CNA's in Psych settings

phil evans · Nov 4, 2003

hi mike. what is a CNA, ? im from ozzy and dont know the term

but i work in psych, done so for about 13 years now, i did some general at the begining, but left it due to the *****ing between the other nurses, ( apoligies to general nurses ) ,

psych is my cup of tea, more relaxed, its not task orientated stuff like a general nurse robot, often the $ is better,

and the interpersonal skills you learn dealing with emotional tradegy at its most worst, can be transplanted into other jobs when you decide to leave

and we need the world wide more males in psych mike,

but bear in mind -in psych you will cure no -one , often there will be so many repeat admissions, and you will see them slowly get worse mentally and physically as the years goes by,

psych nursing is a job done with your gut, the relationships you forge with your paitents, and a sound knowledge knowledge of pathology and meds,

go to the psych wards and give it a go, try it for 6 months, and then you will know,

but if you want to spend your life do tpr bp and temp hourly turns and washing and wiping,

go and enrol with the general nurses,

-it is horses for course, and you may like general stuff many do and the job ( although not my cup of tea ) is satisfying to many and many make a good carear out of it

but try psych

so much diverstiy

see you

FutureRNMichael · Nov 4, 2003

CNA = Certified Nursing Assistant

Larry77, RN · Nov 4, 2003

Hello, I am currently a CNA in a psych unit going to nursing school. I work in acute care...in a hospital inpatient locked unit. What the last person says is totally true, most of our patients are repeats. I have been working there for almost 4 years and have gotten to know a lot of the drug addicted and psychotic people in my community...I don't know if that's good or bad.

My job is basically a peacemaker. I am the first contact person for the patients on the floor. I direct their issue to either the nurse or the counseler who is assigned to them. While sometimes things can get ugly (I've been assaulted numerous times and "beaten-up" once), usually our atmosphere is much more relaxed than the other units. On our floor as apposed to the other floors the worst thing that happens is someone gets hit...noone has died (knock on wood).

Anyway if psych is for you, you will know almost right away. It takes a very special person to be able to work with the mentally-ill and it is obvious if you have what it takes to succeed almost on your first day.

Plus you will have stories like no others!

Good luck,

Larry

FutureRNMichael · Nov 6, 2003

Thanks a lot Larry. I would really like to work inpatient Psych unit.

What type of tasks do you normally do there?

Also, Do you know whether CNA's are used in Adolescent Psych Units?

laurenkst · Nov 6, 2003

Hi Michael:

I'm a nurse educator in a State Psychiatriatric Facility. We have a Geriatric Facility where most of our CNA's work. There

are other CNA's who have worked on the Geriatric units who are positioned throughout the hospital, but a majority work in a Geriatric Building that handles Psychiatric Patients who have developed physical problems. They are and have been patients for a long time on the active units, but when they developed problems that required them to be more closely observed they were transferred to this division of our Psychiatric Center. The responsibilities of our CNA's focus mainly on keeping the patient safe, providing quality nursing care physically and mentally and

teaching the patients coping skills to deal with their mental illnesses and trying to resocialize this particularly ostracized group of individual. Trying to help them function as well as possible in the environment of their choice is an important part of all employees responsibilities at our facility.

lucianne · Nov 6, 2003

Our facility uses patient care associates who do not have CNA training on the child and adolescent inpatient acute unit. Patient care associates are generally--though not always--collge grads who have a related background such as psychology. We've had a lot of PCAs who were working on nursing degrees, expressive therapy degrees, education, occupational therapy as well as many who weren't working on degrees and had no other related background (and these have been some of the best). We've found that the younger PCAs generally don't work out as well with the adolescents--they identify too closely with the patients or are hesitant to set limits-- and sometimes don't even work with the younger children that well.

Our PCAs are the ones who are on the unit with patients at all times. While our nursing staff is also very hands-on, nursing duties such as admissions, discharges, med passes, orders, dealing with parents and doctors, etc. take us out of the milieu at times. We depend on the PCAs to be our eyes and ears and to let us know if someone needs our attention. Our PCAs do narrative charting on their patient assignments, so they have to develop skills in observation and concisely experssing their observations.

The PCAs spend a lot of time interacting with patients and supervising play. They may assist the nurse in leading therapeutic activities or may lead some well-established activities on their own. They wind up doing a lot of housekeeping, comforting, fetching warm milk for kids having trouble sleeping, reading books, cleaning up boo-boos (and vomit, urine, feces at times), bathing kids (not the adolescents, obviously)....

Oddly enough, very few of the nursing students who work as PCAs end up working in psych when they graduate--or at least not for the first few years.

luci

Larry77, RN · Nov 6, 2003

Michael,

My normal tasks mostly involve keeping the pt's content. I get them everything they need besides medications (food, water, juice etc.) I take their vital signs--which if they're a detox pt can be quite a chore. I guess I'm a glorified gofer. We do do a lot of charting, and basic assessments also (we are the ones most closely involved with the pt's so we have to be able to pick up problems and relay them to the other staff quickly). I have learned other jobs on the unit, like secretary (mostly for practice since I'm going to nursing school), and I took training so I can teach classes to everyone in the hospital on how to interact and restrain with an out-of-control pt.

On my unit we aren't specified to what age group we take care of. Our only policy is we don't take anyone younger than 13. Personally I think teenagers are a big challenge because they sometimes don't have any impulse control. I remember one time I was assaulted by a teenager because I pulled him off his mom who he was beating up because she wouldn't take him home right then. That pt had no remorse involving this incident and my rapport with him was shot from then on.

Larry

phil evans · Nov 6, 2003

Hi leading on from last reply,

violence on a psych ward is endemic, often regardless as to how much meds you use, but often or not the violence does not come from the genuinely psychotic patient

it comes from the axis 2 patient -the personalilty disorder, this group of patients woulod make up at least 25 plus % of any psych ward clientele, anti-social maladaptive behviours with a big dose of entitlement and narracissism, make for a firey time when you the nurse have to limit set there bad behaviours on the ward, and when you do they go and cut themselves or worse, in response, and it how the nurse deals with this behaviour that makes or breaks the nurse for the energy expended when dealing with this group of patients, would suck the life out a dead rabbit.and makes the nurse head toward burnout alot quicker than the genuinely psychotic patient, and then of course as the patient mix changes as it does you can end up with more than half the ward axis 2 , and that makes for a hard time, - if you can learn to deal this this lot -you can deal with anything

psych nursing in australia ,is the most violent job in australia.

Larry77, RN · Nov 8, 2003

In my experience most of the violent pt's have been meth abusers or geri psych pt's. Most of the axis-2 pt's I've dealt with are more harmful to themselves than to staff.

FutureRNMichael · Nov 23, 2003

Lots of great information. I appreciate all of it!

I would think I'd come across trouble working with geri psych patients. I always want to have that warm and fuzzy feeling about all old people in general. Kids I could deal with because Ive been there myself...

lmd32 · Nov 23, 2003

IMHO, unlicensed personel do the real work on the psych ward. They're the ones out there interacting with the patients, implementing behavior management strategies, and often, running groups, providing recreation, supervising work or school, you name it. What you do varies a lot from setting to setting. In short term (