Disillusioned

[b-nurse]

I am a nurse with a compassion for people suffering from mental illness. I currently work on a crisis stabilization unit (ICU) at a major metropolitan psych hospital. I enjoy the work and think often about pursuing psych NP. Lately, I have been feeling a bit disillusioned by psychiatry. The revolving door effect, lack of resources/funding for the care of the population, poor med compliance, medication efficacy, burned-out nurses/MDs, patients using the system for "3 hots and a cot"/secondary gain, and rumors of financial ties between medical director and pharmaceutical companies as seen by psychiatrists all being told to what medications to prescribe all seem to be contributing to this disillusionment. A lot of these things are seen in all of health care, but seemed to be amplified in psychiatry. I came into this field hopeful, passionate, excited, and ambitious to work in Psych and become a Psych NP but, sometimes second guess this path. Where is the hope in psychiatry? Where are there changes happening to help these suffering individuals? For psych-NPs and nurses, do you feel like you are making a difference for people? Do you enjoy what you do? I throughly enjoy my job and thankful for the position but I do question if I am actually making a difference. Thank you

[maxthecat]

The very fact that you mention that you have compassion for people with mental illness tells me that you are making a difference. All the problems you cited above are indeed problems, many that need to be addressed at a systems level. But you as an individual nurse have control over your practice and simply by compassionately listening to these people and treating them like human beings you are helping. They may or may not ever tell you that, but never doubt that your kindness did good. Even for the ones who seem to fall again and again.

It's harder to see when you are in the acute hospital setting. You see folks at their worst. One of the pleasant surprises when I started working in an outpatient clinic setting was seeing the number of people who HAVE been helped, are stable, and enjoying productive lives. They're out there, you just don't see them in the hospital.

Don't give up just yet.

[VivaLasViejas, ASN, RN]

From a patient's perspective: A good psych nurse is worth her/his weight in gold. When I was hospitalized a few years ago, I had one nurse who sat down with me and talked about depression with knowledge of the condition herself, and she put more than simple therapeutic communication into our exchange; she was present with me in the situation, and I felt heard. I will never forget her...she stood out from the other nurses who cared for me during my stay. Believe me, she made a difference, and so do you.

[hrnurse]

Consider it a benefit to see the downside of psych. There are deplorable atrocities, no lie . Let that arm you to STAY hopeful . We can't save everyone . Accept what you can do to help .

[UsernameNotFound, BSN, RN]

I agree with @maxthecat with regard to the narrowed scope of vision we often have when working acute inpatient psych. You're looking at a snapshot -- a single episode in a lifetime of many -- and it's often quite "unpretty." I too work inpatient psych, but my facility is designed (unintentionally) in such a way that I frequently encounter past patients waiting in the outpatient clinics. This often results in big smiles, fist-bumps, and even some boundary-breaking hugs. Seeing a patient who has reclaimed at least some of their resilience, however temporarily in the grand scheme, is actually one of the most fulfilling parts of my life. It can be very energizing.

Yes, there is no shortage of struggles, headaches, and heartaches. I learned very early that if you don't amplify the significance of victories and accomplishments -- small they may seem -- the negatives can be stifling.

While I do work with adults, my primary area of specialty is child and adolescent psychiatry. If you want countless opportunities to make a positive impact, this is the place to do it. Don't get me wrong, it is heart-wrenching work. And interacting with damaging parents/families, guardians ad litem, social service agencies, magistrates, etc. can be taxing. But when a patient is being discharged with some new coping skills, hopefully strengthened resilience, maybe some new medicine, etc., and you get the side-hug, handshake, or even just the "that was my awesome nurse!" comment on their way out the door, you feel like a million bucks. And even if the situation is not ideal, you know you were a positive force for some period of time. And that's a privilege.

OK, so this post took a slight turn (smile). But my point is... try to find an area of passion, if you're not already there. It can make all the difference in helping to keep burnout at bay.

One last thought. The burned-out RNs/MDs you mentioned... they can definitely influence the culture. But you can work against that. Being the smiling and at-times-slightly-annoying-but-always-likable RN on the unit makes people feel better at work, even if they snark. And research shows that the physical act of smiling, even falsely, actually improves mood. So fake it! (big smile)

Best!