Can anyone tell me about pediatric psych pros/cons??

stephva1008 · Nov 16, 2009

well i guess it depends on what type of hospital you want to work in. residential is different than acute is different that training schools for mr kids.

we are an acute hospital, 16 bed.

you asked about rn role. in our unit, we usually have 2 rn's on, 1 in charge and 1 "in milieu." the milieu nurse will do admissions and take a patient assignment, lead groups, do 1:1 counseling and issue work alongside the counselors.

the charge rn does meds, treatment team, discharges and staffs the next shift.

pros: you get to work with kids and make a difference. you're not just passing meds either, at least where i work. some places are like that though. you just give meds and the psych techs/counselors do the rest . i love my job!

cons:

--you have to work with families who often aren't invested in their child's recovery. it feels like you're beating your head against the wall some days.

--you have to separate their history with their current behavior. we do side hugs only when asked. these abused kids need lots of structure. many of them have had multiple placements and know the system. you can have compassion for them but not take their pain onto yourself. being proactive and teaching them how to cope with the day to day is enough of a challenge. it is hard and the stories are horrific but you'll get used to hearing them and will be able to "leave them at the door" like any other type of nursing once you get grounded.

--you need to have firm limits with the teens and the littles. they can smell weakness. good continuity across shifts helps.

--you might get punched or kicked or spit on (that's true with any kind of psych nursing though).

i've done all types of nursing and i feel this suits me to a t. i'm found home!

good luck! ask more questions if you want!

Squeaky44 · Nov 16, 2009

Thank you so much for your input! I am definitely considering a change to psych nursing. Your job sounds really interesting.l One more question though! Do you know about how residential psych is different? I know you have the kiddos for a long term period. Are more of them MR?? Again I really do appreciate your input! :yeah:

stephva1008 · Nov 23, 2009

Residential is for more chronic behavioral/emotional issues that can't be managed at home. These kids can't function at home or in a traditional school setting. The kids usually go to school on site and stay 6 months to a year. They don't get as much "therapeutic" time as an acute unit. The facility gives them the structure they need and also gives their caregivers a break. In my opinion, you function more as a "pill and paper pusher" than on an acute unit interacting with patients. I enjoy acute much more than residential. On a side note, medicaid is reimbursing less for residential so the push will continue to be to return them to the "community."

HTH!

elkpark · Nov 23, 2009

Residential programs are typically set up for either MR/DD kids or psychiatric kids, but the two populations are rarely mixed (that would be a sign of a place you don't want to work at ...) I've done both acute psych and residential, and one advantage of residential is you do get to spend more time with the kids, get to know them better and form stronger therapeutic relationships, because of the longer LOS, than on acute units, where the kids are constantly coming and going.

I did not feel at all that I was a "paper and pill pusher" in residential treatment -- my experience has been exactly the opposite. I feel that's much more the case on the acute unit in which I'm currently working, where there's v. little time for anything more than giving meds and completing the required paperwork.

kiwipsychnurse · Nov 24, 2009

Cons: some kids maybe classed (

Jules A, MSN · Nov 24, 2009

Cons: some kids maybe classed (
It is a shame that they don't adjust this policy. At my facility they try to match them by more than just their ages and that works well for the most part.

elkpark · Nov 24, 2009

Cons: some kids maybe classed (
In my experience, every program I've ever been aware of (except the place I am currently working!) does not mix children and adolescents, but has separate programs.

Squeaky44 · Nov 25, 2009

I agree with the difficulty with age mixing. As I said I have not worked as a psych nurse, but I was a special ed teacher and taught summer school in a boys home with kids from 5-18 all together. Things could get pretty interesting! I want to thank everyone for the input on this subject. I am know in the process of updating my resume and hope to make the move out of the regular hospital into a residential facility after the first of the year. Wish me luck! :coollook: