Confusion over what psych nursing is really like?

Posted
by PsychNursStudent (New) New

Hey, I'm currently in a psych nursing program and am really passionate about working with the mentally ill. However, I've started to realize that I really don't have a clear picture of what psychiatric nursing looks like on a daily basis. I have friends in the program who keep telling me that its going to be "just sitting there and talking all day", while others say that psych nurses are still mostly concerned with physical care, but specialize in doing physical care and nursing type tasks for individuals who are also suffering from a mental illness (and therefore need to be communicated with in a unique/different way). Could someone possibly clear this up for me so I have a better idea of what I'm getting into?

Thanks

mikayyCNA_

43 Posts

I work as a tech on the psych unit at one of my local hospitals. I love our nurses to death,and of course if the techs ever really really needed their help they would be there. However, their day to day responsibilities (on a 12 hour shift) are only to chart and pass medicine. When we have other nurses float to our unit, they always say it's one of the easiest units that they've ever worked on. I'm in the beginning of a LPN programs and my bosses keep asking if I'm going to stay on the unit. I love patient interaction way too much to stay!

newrpn

Specializes in Pscy / Mental Health. 33 Posts

I love being a Psyc nurse and for me, it's not just passing meds and charting! Today I did my meds and charted for my patients, but susi did mental status exams on all of them, did iv meds and an in and out catheter for my patient q4 hrs, did medication education, diffused many situations, counseled a pt on alternatives to medication for severe anxiety, did 2 dressing changes, passed meds, prns and charted it all!

concretegold91

31 Posts

Love it!! I'm in the program to be an RPN, will graduate in April 2017. May I ask what province or type of ward you work on? IV meds aren't super common in psych, from what I've seen in clinical so Im curious!

canigraduate

3 Articles; 2,107 Posts

Depends on the setting.

In acute care, it's a lot about stabilizing, medicating, and de-escalating or sometimes restraining. In inpatient, it's more about group therapy, safety checks, and medication. In outpatient, it's mostly establishing resources for medication, transportation, and safe environments.

Group homes, halfway houses, and addiction centers are all different, too.

Psych nursing is very rewarding, but it can be very difficult. You have to be able to take a lot of verbal abuse and harassment in the acute phase of a patient's illness. You must also be a good communicator and team player so you don't get manipulated. But, above all, you must remember that in mental illness, behaviors are about the patient's illness, not about you. Except for the 10% that are a-holes even when they're stable.

Awesome replies! Thanks everyone, I have a much better understanding now!

...oh and you all sound like great nurses :)

NurseLCoop

Specializes in CNA Certified. 50 Posts

I work in a state psychiatric facility as an RN extern-- May will be a year I have been an extern. I graduate in May and I perform all RN tasks and duties.....so I will speak from my experience:)

Acute womens lodge 44 bed capacity

Most of the RN's job duties depend on your unit-- there is acute women, acute men, longterm men, longterm women at our facility.

On the long-term unit you are able to see how a pts' comorbidities contribute to their mental illness. You can directly see the long term affects of medications and mental illness on their lifestyle and relationships. In this type of setting I've had to pay attention to medications a lot and be aware of medications that can interact and affect the drug mechanisms. You will provide a lot of teaching in this setting, updating careplans, assisting in ADL's, provide redirection, crisis de-escalation, group therapy. All of these things can be very challenging when you look at all of the factors in play. There is a lot of innovation needed in this type of setting.

On an acute unit there is a lot of quick decision making that needs to be made. This is usually the younger population-- but can be some elderly depending if they are violent. You are more focused on stabilizing and getting them out to care for themselves ( remember their usually just finding out a new Dx). Daily tasks will include-- care plans, lots of admission assessment, dressing changes, teaching, documentation, setting boundaries, seclusions, redirection, encouraging coping mechanisms, watching for adverse side effects of meds(many ppl with mental illnesses have history of seizures), legal implications, family counseling. Compliance is a huge problem in this setting....so teaching is everything!!! (That is my favorite part about nursing so I love this part about it!) You will see many addicts, borderlines, depression, intermittent explosive, and very rare Dx etc. You will do a lot of learning in this setting because your usually getting the worst of the worst! Pay attention to the milieu and learning innovative ways to manipulate your patient before they manipulate you ;) It can be very tough! A lot of ppl tend to compare the psych RN and Med surg (especially skill sets) but Psych RN's have their own special set of skills....and they are great at what they do!

Hope this helps!

angeloublue22, BSN, RN

Specializes in Addictions, psych, and corrections. Has 12 years experience. 1 Article; 238 Posts

We educate our patients a lot. I do pretty much anything that is needed. I make beds, do laundry if needed, I even sewed a guys pants once because they were his only pair. Also creativity is key (I once spent 45 minutes going through an aggressive manic patient's bead collection with her to provide some distraction, it was better than having her hit my staff). I of course pass meds, attend daily team meeting on each patient, complete daily assessments, deal with any emergencies that come up, transcribe about a million orders, admitted 5-6 patients a day, AM blood draws, intervene in patient altercations (that one is always fun.) Maybe, I worked in a especially hard hospital but I rarely had any time to sit down or even have lunch most days because there were always fires to put out. I still loved it though. Every day was seriously different, like really different.

mikayyCNA_

43 Posts

I apologize to anyone who was offended by my comment. I didn't mean to down talk psych nurses. I love my job and the nurses I work with so much! A lot of the stuff people are naming off (such as diffusing situations, assisting in ADLs, making beds, joining patients and their therapists for group therapy, etc) is left up to the techs at my hospital. Our nurses main priority in the day is charting and getting their meds passed on time. I've been in a situation before where a family member asked one of the nurses about his progress and the nurse directed the family member to me. Of course I could tell her basic things, but I didn't know any of her nursing questions! I guess it just depends on the environment. I would love to find an psych environment where I can have as much hands on opportunities as I do as a tech now. You might have a different experience! From all the responses it seems psych is definitely different from place to place

angeloublue22, BSN, RN

Specializes in Addictions, psych, and corrections. Has 12 years experience. 1 Article; 238 Posts

I didn't think you were downplaying nurses. It sounds like you are a great tech and make your nurses jobs easier. I would have loved to have you at my hospital.

newrpn

Specializes in Pscy / Mental Health. 33 Posts

Love it!! I'm in the program to be an RPN, will graduate in April 2017. May I ask what province or type of ward you work on? IV meds aren't super common in psych, from what I've seen in clinical so Im curious!

I'm with at 2 different hospital on acute inpatient wards, in BC.

PG2018

Specializes in Outpatient Psychiatry. 1,413 Posts

I only did RN inpatient work for two months but spent all the time charting extraneous details and supervising patients in effort to enforce safety violations, breaking up fights, being asked to fetch things by patients, and trying to coerce patients to take their meds