Any advice for psychiatric rotaion?

suzy253, RN · Jun 24, 2005

I found my psych rotation very interesting. Everything we were reading in the books, we were now seeing, i.e. suicidal ideations, personality disorders, schizophrenia, bipolar, etc., etc. If you have your psych book already, you might want to read up on some of these.

IttyBittyCritty · Jun 24, 2005

I get my book next week. Now that I know where to start, I won't feel as lost as an easter egg...So much info and no time to "learn" it. Thanks Suzy.

nataleern · Jun 25, 2005

I start my Psychiatric rotation in August. What should I be studying so I can get a heads up on the semester. Does anyone have any advice? I heard it is the most difficult semester.

PSYCH WAS ACTUALLY THE EASIEST FOR ME! IT SEEMED TO BE JUST ALOT OF MED PASSING! ITS NOT YOUR TYPICAL MED SURG FLOOR! I LIKED IT BUT WOULD RATHER DO ANOTHER SPEC. MY INSTRUCTOR TESTED ALOT ON THE PSYCHOTROPIC MEDS AND OTHER SEFFECTS THAT OCCUR WITH THE MEDS GIVEN TO PSYCH PTS. GOOD LUCK!

truern · Jun 25, 2005

Psych...the clinical I dreaded the most, and enjoyed the most

We didn't actually pass meds that clinical, but had to have drug sheets for each of them...our whole focus was on therapeutic communication.

It was the most rewarding clinical experience, and one where I felt I actually made a difference in someone's life.

Good luck...and happy communicating

rn/writer, RN · Jun 25, 2005

I worked in psych for quite a while but didn't see the nursing students that came to our hospital because I worked night shift.

I can give you a few pointers, though.

Read your text book ahead of time. Get familar, not only with the commonly prescribed psych meds, but their side effects and adverse reactions. EPS--extra-pyramidal side effects--are something you should be aware of in patients taking anti-psychotics. If a patient starts showing signs of this kind of problem and they are not immediately taken off the offending med and given the proper treatment, the symptoms can become permanent.

Some psych meds make patients vulnerable to heat. One reason is their thermoregulation becomes compromised by the med. The second, and more serious reason, is that their ability to sense a rise in their own or the ambient temperature becomes impaired at the same time. This is like playing with matches inside your house while disabling the smoke alarms. A few years back, before this was widely known, we had a long, hot summer where something like 8 people in our metro area were badly affected by their anti-psychotic meds and several of them died.

Never turn your back on a psych patient. The sweetest old lady can become a tiger in a heartbeat. Ditto for little kids. Just as nurses develop and "antiseptic conscience" and a super awareness of contamination, psych staff have to develop a safety conscience that sets off alarm bells when something just isn't right. Maybe the clues are so subtle that you just can't put your finger on what's wrong. Nevertheless, follow your gut. Get yourself out of the situation and ask for help, if need be, to figure out what tripped your trigger. We have those hairs on the back of our necks for a reason.

Resist the urge to feel special. Psych patients, as a rule, like attention. Many have become treatment-wise over the years and know how to say just what the doctor ordered. One of the hallmarks of mental illness is a proclivity toward manipulation. I'm not saying all psych patients manipulate. Only the ones who are breathing. That probably sounds cynical but it's true. I think it goes with the territory. Some of these folks are severly depressed, some are manic. Some are hyper, some are sad. Some see and hear things that aren't there. Some have PTSD from flashing back to things that WERE there but aren't anymore. The common denominator is fear. And when people are afraid, they do whatever they think will make them feel better.

What does this have to do with feeling special? Psych staff in general and nursing and med students in particular are vulnerable to having a patient confide in them, respond to them, act like no one has ever taken the time to listen to them before. This is heady stuff to someone just coming onto the ward, especially if they were apprehensive to begin with. You get told a few times that you are really helping them, that you are making a difference in their lives and it feels pretty good. If you recognize what's happening and resist getting a big head, the whole dance can be quite interesting. If, however, you start believing that you and your patient have a "special" bond, you can end up getting sucked into staff splitting, ego tripping, and making mistakes where safety is concerned.

I don't mean to sound like a grinch. I liked psych enough to pick it as a specialty. I just want any newbies to be prepared. Probably the most important thing you need to know about psych (and this will give you some protection against being manipulated) is that whatever is attempted or done by a patient isn't personal. It can't ever be about you. It is always about them. Healthy skepticism is a good thing on a psych unit.

I wish you the best.

Miranda F.

stressgal, RN · Jun 25, 2005

Wow, great advice rn/writer! I just completed my psych rotation and LOVED it. In some ways that makes me feel bad, because so many of the clients/kids were suffering from awful issues/illnesses. But it was a field I can see myself persuing in the future. Even if I'm not, I gained soooo much insight into "normal" clients actions.

