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Day in the life of a Psych Nurse?

Psychiatric   (17,636 Views | 10 Replies)
by littlebitt littlebitt (New) New

1,083 Profile Views; 13 Posts

I posted this earlier, dont think it went through...anyway, Could any of you describe your day from beginning to end working as a Psychiatric Nurse? Any type of setting, but I am particularly interested in those working in community mental health centers and hospitals as basic staff RNs. I am taking nursing pre-reqs, but still considering social work :uhoh3: ..I have heard there is much more one on one... unless one has an advanced degree. (NP) I have been to the APNA website and reviewed the FAQ for basic level psych nurses but the description is somewhat vague. Thanks a bunch! Have a great day! lilbit3443@yahoo.com

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86 Posts; 2,243 Profile Views

which did you hear has more one to one? nursing or social work?

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13 Posts; 1,083 Profile Views

which did you hear has more one to one? nursing or social work?

social work.... in regards to "counseling" one on one ....spending more time talking with patients.

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621 Posts; 8,160 Profile Views

In social work, don't you need an advance degree anyway? At least for the ability to do counseling or whatever. I could be wrong here?

If you need an advance degree, you might consider an advance degree in Psych nursing also. When you are dealing with a person who has a mental illness, the person lots of time have other physical illness also (e.g. diabeties, hypertension, ... etc), as a train psych nurse, you would be able to recognize these symtoms and maybe doing something about it while a social worker is not train to handle the biological level.

Take a look at the description of psych nursing in different schools, sometimes they give more detail information. For example, take a look at

http://nurseweb.ucsf.edu/www/spec-psy.htm and

http://nurseweb.ucsf.edu/www/spec-psy.htm#faqs

Notice the difference between NP and CNS and notice that you can actually be the primary care provider.

Bascially at the graduate level of psych nursing, you are train at the bio-psycho-social level while in social work you do not really have much training at the bio level. In medical, you are more a specialist at the bio level compare to nursing training. It is really a matter of what kind of focus you like.

-Dan

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7 Posts; 1,012 Profile Views

In order to be a social worker you need a MSW or Master's of Social Work degree. A nursing degree, although it might be helpful, I don't believe is enough.

But, I could be wrong. If you're looking to be a therapist you might want to go for the MSW.

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64 Posts; 2,008 Profile Views

I have been a psych RN for 15 years and have worked with every age from 2 to 99. I know for a fact that I would never want to be a social worker for the pure fact that I would be limited in what I could do for them. Right now I am a Mental Health RN for a huge Women's prison and I love what I am doing. I get to spend time with each of the inmates (like a social worker does), I get to do groups with the inmates, I get to handle crisis interventions, and best of all I have an excellent relationship with my psychiatrist and I make sure these inmates get the meds that they need or get them changed as needed. I am the only Psych nurse for 1800 women and it's such a great feeling hearing an inmate say that they are feeling 100% better since starting on their meds and that they actually have goals for when they go home. I start my day at 7:30 am or 8 am depending on when I want to come in. I get in my mailbox to see what MSR's (medical services requests) have been submitted from the day before. I then look up on the computer when they were last seen by a psychiatrist, what meds they are on, if they have been compliant with meds and what they are wanting to be seen for. I then call out the ones that I need to see. I might spend 4 hours a day talking to inmates about what their problems are and how meds might help them. Then I spend the remaining time charting on my computer everything I talked to the inmate about. I then order the meds, make copies and take them over to Medical so that they will pass the meds that were ordered by the psychiatrist. There are days that inmates are sent over from medical in a crisis (crying, anxiety attack, etc) and I will deal with them on an individual basis getting them whatever they might need. I will also go over to the mental health side of the housing unit to see the ones that are in a program for the mentally ill. I have groups with those inmates. My biggest job though is ensuring these mentally ill inmates are taking their meds and if they aren't why not? It's a great job and I love what I am doing. There is some days that there is stress but it's very short lived and easily manageable. The officers are a huge help in all situations because if an inmate gets out of hand or raises their voice in a threatening manner, all you do is call the officer and they take the inmate away. I almost always leave after working my 8 hours. If I want to work 4 ten hour days and take a 3 day weekend I can. But I usually just do my 5 days a week. There is virtually no overtime and I rarely leave any work undone from that day. When I worked in a Forensic Hospital (Maximum Security) I worked with aides and WE had to deal with the aggressive patient. So I was in physical altercations almost everyday. I got hurt more times than I can count when I worked there. I finally decided that my life was more important than losing it working with those kind of mentally ill patients. Prison is SOOOOOOOO much better. I hope this helps you in seeing what kind of day I have when I work everyday. The drive to and from work is the only thing I hate about my job because it takes me an hour to and from work. But so far it's worth it to have this great job. Good luck to you in whatever you decide to do. Regular hospital nursing on Med/Surg was probably my worst job ever and working with children and adolescents in psych has been my best job ever. Take care! :balloons:

