sometimes hard to look at psych patients and think of them as being someone's beloved child, mother, sister, grandparent, etc. I try to get that visual/thought in my head and it keeps me going.
  6. by   NCindasun21
    Thank you. I'm going to print out your saying tonight and have it hung by tomorrow.

    Bless you!
  7. by   Elladora
    You're welcome! I hope it helps you as much as it has me.
  8. by   Meriwhen
    I love what I do. I'm helping a population that is frequently stigmatized and written off both by healthcare organizations and society in general. I feel like I'm making a difference. Granted, it's sometimes hard to see that difference, or that difference may be long in coming...

    I'm also lucky to be working in a very supportive environment and for an organization that takes mental health and psychiatric nursing seriously.
  9. by   LilPita
    I just wrote this long post that, of course, I accidentally deleted immediately afterward. I LOVE the autonomy of working overnights on my psych floor. It's me, 2 MHC's, and 15 patients. We do admissions/handle medical problems/de-escalate if necessary. I live on adrenaline, and there's plenty of that to go around in this specialty! I also love making people smile when they feel the rest of the world is crumbling at their feet. I love making a difference and giving someone hope. I am also pretty good at letting people talk their demons out and just LISTENING. That is why I love, love, LOVE my job! (most days, of course!)

    - Pita
  10. by   Midwest4me
    Quote from Elladora

    Plus whenever I get frustrated I remind myself of this (and I say this to myself a LOT - even have it hanging in my locker at work): Every person here at one time meant something to someone. They are someone's loved one. If they aren't, it's all the more reason they need 100% from me..
    Thanks, Elladora, for sharing that. I think I need to memorize that! Our ward has been "high" lately....seems the patients' degrading, verbal abuse is on the rise(which I have ALWAYS taken personally--and even more so as I age.... I am more sensitive these past few months anyway due to financial issues, and husband's health issues) too.
    I stay at the job because of the benefits and because I'm nearly the sole provider since my husband is ill and on disability. I hope to retire in 5 years; I sure feel like I'm semi-retired now since I do my 40-hr work week in 3 days, but
    am getting really worn down by the verbal and potential physical abuse every day!
    Last edit by Midwest4me on Oct 9, '12 : Reason: additional info