Confusion over what psych nursing is really like?

[yhl1975]

I never did inpatient psych,only 9 years outpatient for court mandated patients. I believe in preventative care and long acting medication. I hate inpatient and will do everything to keep patients out of hospitals.

The fact is, the careless disregard that is usually the lot of those who are chronically and seriously ill mentally does not come from improper living arrangements but from improper care. Nevertheless it is true that there are certain times when a particular patient is better off in a hospital and other times when he is better off at home. Those considerations that are relevant in determining whether to hospitalize someone include the following:

The potential of a patient to commit suicide or to injure himself in some other way. In general, patients who are actively suicidal should be in the hospital, although it must be noted that patients not infrequently kill themselves even in that relatively protected setting, so that even there they need to be observed closely.

The potential of a patient to injure others. People have an exaggerated conception of the potential of most psychotic patients to do violence; but some such patients do exist, and they should be admitted to a hospital for their own benefit as well as that of society.

All other "reasons" could be controled by outpatient care.

I hope I will never be back for inpatient work ar treatment for my family/freands/myself.

[PsychNursStudent]

The response to this thread has been amazing. Thank you everyone. I am so interested in working in the mental health field and this has opened my eyes up in a huge way, to better understand the various roles of the psychiatric nurse in both the hospital setting and the community.

[morganbrookeRN]

I think this fully depends on what type of mental health nursing we are dissecting. I will be blunt and get to the nitty gritty - I work in an inpatient state facility that deals with very acute patients - ranging from manic to suicidal to very aggressive and everything in between. The unit I started on was a civil admissions adult unit - chaotic and stressful, full of what we call de escalations and if that fails, "S and R" events (seclusion and restraint) to protect staff and patients. My day consists of constantly assessing not only my patients but my surroundings due to patient's psychosis - many are aggressive here. We do treatments, medication administration, monitoring, suicide assessments, working in a collaborative team with social workers, psychologists, psychiatrists and our nurses aids (psychiatric care technicians). I would run around NON STOP for my entire shift. It is an insult to me when people think psych nursing is a piece of cake. I have been hit, I have been spit at, I have had bodily fluids whipped at me. I have had to intervene when people try to strangulate themselves. I have seen people insert foreign objects into every orifice imaginable and swallow the most questionable objects. I have had to restrain people to keep me, my staff, and patients safe. Psych nursing is a different breed of nursing. I have also helped provide initial care for patients suffering from stroke and heart attacks. Inpatient acute psych is wild. Where I work, I equate it to the "ER" of psych. I am not saying ALL psych nursing is like this - I think outpatient you would be able to have more of a "laid back" atmosphere. We all know nursing can be physically and mentally draining no matter what specialty you choose and psych is no different. At the end of the day, it can be rewarding to watch a person transform from psychosis and believing you to be the devil (literally - I have had patient believe me to be the devil due to psychosis) to being able to hold a conversation with you. I now currently work on a different unit that specializes in pediatric psych - we have a lot of behavioral factors on this unit as well as see drug induced psychosis. We have many borderline personality disorders, self harmers and aggressive patients who have suffered from trauma of some sort. It is difficult to learn some of their histories and try to help them cope. I am not sure if this sheds any light on psych nursing or if this was one big speech on a soap box. It can be rewarding at the end of the day. I am not trying to scare or deter anyone from ever entering this field - it can be wonderful and you do bond with your coworkers very tightly. It's a wild, wild ride in psych. :-) I am proud to be a psych nurse.

[Tylerr]

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

Hey there,

I'm also a psychiatric nursing student and sorry to tell you but you will never have a clear picture of what RPN's will do on a daily basis. Depending on what field of PN you go into, forensic psychiatry, Neuropsychiatry, etc., that will help you narrow down the general job description. However, there are so many unexpected things that will happen on a daily basis that my best advice is to expect the unexpected. But, once you figure out the environment you want to specialize in, I think you'll get a better idea of what happens on a daily basis.

[vintagemother, BSN, CNA, LVN, RN]

Each psych facility is different. In my job as a psych nurse, I interacted with pts a great deal, I spoke to them, de escalated them, talked to them individually to update their care plans, etc. sometimes, I just listened to them vent. Oh, I loved my job!!

Anyhow, I went back to school to become an RN and the facility we did clinicals in had mostly the nurses within a tiny station all day. Or behind glass. The nurses did not meaningfully interact with pts, except to pass meds and do charting--again, all done while the nurse was inside the station, it kind of had a "drive through window", nurses came out to give take FSBS and give insulin....but that's about it.

Where i worked and did clinicals, the pts were medically stable, no IVs, no foleys, etc.

But some psych facilities are different and you'll do medically complex care as well as manage the psych care.

[RG-RN2014]

Been a Psych Nurse for almost 2 years. I work in acute care so we handle patients at their worst. I work night shift. Our routine is usually chart checks, shift assessments (you typically have 6-8 patients at our hospital), passing medications, charting, CIWA/COWS protocols, providing PRN medications, de-escalating patients to prevent seclusion/restraints, AM lab draws, assisting techs when they need it. We also have to round every 2 hours on pts while the techs do the 15 minute checks. A lot of things can pop up in between but that is the typical night. It is definitely a rewarding but demanding field. It is not as task-oriented as medical nursing but you still have to use nursing judgement during medical emergencies.