I am due to graduate nursing school in December of this year. I feel a very strong pull toward psychiatric nursing. I discovered a thread on this forum entitled "A Day in the Life". It asked what the average day was like for a psych nurse. None of the replies included much in the way of talking to the patients (like we did in nursing school).
I do not want to be naive in my decision to enter the field of psych nursing. What interested me in this field was based on my clinical experience in school. We did not dispense medications or chart, we focused solely on therapeutic communication, which I found to be immensely gratifying.
Of course I realize that charting and med dispensing are key functions of the job, but I am wondering if there will be enough face time with the patients in order to feel like I'm making a difference. Or is psych nursing just like med surge in that it's mostly rote tasks and you're lucky if you get time to actually address the patients psychosocial needs in a genuine way.
Actually when I had my three-month "so how is this job that you chose out of nursing school?" my response was "Seriously? A lot more paperwork."
Depends on what happens during the day, a patient visitor who isn't stable themselves ended up with 2.5 hours of paperwork and meetings with four different people to recount the event, make sure we were in the legal right, etc. (BLERGH!) or they're ill and need to go to ICU and you really can't focus on anything but getting/keeping them stable until there's a bed or an admission, I think our last count for paperwork was 34 pages and that definitely ties you up for at least an hour and a half, and that if they're communicating appropriately and you don't have to hunt down old charts or their auntie Mertle to get an idea of their history!
I'd say on a regular day, though, I get about 10-20 minutes per pt. to talk to them and get a good idea about how they're doing. We do a community meeting once per shift and we're to have an RN in those, and I always try to go because it helps a lot - are they agitated sitting still? What's their affect? Are they responding appropriately to questions? etc. We've been trying to develop nurse-led groups but they haven't been happening much - which is too bad, I liked doing them.
hello everyone! i worked in a state psychiatric hospital for 3 years as a mental health technician. i worked 3rd shift, 11pm - 7:30am. the rn's did nothing but paperwork, the lpn's gave out the medications and we did the rest... vital signs, urine and bowel collections, baths, and only spoke to patients during all of the commotion. during the day the patients had either group or an activity. sometimes they did nothing at all. they would see the psychiatrist maybe once while they were there and would be lucky if they got to see the doc twice during their time there. treatment plans would be written but not carried out. medication was just about the only treatment they recieved. i know it is sad.
someone said the state hospitals have good benefits and good pay??? from experience, i am sorry but i have to disagree with you. of course everything i mentioned in this post is my experience. i would love to hear experiences others have had. :typing
I'm definitely more interested in a long term care setting (VA, state hospitals, etc)...so perhaps more communication can take place there as opposed to the "in-n-out" short term units. From what I've been able to learn, state hospitals pay less, but the health care and other benefits are better. Because my husband is a nurse, I would be able to accept a job that didn't pay new grads as much as other jobs. I figure as long as I'm doing what I love, I can live with a few dollars less per hour.
If I had to do it all over again, I definitely would have chosen psychology with the aim of doing psychotherapy. I'm in my last semester so I'm a bit stuck, but not forever.
I do have exceptional time management skills, perhaps that will help me perform my other duties and still carve out enough time with my patients in order to really communicate with them.
It's always good to know what I'm in for, lol. Glad I asked so I didn't end up thinking that my psych rotation during nursing school was a representation of what the job was like. Too good to be true
If I had to do it all over again, I definitely would have chosen psychology with the aim of doing psychotherapy. I'm in my last semester so I'm a bit stuck, but not forever.
It's always good to know what I'm in for, lol. Glad I asked so I didn't end up thinking that my psych rotation during nursing school was a representation of what the job was like. Too good to be true
Nurses salaries are much higher than psychotherapists, but you may need to search around a bit to find a nursing job that comes close to fulfilling your desires to do therapy.
I am an inpatient psych nurse. When I started back in 78, we had patients for months to years, We did group therapy, family therapy (as a co-therapist),movement therapy, art therapy, and (not kidding) horticultural therapy; individual's with primary patients we knew very well. Do I miss the old days? well yes and no. The downside was that we kept people hospitalized (confined, but they did "earn" grounds status and passes home for the weekend) until they were "well". It was probably too long. As in politics, the pendulum swung way too far in the other direction, so that people were hospitalized ONLY until they could go 15 minutes without suicidal intent. I'm hoping we can find a balance during my career.
In New England, where I work and live, the state hospitals have waiting lists longer than the high end rehabs. Hence we discharge people to the high stress living environment of homeless shelters (and Hey, they are doing the best they can!). We have no long term care, like I hear the South still does.
So, what do I do at work? Crisis intervention! Do I make a difference? I hope so. Do I spend an hour or 2 with the family of a newly diagnosed schizophrenic/bipolar/MDD? Yes I do, even if that means I dont leave on time. Why? Because I hear from a patient or their family, that during their darkest hour, they found a human being willing to offer compassion, support, humor (gotta have that), an ear, and information. Do I hear it daily? Absoulutely NOT! But, I guess I hear it often enough to keep going.
Do we do intensive therapy? NO, that's not fair to our patients. Save the hardest stuff for a person who will be with you for months or years, not those of us who will be there for the short haul, that would be cruel!
I used to want to be a "therapist". After I worked for 1.5 years in a residential facility as the only nurse, and heard about their day to day struggles (the therapists), no thanks. I want to impact at the crisis, not wait for folks to be ready to open those deep doors, years later.
OMG, these late night Olympic shows are making me an emotional floodgate, too passionate about my patients. OH, and by the way, I have known many of my "crisis inpatients" for 25 years. I see them every so often, and they see me.....still there for them. OOPPS, there I go again.