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Thunderwolf has 32 years experience as a MSN, RN and specializes in Med-Surg, Geriatric, Behavioral Health.

6 Articles; 6,621 Posts; 44,481 Profile Views

A lot depends on your state and their requirements to provide a certain level of care. The field of mental health, not always, seems to be pushing towards a masters degree in a related field, especially outpatient. But again, this depends on your state. Nurses, being part of the health care system for so long, have some reprieve to this. Many RNs do not need a bachelors because of this, but there has been some pushes to change this. How your typical day starts and ends depends on the setting you are working in...community health centers, outpatient (hospital based or free standing), partial hospitalization programs, inpatient wards, or prisons. In community mental health centers, the focus can be very different (some are more case management "social worker" driven, some are more more counseling/psychologically driven)...with nursing being utilized to provide case management, therapy, and medication monitoring/education. It depends on how that community mental health center interprets nursing as a field to be utilized in their setting. Some settings utilize nursing purely from a biological level, the eyes and ears for the doc when he/she is not there, regarding patient's medications and medication monitoring.

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23 Posts; 1,420 Profile Views

I currently work as a behavioral health home care nurse and I entered nursing in a communtiy mental health center. This was pure luck-- single mom, new grad, 8-5 M-F, on-call q6 weeks and all major holidays off. Because it is a specialty, I started out making almost $4/ hr more than a friend who worked 12 hour shifts in the ICU!! As a nurse case manager, I had the best of both worlds. I had to help consumers with securing and maintaining benefits, create budgets when the agency was the payee, shopping, attend appointments, socialization-- only I could also carry the Decanoate and syringe with me to admin in the home. I filled weekly med planners, ordered meds, filled med packs for daily to twice daily drops, completed health assessments, behavior mod, symptom management groups, did teaching on health conditions and the impact on mental health, and tons of dual diagnosis stuff. The treatment teams functioned like an extended family and most of my interactions were one-on-one. I get this in home health too but less of the social work function. I also worked in a crisis center and when we were short staffed, I did the entire assessment-- RN & SW. I could diagnose (of course with the doc's review and signature) from the DSM and even got trained to complete involuntary hold orders on my own assessment. Many of the SW would tell me they wished they had gone through nursing school-- wages are incredibly low for an MSW in my area. Some of the things I hear make me wonder about the future of humanity, but most of the time I wish I could write a book about the things my clients do/ say!! If you like working with AoD, you can obtain CCDC certification without a master's degree. I enjoy psych nursing and you couldn't pay me enough to be stuck on a floor running from one end of the hall to the other-- been there, HATED IT. I like being able to learn about my clients and just know when something is wrong; you also have time to work with a weakness and turn it into something with positve outcomes. You also learn to appreciate how good your life is. When I get caught up in what the Jonses have, the next day, I see how little the Smiths have to work with.

