cna in psych vs med/surg renal pulmonary

[bluewater]

hi, i recently interviewed for a position similar to a cna position at a hospital, on a med/surg renal pulmonary floor. the position is PRN, with duties comprising being a unit clerk half the time, and patient care the other half. i have another interview coming up for a full-time psych position (PRN is available, but i'd prefer full time) at a psych hospital on a floor with adult patients who have thought disorders. when i interviewed for the med/surg position, the unit clerk i talked to said it would be very stressful due to the position being an evening shift, when a lot of admissions happen.. i'm not sure how the psych position will be, but i'm wondering, if people here have experience, which of these positions might be better if i have the opportunity to choose? i know that the psych one would be less invasive, since the patients here don't have ivies, etc.; however, i'm interested in medical school in the future, and don't know which one might be better to get the most experience. i've never worked on a psych floor, and am a little nervous, but i know that it would probably expose me to a unique group of patients...i'm not really interested in the unit clerk portion of the first job, but i would have to do it if offered the job.

thanks so much for your assistance and time!

[casi, ASN, RN]

I would go with what one you think you would like better, not which one would give you the most experience.

[AJPV]

One thing to keep in mind is that psych facilities all around the US have been shutting down in droves over the past decade. The funding isn't there to support them. There is a lot of financial pressure to not admit a psych patient for inpatient treatment unless absolutely, absolutely necessary (ie, they are threatening suicide in an ER). The # of psych beds per capita in most cities has shrunk by about 80-90% over the past few decades. There are new announcements of psych facility closures in our city every year.

[ddunnrn]

Psych units tend to be mentally draining more than physically, I think. Will you be responsible for physical interventions with the patients? For example, physically restraining violent or self-injurious patients (under appropriate direction, of course), or there be some sort of security staff that do that? You may have some unpleasant hygienic problems to deal with, but you might have that on a medical unit, too. Depending on your facility's rules, you may have to supervise patients' smoking, which becomes a major health risk for you. I have never been a nurses aide or equivalent on a psych unit, but I was one in a nursing home, and I would say that to the outside, lay person it looks like the psych tech (one of several names for these positions) has a lot more "down time", but that it not really the case--you always have to be ready for a crisis to occur, and mental patients can be very unpredictable, especially with the prevalence of dual diagnosis (drug abuse and mental illness). It just occurred to me that the psych tech also has a lot more paperwork to do--documentation of suicide watches, one-to-ones, and rounds, etc.

Concerning psych units closing, if you can find a position in a teaching hospital (connected to a med school of some sort), the position would be more secure, because med schools have to provide in-patient psych experience, and it is usually most efficient for them to have their own units. I can only speak for my urban area (Philadelphia), but experienced psych techs here have a variety of places to work.

Please feel free to email me if you have any more questions.

[bluewater]

Psych units tend to be mentally draining more than physically, I think. Will you be responsible for physical interventions with the patients? For example, physically restraining violent or self-injurious patients (under appropriate direction, of course), or there be some sort of security staff that do that? You may have some unpleasant hygienic problems to deal with, but you might have that on a medical unit, too. Depending on your facility's rules, you may have to supervise patients' smoking, which becomes a major health risk for you. I have never been a nurses aide or equivalent on a psych unit, but I was one in a nursing home, and I would say that to the outside, lay person it looks like the psych tech (one of several names for these positions) has a lot more "down time", but that it not really the case--you always have to be ready for a crisis to occur, and mental patients can be very unpredictable, especially with the prevalence of dual diagnosis (drug abuse and mental illness). It just occurred to me that the psych tech also has a lot more paperwork to do--documentation of suicide watches, one-to-ones, and rounds, etc.

Concerning psych units closing, if you can find a position in a teaching hospital (connected to a med school of some sort), the position would be more secure, because med schools have to provide in-patient psych experience, and it is usually most efficient for them to have their own units. I can only speak for my urban area (Philadelphia), but experienced psych techs here have a variety of places to work.

Please feel free to email me if you have any more questions.

Thanks so much for all the responses! Actually, this position is in a well-establish psych hospital, but I can ask about funding issues when I interview.. from what I've been told, the psych assistant's duties are to observe patients, check blood glucose levels, take vitals, perform EEGs, update urine samples, sit down with patients, and facilitate groups--there's probably more, but this is the gist. Since I've never had a CNA job before, this is all very new to me, so this is why I was seeking advice from you people who are very experienced and knowledgeable about all this. Unfortunately, I cannot send a PM yet because this is only my second post.

Anyway, thanks so much for your help!