Any advice for a (potentially) new psyc nurse?

[BrightEyes3468]

Hi there everyone! I'm in the process of making a huge career change and looking for some advice and help.

A little bit about me - I've been working as an RN for about two years now. I've worked in a rehabilitation unit specializing in not only rehab care but also long term and hospice care as well (which gives me some geri psyc experience). I'm at the point where I personally feel like I've learned all that I can learn where I am now and have been looking on moving on.

Recently I had an interview for a community nurse job relating to mental health and substance abuse. It would be a full time job and I'd be able to make my own schedule. During nursing school my psyc clinical was in a facility that also treated inmates (some of which I actually interacted and worked with) and a few days in a pediatric/adolescent psyc ward. However, I'd be working out of both an office (I'd have my own) and also would have to go out in the community as well. The idea of having to go to someone's home isn't such a big issue even though it is out of my norm. The issue is part of being a community nurse I would have to get involved with my patients in the outside world (ie. if there was a patient who skipped out on an appointment and they are not the type to do that I would have to go and get them from their home or go investigate their regular "hang out" spots and if I'd find them I'd have to bring them in, all using my own personal care). This is the biggest con of them all and thus deferring me of making a final decision. *Clarification - I am not forcing the people to come with me. As with any other aspect of nursing the patient has the ultimate choice on refusing any and all treatment and therefore I cannot force them to come with me. It's still an uncomfortable feeling that a stranger such as a patient will be with in my vehicle.

Although, the person who interviewed me did mention that if I felt uncomfortable going alone that I could take her assistant with me, but obviously I can't do that every time I need to go out into the community.

More aspects of the job as well would not only be nursing management, but counseling, medication management, and work similar to social work as well. I have yet to meet with HR and discuss benefits and pay (which isn't a priority) however I will be shadowing a day with one of the lead nurses to get an idea as to how their day goes and to see if this is the job for me.

Does anyone have any advice or suggestions that they give me? I personally love the idea behind this job because I love challenges but I know as many of you have gone through I feel as if my fear is holding me back. The way I've tried looking at it is regardless of the environment we're in, nurses and their safety are always at risk.

[elkpark]

What's this about going and finding people who skip appointments and "bringing them in"? Under what legal authorization would you be expected to compel anyone to do something s/he doesn't want to do? And is your potential employer talking about you trying to talk people into coming to office (and, if that doesn't work, so be it), or actually, physically, wrestling them into your car against their will? That seems like a huge red flag to me.

Even working in inpatient psych over the years, if a client elopes from the unit, the policy has always been, everywhere I've worked, that a staff person follows to keep them in sight and keep track of where they are and monitor their safety (if we see someone leave), but under no circumstances to engage physically with them, and the unit notifies the police, who do any official wrangling indicated.

[BrightEyes3468]

What's this about going and finding people who skip appointments and "bringing them in"? Under what legal authorization would you be expected to compel anyone to do something s/he doesn't want to do? And is your potential employer talking about you trying to talk people into coming to office (and, if that doesn't work, so be it), or actually, physically, wrestling them into your car against their will? That seems like a huge red flag to me.

Even working in inpatient psych over the years, if a client elopes from the unit, the policy has always been, everywhere I've worked, that a staff person follows to keep them in sight and keep track of where they are and monitor their safety (if we see someone leave), but under no circumstances to engage physically with them, and the unit notifies the police, who do any official wrangling indicated.

I apologize for not clarifying better. It was my understanding that if they do not show up and that's unlike them I'd have to go find them. They did not say that I had to force the patient because as any other patient they have to refuse any and all treatment. Sorry for the misunderstanding. Will update original post

[SouthpawRN]

The issue I see with this is safety and liability. IF you are female, I can definitely see concerns for your safety. I also would not really want psych patients knowing my vehicle license place and thus easy to track where I live. As a male, transporting a female is just asking for legal trouble. One accusation by the female psych patient that you touched or said something inappropriate and there goes your license or worse. If you decide to do it, get a dash cam with internal cameras that records every time a patient is in your vehicle and save every one of those videos. Also, I would always make the patient ride in the back seat.

[BrightEyes3468]

The issue I see with this is safety and liability. IF you are female, I can definitely see concerns for your safety. I also would not really want psych patients knowing my vehicle license place and thus easy to track where I live. As a male, transporting a female is just asking for legal trouble. One accusation by the female psych patient that you touched or said something inappropriate and there goes your license or worse. If you decide to do it, get a dash cam with internal cameras that records every time a patient is in your vehicle and save every one of those videos. Also, I would always make the patient ride in the back seat.

Thank you for the advice! I plan on bringing this up when I go shadow. They told me this doesn't happen often but it's the fact that it can and potentially will happen. Do you know if dash cams are expensive? Also, the way I look at it as well, doesn't this risk happen with home nurses as well? I mean, they have to drive to patient homes and stay there and also have to drive patients to/from appointments no? I guess I've been trying to look at it in a perspective that others have done it before me and have done okay.

[nursejessica722]

I used to work in a similar position and occationally when i had a sketchy home visit or something I wasn't sure about I was able to take someone along. If its something they want/need you to do for your job and you don't feel comfortable going alone, they won't have an issue with sending someone with you. Also, after several months and I got more comfortable with my patients, the areas in which they lived and my job, I found myself needing to take someone with me less and less. Good luck.