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37 Posts; 1,315 Profile Views

I have been a psch nurse for 5 years now, before that worked in a state school for folks with MR before, and prior to that med surg. For 2 years now I have worked in a community out patient clinic.

I am scheduled 22 pt to see daily - not all of them show up because of the nature of the disease process- I usually wind up seeing 12-15. Some come to the clinic weekly, q 2 weeks q 3 weeks or monthly depending on their status. Pt come to see the doctor at least q 3 months or prn.

PT may come in for quick status check and prepare one weeks medications, have a crisis, and lots of haldol or prolixin dec injections. ON a routine monthly visit a mental status exam is completed,I always ask pt how they take their medications- if they can't recall chances are they are not taking their meds, aims completed prn, VS and weight prn, I prepare lab work papers and teach lab instructions

Always teaching q visit- usually pt has questions. If pt has psychosocial issues (no food, wants counsleing) I call the Case Manager I also take down information for next doctor visit- what medications they are taking other than ours allergies, ect-usual clinic nurse responsiblitys. I am also the infection control nurse Our clinic has 500-600 pts that are seen here monthly. I work with an LVN and have only one doctor at this time. Bear in mind I do live in rual wext Texas.I am an ADN they would have had a BSN for the job but apparently the expreneces I had helped.:rolleyes: This job is a real adventure and I like the autonomy!

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8 Posts; 1,091 Profile Views

I work as a staff nurse on a children's unit. Prior to that I worked on a geriatric unit that had mainly Alzheimer's patients who were combative. I really like psych nursing. It is the niche that best suits me. Of my favorite areas, I like working with patients who have dementia. It take a lot of patience while working with that population but it is rewarding. :)

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257 Posts; 4,005 Profile Views

I posted this earlier, dont think it went through...anyway, Could any of you describe your day from beginning to end working as a Psychiatric Nurse? Any type of setting, but I am particularly interested in those working in community mental health centers and hospitals as basic staff RNs. I am taking nursing pre-reqs, but still considering social work :uhoh3: ..I have heard there is much more one on one... unless one has an advanced degree. (NP) I have been to the APNA website and reviewed the FAQ for basic level psych nurses but the description is somewhat vague. Thanks a bunch! Have a great day! lilbit3443@yahoo.com

Hi.

I am a Psych Nurse, and have been one since 1973. I have worked in in-patient units, Adult out-pt. units, Adolescent Units, and Community Mental Health (where I am now).

I ws hired right out of Nursing School by a Community Mental Health Clinic where I had done Student Nursing. They felt like I "had the gift" and no prior experience/degrees were required. I now work for a County in an out-pt. clinic: this is how my days pretty much go.

I get to work. I get some coffee. I check my "mail-box, I check any messages to me on my line. Then, depending on the need, I either reply to phone messages or see patients directly. I consut with the Docs (who are peers compaired to what nurses hae to content with on Medical Floors). I give meds, or give injections or draw blood for studies.

My one-to-one time with patients is great. I really am good at listening and responding to their "reality." This gives my great pleasure. If u are interested in how the mind creates experience, psych. nursing is very interesting.

I lead groups, go to team meetings where we discuss patients and create programs. I create "care plans" which are appropriate for the patient goals/needs. I do crisis intervention.

In in-patient settings, I did all of the above, plus "take-downs" at times with psychotic or manic out of control patients. I am too old for this kind of work now, so prefer the out-patient setting.

If u like to talk with people and listen, psych. nursing is great.

In Community Mental Health u will be working primarily with the Indigent population. A lot of Homeless people. A lot of drug and etoh abuse.

Working in Commnity Mental Health does have its problems, as funding is sometimes a problem (depending on the County that u work for).

Where I work, this is now a problem, as the budget has been cut, and services will be more limited, and people will be doing more with staff cuts.

I suggest u investigate the Economics of your County.

In general, though, my experience in Community Mental Health has been a very positive one. I have helped a lot of people, have been a patient advocate and have helped reduce the "stigma" that exists about mental health problems.

Hope this helps.

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