Is it possible for you to access the professor's web site or get a reading list from a previous student? I have found this the most useful way of preparing for an upcoming class.

The most common comment I heard from those who didn't like psych were " I understand it, I just don't agree with it."

Good luck, and just keep an open mind.

IttyBittyCritty · Jun 25, 2005

Wow Rn Writer! :eek: I Don't think it's possible to get a real life perspective like yours from Nursing School. Your advice is really going to help me "connect the dots". I appreciate everyones insight. I have 2 aunts in Nursing school/ Psyc rotation as we speak. I will definately invite them here to read this. There is no telling what we will be learning this semester considering we were out of school 1 month for "Ivan". We are still behind, and no one in my class has even started an IV to say the least. I couldn't imagine my first administration being a psyc patient...YIKES! Hope the best for me. And again, thank you q one for your advice.

suzy253, RN · Jun 26, 2005

Excellent advice Miranda!

Havin' A Party!, ASN, RN · Jun 27, 2005

Thanks for thr great info, rn/writer!

(P.S. Do you also write as a hobby? Please elaborate if you care to. Thanks.)

rn/writer, RN · Jun 27, 2005

Thanks for thr great info, rn/writer!
(P.S. Do you also write as a hobby? Please elaborate if you care to. Thanks.)

I don't write as a hobby. Writing is my other career. So far, I've kept the writing and nursing fairly separate. Every once in a while, I wonder if there is a way for me to combine them. I know others have done this. I just haven't found the right project yet.

crb613, BSN, RN · Jun 29, 2005

I worked in psych for quite a while but didn't see the nursing students that came to our hospital because I worked night shift.
I can give you a few pointers, though.
Read your text book ahead of time. Get familar, not only with the commonly prescribed psych meds, but their side effects and adverse reactions. EPS--extra-pyramidal side effects--are something you should be aware of in patients taking anti-psychotics. If a patient starts showing signs of this kind of problem and they are not immediately taken off the offending med and given the proper treatment, the symptoms can become permanent.
Some psych meds make patients vulnerable to heat. One reason is their thermoregulation becomes compromised by the med. The second, and more serious reason, is that their ability to sense a rise in their own or the ambient temperature becomes impaired at the same time. This is like playing with matches inside your house while disabling the smoke alarms. A few years back, before this was widely known, we had a long, hot summer where something like 8 people in our metro area were badly affected by their anti-psychotic meds and several of them died.
Never turn your back on a psych patient. The sweetest old lady can become a tiger in a heartbeat. Ditto for little kids. Just as nurses develop and "antiseptic conscience" and a super awareness of contamination, psych staff have to develop a safety conscience that sets off alarm bells when something just isn't right. Maybe the clues are so subtle that you just can't put your finger on what's wrong. Nevertheless, follow your gut. Get yourself out of the situation and ask for help, if need be, to figure out what tripped your trigger. We have those hairs on the back of our necks for a reason.
Resist the urge to feel special. Psych patients, as a rule, like attention. Many have become treatment-wise over the years and know how to say just what the doctor ordered. One of the hallmarks of mental illness is a proclivity toward manipulation. I'm not saying all psych patients manipulate. Only the ones who are breathing. That probably sounds cynical but it's true. I think it goes with the territory. Some of these folks are severly depressed, some are manic. Some are hyper, some are sad. Some see and hear things that aren't there. Some have PTSD from flashing back to things that WERE there but aren't anymore. The common denominator is fear. And when people are afraid, they do whatever they think will make them feel better.
What does this have to do with feeling special? Psych staff in general and nursing and med students in particular are vulnerable to having a patient confide in them, respond to them, act like no one has ever taken the time to listen to them before. This is heady stuff to someone just coming onto the ward, especially if they were apprehensive to begin with. You get told a few times that you are really helping them, that you are making a difference in their lives and it feels pretty good. If you recognize what's happening and resist getting a big head, the whole dance can be quite interesting. If, however, you start believing that you and your patient have a "special" bond, you can end up getting sucked into staff splitting, ego tripping, and making mistakes where safety is concerned.
I don't mean to sound like a grinch. I liked psych enough to pick it as a specialty. I just want any newbies to be prepared. Probably the most important thing you need to know about psych (and this will give you some protection against being manipulated) is that whatever is attempted or done by a patient isn't personal. It can't ever be about you. It is always about them. Healthy skepticism is a good thing on a psych unit.
I wish you the best.
Miranda F.

Great advice!! I loved psych & think this is probally where I will end up. I might also suggest for testing purposes use your NCLEX book, I used Saunders it covers alot & helped me ace the tests. Good Luck