Specializes in telemetry, med-surg, home health, psych.
Nurses salaries are much higher than psychotherapists, but you may need to search around a bit to find a nursing job that comes close to fulfilling your desires to do therapy.
Our therapists have Masters Degrees and salaries are much higher than the nurses. I wish we did make as much as they did !!
I work in a medium-sized hospital (around 800+ beds) with one floor devoted to psych. We have an acute unit, a step-down unit, and a geriatric unit. Sadly, we can't keep staff. I work 3-11 usually. I would say it is an excellent night if you get to sit down for 10 minutes with each of your patients and have 1:1s. Otherwise, you're basically a glorified secretary. You're trapped in the nurses station, facing a wall, charting in the paper chart and documenting in the computer, calling the doctors, doing admissions that take forever, answering the phone that never stops ringing etc. We have one clerk for the entire floor and she works days, plus we have 3 seperate units. We only have 2 LPNs that work the entire floor and we don't treat them any different than the RNs- everyone passes meds and does admits. Nurses don't do groups at my facility and don't attend them either- there's no way a nurse can be off the unit for that long. We're lucky if anyone ever gets a lunch. The counselors do one group per day, except Thursdays when they do 2. We haven't had a recreational therapist in almost a year and heaven forbid the counselors work eves or weekends, so the pts have nothing to do during those times. Truthfully, I enjoyed being a CNA much more than an RN. I actually felt like I was improving people's lives and helping them. This job is miserable.
Specializes in telemetry, med-surg, home health, psych.
I work in a medium-sized hospital (around 800+ beds) with one floor devoted to psych. We have an acute unit, a step-down unit, and a geriatric unit. Sadly, we can't keep staff. I work 3-11 usually. I would say it is an excellent night if you get to sit down for 10 minutes with each of your patients and have 1:1s. Otherwise, you're basically a glorified secretary. You're trapped in the nurses station, facing a wall, charting in the paper chart and documenting in the computer, calling the doctors, doing admissions that take forever, answering the phone that never stops ringing etc. We have one clerk for the entire floor and she works days, plus we have 3 seperate units. We only have 2 LPNs that work the entire floor and we don't treat them any different than the RNs- everyone passes meds and does admits. Nurses don't do groups at my facility and don't attend them either- there's no way a nurse can be off the unit for that long. We're lucky if anyone ever gets a lunch. The counselors do one group per day, except Thursdays when they do 2. We haven't had a recreational therapist in almost a year and heaven forbid the counselors work eves or weekends, so the pts have nothing to do during those times. Truthfully, I enjoyed being a CNA much more than an RN. I actually felt like I was improving people's lives and helping them. This job is miserable.
Oh what I would give for a unit secretary !!!! Too much time wasted answering the phones, for sure....Our nurses have been told not to lead groups any longer, the therapists are doing that now...It does give us more time, but we are not able to adequately assess all pts. q d. We had 34 pts. with 2 RN's, countless blood draws, EKG's, wound cultures, etc, etc...we are beginning to look like a med-surg floor...no time to talk to each pt. it seems....With all the discharges and admits, it leaves no time to really talk with each pt.....only the ones that act out and you must address....several of us are getting burned out quickly.....we have lost 5 RN's in the past month.....unable to hire anyone, either....
don't know what it going on but am ready to pull out, too....
Sorry for the vent, but thanks to all.....:redbeathe
In the first inpatient unit I worked, we barely had time for therapeutic communication because we were trying to keep the patients from killing us and each other (mostly prison population)...the second place was WONDERFUL...after the first round and assessments were charted, I spent a great deal of time with my patients (in addition to all that other stuff we must do LOL).
I now work in a county mental health clinic and it has by far been the most gratifying as far as communication and education. I see the patients when they're stable and functioning, and I get to do a TON of education by running medication classes, a diabetes class...also I see some patients every 2 weeks for injections and I get to know them...it's wonderful!!
I guess the degree of communication in which you get to engage depends on your facility and acuity of the patients on the unit.
Specializes in psych, addictions, hospice, education.
Psych nurses can be very busy, just like all nurses can be busy. However, I've seen , in two different psych hospitals, that sometimes it seems to be the usual that psych nurses stay in the nurses' station and visit with each other in times they could be out with the patients. I've taken students to psych hospitals for a lot of years. One comment they make is that the nurses don't have hardly any patient contact. I think those that don't leave the nurses' station but DO have the time to do it, should. One of our best tools in helping people heal is through therapeutic use of self! Besides, it's interesting!
CrescentLuna
20 Posts
Actually when I had my three-month "so how is this job that you chose out of nursing school?" my response was "Seriously? A lot more paperwork."
Depends on what happens during the day, a patient visitor who isn't stable themselves ended up with 2.5 hours of paperwork and meetings with four different people to recount the event, make sure we were in the legal right, etc. (BLERGH!) or they're ill and need to go to ICU and you really can't focus on anything but getting/keeping them stable until there's a bed or an admission, I think our last count for paperwork was 34 pages and that definitely ties you up for at least an hour and a half, and that if they're communicating appropriately and you don't have to hunt down old charts or their auntie Mertle to get an idea of their history!
I'd say on a regular day, though, I get about 10-20 minutes per pt. to talk to them and get a good idea about how they're doing. We do a community meeting once per shift and we're to have an RN in those, and I always try to go because it helps a lot - are they agitated sitting still? What's their affect? Are they responding appropriately to questions? etc. We've been trying to develop nurse-led groups but they haven't been happening much - which is too bad, I liked doing them.