Child Psych? Your opinions...

cdoesc · Aug 22, 2011

I have worked in a psychiatric long term facility dealing with adolescents for about 5 years, and all I can say is that I really love it. Sure there are good days and bad days. Some kids have a long road ahead of them and its discouraging, but when there are break throughs and successes, it makes it all worthwhile.

Jules A, MSN · Aug 23, 2011

I enjoy working with adolescents more than the under 12 crowd but they are ok. Definitely do a share day first.

ajt575s · Aug 23, 2011

Can you do a job shadowing day? I work in adult psych but float down to our peds unit also, and I've been surprised to find that I enjoy it and find it very rewarding. Like one of the other posters, I tend to enjoy working with adolescents better than pre-ads.

nursemelyn · Aug 23, 2011

Can you do a job shadowing day? I work in adult psych but float down to our peds unit also, and I've been surprised to find that I enjoy it and find it very rewarding. Like one of the other posters, I tend to enjoy working with adolescents better than pre-ads.

I've asked the nurse manager if I could come see the unit, and I've turned my application in so I'm hoping to hear back from her soon! I think the unit is mostly adolescents. My husband has seen the unit (he's in med school, interested in psychiatry) and said they assessed mostly teens. I really want to like it!

gnursjr2 · Aug 23, 2011

I personally have had my worst days as a psych RN on the adolescent unit, that's what my grey hair is from. It was heart breaking, and it opened a world that I never in my wildest imagination knew existed. I would say that 99% of the kids had been thru horrible trauma - sexual or physical/both usually. A lot of cutting, suicide attempts, 1:1's, self harm, attacking staff etc. etc. I personally like working with the adult pysch patients. Good luck.

stephva1008 · Aug 23, 2011

I am the nurse manager of a child psych unit and wouldn't do anything else. You will likely either love it or hate it. The nurses that stay say "this is what I went to school for, to help people." The ones that leave say, "This isn't real nurses (they aren't doing IV's, etc. Usually the new grad).

Definitely do a job shadow, every facility may have a different job description for RN's. The nurses on my unit function as a counselor, they take a patient assignment, process issue work, do 1:1 counseling with the kids, lead groups, etc. Nurses on other psych units function more like an adult psych nurse (meds, glucs, etc) and they may have a "case management" model (i.e. an LPC does therapy with the kids and leads the groups and the psych techs do 15 min checks and support, nurses pass meds and handle medical issues, etc).

We see kids ages 4-18 and are a 20 bed acute unit, our average LOS is 5 days (was 7-10 a few years ago and we could do a lot more with the kids. Now the insurance companies are putting the squeeze on our LOS. Basically, as soon as they are no longer a danger to self or others, they are pushing for discharge. This could be as early as day 1. Very frustrating but that's another thread...)

The littles are more challenging for most of our staff but some staff really love working with them. We use an acuity model to staff and the littles are often 1:1 with staff because they are so "off the hook" hyper or aggressive.

I get more fulfillment from the teens who are having their first psychotic break. The reason is that they respond well to medication, clear up, and you really can see what you've done (their LOS is 10-14 days).

Everyone has a different population they like. Do a shadow and see what you think.

Good luck and keep us posted!

allnurses Guide · Aug 24, 2011

I worked in a child psych unit for 1.5 years, and did not like it at all. I agree with the person who said that you will either love it or hate it. I thought going into it, that it could be my dream job. I loved kids and I loved psych. However, the combination was not so great for me:uhoh3:.

I did enjoy working more with the children, mostly older children 10,11 or so, who had genuine organic psych issues. I did not enjoy working with the little kids who's behavior was largely a result of their environment. In child psych, you will encounter a LOT of children who have been horribly abused and neglected, and of course this background affects their behavior dramatically. It can be very depressing as well, hearing about their stories.

It can also be very rewarding though, if you are truly able to make a difference in the lives of these children. It can be done.

I will also say that I enjoyed working with the adolescents a little bit more... but all in all I prefer adults.

Yosemite, RN, ASN, EMT-I · Aug 25, 2011

I've never worked child psych, but I'm sure of the heartbreak. I've done my share of adolescent psych, though. Like any other age group, it's a mixed bag. Lots of difficulty understanding how adults and parents could ever contribute to hurting children. Some success and joy at times. Again, heartbreak when seeing the same faces over and over again. And, if that isn't enough, there are the few who have developed terrible personality disorders... "gangbangers" and "wanna bes," hardened teens who are set on hurting others, themselves. I've had these unfortunate ones tear up the unit, attack other kids as they set the scene of their stay and make it known that they are in charge, KNOWING there is little staff can do to them. I've heard numerous teenagers proclaim they are destined for prison and have literally set this as a goal.

For me, the few "success stories" were not enough to even out the disaster stories and even the injuries sustained. Maybe that facility was unique in its clients and administration/treatments/sucesses/failures. What ever you decide, shadow a few shifts, if possible; talk to staff.

kdrose01 · Sep 4, 2011

The nurses on my unit function as a counselor, they take a patient assignment, process issue work, do 1:1 counseling with the kids, lead groups, etc.

Thank you so much for posting this response! I've just had the lousiest day on the clinical floor and was considering dropping out of nursing school, but this description matches me exactly! Now I remember why I started nursing school in the first place - this is exactly what I want to do! I really, really want to counsel people and have since I was a teenager. Now at 32, I'm finally on my way! I just wish I'd known back then that nurses, and not just psychologists, counsel people. Thank you! I will be much more positive about my telemetry rotation, since it's just another hoop for me to jump through in order to reach the goal. Yay! I'll be able to sleep tonight instead of lying awake, wondering why on earth I'll have to drag my tired butt out of bed to do something I don't want to do tomorrow.

xtxrn, ASN, RN · Sep 9, 2011

I worked adolescent psych for a couple of years, and really liked it. Very true about the horrors in their background. Back when I worked there, we kept kids for months, and many cried when they had to leave (tried to get long term placement as much as possible). Some nights were crazy (I worked 7p-7a). Most of the kids just wanted someone to hear what they had to say, and not be ignored, abused, insulted, rejected, abandoned....

Sexual abuse was common in their backgrounds. One kid had a stepdad (I think it was stepdad) BITE the kid's finger off because he got ticked off at him :eek: Most had some significant issues that they didn't know how to verbalize, so they'd act out.

I floated to the kids unit to help the nurse there time contractions on a 12y/o...her dad's baby. That kid was terrified.

It could get really overwhelming, but it was also really rewarding, and I learned a lot :)

aloevera · Sep 13, 2011

A great big "KUDOS" to all adolescent psych nurses........ I worked youth for two years after working with adults.........I left and went back to adult psych...It was just too overwhelming and heartbreaking for me....

The kids stories of the tragedies that they have endured just wore me down...I had to deal with the parents also...and that was harder than the kids. After meeting the parents, 9 times out of 10 you knew why the kids were the way they were.........We did help some, medication and therapy, but knowing some were going back to the same home situation really took its toll on me.

We also had a lot of frequent flyers, those we could not reach. Way too depressing for me...........But I admire those that can do it immensely !!!!