Bias in psychiatric nursing...how do you overcome it?

romie · Apr 11, 2006

Expect the unexpected. I used to work with children with behavior disorders. Most of these children have seriously harmed other children (including one little 5 year old who killed his twin brother) and most have sexually molested other children. But at first glance, these were the sweetest and cutest children you have ever met. Do you think you would have a hard time working with them?

RNin2007 · Apr 11, 2006

Expect the unexpected. I used to work with children with behavior disorders. Most of these children have seriously harmed other children (including one little 5 year old who killed his twin brother) and most have sexually molested other children. But at first glance, these were the sweetest and cutest children you have ever met. Do you think you would have a hard time working with them?

I guess because I have never been around these types of people (children even in your situation) I can't even imagine a 5 year old capable of murder. It is only what I have heard on TV/news and you know how beautiful of a picture the media paints...

I just don't want my inner-reaction to interfere with what needs to be done, you know?

~J

romie · Apr 12, 2006

I guess my point is that there is a moment when the evil that someone does kind of fades in the background and allows you to deal with them as a person. Of course, with dangerous and violent people you have to always keep one eye open and have policies in place to protect the staff and other patients. With the children, there was always at least one set of staff eyes on them at all times and most of the training we recieved related to policies and procedures to maintain safety at all times.

Someone once said in nursing school that because she opposed abortion, she wouldn't provide nursing care to someone who had an abortion. If a woman who was injured as a result of an abortion landed in her care(hypothetically speaking, let's say this isn't an abortion clinic and the nursing student wasn't even in the same part of town that the abortion happened), this nursing student would let her personal biases get in the way of being a nurse.

But this situation is more about letting your morals dictate who you think deserves your nursing care as opposed to how you deal with your visceral reactions to certain patients.

RNin2007 · Apr 12, 2006

Thank you for your insight and sharing your views with me. That was really helpful in my own thinking processes.

I highly doubt I could ever deny a patient, no matter what was involved. I really like what you said about circumstances fading into the background...

~J

CharlieRN · Apr 12, 2006

I focus onthe fact that this person, not his or her victim, is my patient. I am responsible for the welbeing and healing of my patient , not the world. I am his or her advocate. At least until my patient becomes a treat to someone else, their conserns come first. This is not really all that hard once you have gotten into the "non judgmental" mind set.

MarkRN · May 1, 2006

I think that those of us in Psych need to frequently do some self-reflection and assessment into what population(s) seem to irritate us the most. For example, many nurses have difficulties with personality disorders (i.e. borderlines, antisocials, etc.) and patients with substance abuse issues. I think an important part of psych nursing is to acknowlege these feelings and share them with their fellow nurses so that they can receive the additional support they need. Likewise, we need to return this favor to other nurses who have issues with other types of patients. This is crucial to avoid negative countertransference toward patients and to help prevent our own burnout in this profession.

Red Wing Magnolia · May 1, 2006

I have spent many years working with the mentally ill / mentally retarded and have found the work very rewarding. Many a nursing friend has said to me "I couldn't do what you do." The truth is, there are field of nursing that I don't know that I would enjoy as much. I think that is the key to having a successful nursing career. I now work for a state mental health program office and monitor a program the state contracts for sexually violent predators. I am sad to say I have seen the nurses act very unprofessional toward the men. Their actions and words are at time very harsh, cold, and appear uncaring. When a nurse finds him/herself that unhappy, I would hope they would move on to another challenge. These men may have committed terrible crimes but their crimes are not for us to judge. They have served their debt to society in prison and then, when they are due for release, they are placed in civil commitment, a locked jail-like environment for treatment because they are a risk to society. Nurse must carry out the responsibilities they have accepted when they agree to the job and they must leave their emotions at the door when they arrive at work. If you can not do this, please find the population that you can serve well and with joy in your heart. It is every nurses' responsibility to perform their work in a manner that maintains respect for our profession.

RNin2007 · May 1, 2006

I've enjoyed reading all your responses...thanks everyone. I am also really, really enjoying my rotation in the psychiatric unit! A little slow at times, but it's turning into an unforgettable experience, and I am learning a lot.

~J

Psychaprn · May 10, 2006

I've enjoyed reading all your responses...thanks everyone. I am also really, really enjoying my rotation in the psychiatric unit! A little slow at times, but it's turning into an unforgettable experience, and I am learning a lot.
~Good luck with your psych. rotation. I think it's critical that anyone who works in psych. have regular clinical supervision and/or personal psychotherapy. You must understand your own feelings and behaviors to do the best job with psychiatric pts. Even among experienced psych. nurses, there may be times when you can't work with certain pts. due to strong negative feelings and if possible you should have someone else work with that pt.(i.e. you were sexually abused and are asked to care for a sexuaL predator or victim). When possible maybe you can negotiate with another nurse to care for that pt.

lisabeth · May 14, 2006

I imagine it would be a very difficult field of nursing to be in, but I just cant help it, I have always been interested in it. I know for some, there is no real treatment. In many cases it is because the person thinks they are the only one who doesnt have a problem.

romie · May 14, 2006

I think another idea that can help people with their bias in pysch nursing is to realize that everyone fits at least one diagnosis according to the DSM.

Also realize that there is bias in other areas of nursing. For example, some nurses may harbor negative feelings towards bariatric patients-- morbidly obese individuals with mulitiple health problems because some nurses think that these individuals brought these problems apon themselves. It may be the same case with other "lifestyle diseases".

I personally tend to have more bias towards "normal" non-patient people because they at least supposedly have more control over themselves. My patients, well, it isn't their fault they are mentally ill, mentally retarded, developmentally disabled, have dementia, ect.