Child Inpatient Psychiatry or Psychiatric ER?

angelmomjr · Oct 2, 2016

Congratulations on your future as a nurse! Stressful situations occur in NICU, postpartum and just about any area of nursing. Birth, death, illness mental and physical, life changes marriage, divorce, nursing school all stressful in their own ways. It depends on your investment and ability to care for yourself, take time off and other outside interests.

Violence occurs in most areas of nursing. ER violence is well documented. Any psych work can be violent, it is one of those learning times on developing the "eyes in the back of your head" or the ability to "sense" the atmosphere of the unit. You are taught de-escalation techniques and CPI. This ability to sense the vibration of the unit is something that I developed over years of working in psych. I was able to listen to the unit and know when there was something that was going to happen. Something I don't know how to teach or explain to you.

As for children versus adult, I've worked both and prefer kids and adolescents but after 20 years I was burned out. I became too enmeshed. That being said I enjoyed working with the kids. I remember after a snowfall, grabbing trash bags and going out with the kids for sledding. Also worked with a company that had a Prom for the teens. I now am working in addictions(which is classified a part of psych).

Any type of nursing can be rewarding and enjoyable. You just have to have an open mind and be able to "look out of the box". One of the many benefits of nursing is that there are so many different areas in nursing. I have also worked in ICU, blood drives, home care, forensics. Enjoy and have fun whatever it is you do.

Jules A, MSN · Oct 3, 2016

Ahhhh the kiddos, the above poster reminded me of my first nursing job when there were nights on the inpatient pediatric psych unit that I would tuck in and read bed time stories to patients after meds and the other nursing tasks were complete. I can remember thinking I can not believe I'm getting paid to do this! That was one of the brighter moments but of course there were also melt downs, fights, tears and the background stories of severe neglect and abuse. Over all I loved it but it wasn't imo exactly psych nursing, more behavioral and bad home situations for the most part. In adolescent psych you start to see more true pathology but there the danger level is even higher and not as much true psych variety as adults. Of your choices you will probably learn more psych stuff in the ED but if you are worried about violence in my experience that was a more dangerous area of nursing and it will probably be more fast paced and overwhelming for a new grad. Good luck with whatever you decide.

Nature_walker, ASN, BSN, RN · Oct 3, 2016

I'm a new nurse and I work on a psych ED floor. I have to say I love it. It is hard work, but I think all nursing jobs are hard. One thing to remember that in psych ED we see people on the worst day of their lives. They are often unmedicated, often brought in against their wishes and not generally too happy to be there. That being said, I have met some amazing people where I work and it is a fast paced environment.

Meriwhen, ASN, BSN, MSN, RN · Oct 4, 2016

I honestly really thought I wanted to work in the NICU or Postpartum (hence my username:sorry:)

If you want to change your username, go over to How do I change my username, password, or email address? – allnurses.com Help Desk as that will tell you exactly how to do it.

Look at the timeframe aspect of things: in child psych, you're going to be working with a specific population for a longer duration. There's going to be some measure of stability and consistency because you'll know (generally) what psychiatric conditions you're going to see frequently, you'll know that they'll always be pediatric, you've a chance to get to know the patients since they're there longer, and you can really see how they progress over time. The potential for stress and violence is always there, as in any psych setting.

Whereas in a psych ER, you will meet a wide variety of patients and see almost every psych condition there is. You literally will never know what will walk--or be carried--through that door. But just like in a regular ER, your goal is to stabilize and move them on out, whether out is back on the street or to a higher level of care. It's uncommon to have a patient in the psych ER for more than a day or two. For you to really learn about how psych conditions affect patients, you're going to have to do a lot of reading up on your own, because you're not going to get to know the patient in-depth, nor have the ability to see the psych condition progress with time and treatment.

Having done both, I prefer psych ED only because I have a hard time working with kids of any population.

kingvonnBSN2017, BSN · Oct 6, 2016

Thank you guys for the reply! I've been doing a lot of consistent research on different psychiatric units and one that I have recently come across is geropsych. Working with the geriatric population is something I would love, I was never the biggest fan of pediatrics (other than neonates). Any of you guys know anything about working in geropsych?

Jules A, MSN · Oct 7, 2016

Geri is challenging but an excellent specialty niche. It is a sub-specialty usually in even more demand that psych already is because so few have a tolerance for it.

B52Bomber · Nov 23, 2016

I worked in an emergency psychiatric crisis center at a level 1 trauma center and not one patient or scenario was similar, including our frequent fliers. Our clientele included anyone from the pleasantly confused elderly woman to older individuals who were in prison for +20 years after committing vicious crimes and trying to reaclimate themselves. Never a dull moment, especially in triage where they're brought in by PD or EMS right off the streets requiring emergent care. I really learned to be creative working with my patients and after 2 years, I was the only nurse on that unit that was never injured or attacked by a patient. I've also worked PHP programs with children and adolescents and it just wasn't as exciting or satisfying.