Do you have enough time to help yr patients?

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Hi I'm a student and interested in psych nursing. I decided to go to a therapist myself to work out some issues before entering psych nursing - mainly social anxiety.

Do you feel you have time to interact with your patients and help them?

My therapist disturbed me when he said that I wouldn't have any time to really interact with my patients in psych nursing and it would mainly be just giving meds. Is that what it is like or is he wrong or would it depend on the facility?

I'd really like to deal with the patients personally as one reason I want to go into psych is close friends who committed suicide when I was younger (incredibly sad to see a 19 year old only child kill himself), an anorexic classmate starving herself to death....I'd like to think I could make a difference in someone's life and maybe help them make the decision to turn them away from suicide or destructive choices.

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I work in crisis stabilization for substance abuse and MH patients (we call them consumers). There are 2 nurses on duty per shift for 30 consumers. The charge nurse works up referrals and does the initial nursing assessment on admission. After that she has no patient contact. The med nurse on the other hand has a lot. I'm the only nurse that works at this facility who always volunteers to be med nurse. Yes, I have a lot of paperwork also but I do have periods of time when I'm not counting stock, pulling meds or taking off orders. When I don't mind interruptions I leave my half door open and welcome the consumers stopping by just to talk. And when I have down time I get out and walk the floor interacting with them or just checking to see what they are doing. And of course when there is a medical emergency everyone yells for the med nurse! I love it. The charge nurse, on the other hand is bogged down with loads of paperwork, phone calls, and meetings. I view her job as strictly a desk job. By the end of my first shift of the week I always know all 30 of our consumers by first name. The charge nurse is always asking "who is so and so?" or "show me a picture of him". I don't have as much contact as I'd like, but it's way more than she does. Do I feel like I help people? Yes! (of course not all 30, but some) and it makes me feel good. Also, a bit of advice: techs are invaluable! Keep a good working relationship with them because the are a great resource. MH patients are hard to assess in short intervals and some won't even converse with a nurse or Dr at all. The techs will give you wonderful insight into what goes on with them throughout the day. Oh, and I just wanted to vent that there's SO much paperwork involved with nursing and it's frustrating, so get ready for it. And I tried the hospital, it's even worse there! Good luck!!

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Passing meds is an important part of psych nsg.! Passing meds involves interaction w/the pt. Trust is a big issue w/alot of psych pts., especially when it involves medications! And that type of rapport takes time spent w/your pts. A good question to ask your therapist (albeit, alittle confrontational) is, "how many full, 8-10 hr shifts s/he has spent on a psych unit, on the floor, interacting w/their pts?" The NA's are the ones who spend the majority staff time w/pts, and are a priceless part of the team. And the nursing team as a whole, spends the most time w/a pt, when hospitalized, aside from other pts that is....period. I am kept very busy with an absolute ton of electronic/non electronic paper work, but thats all nsg. I think. You have to learn to juggle your time & attempt to make your interactions count, no matter what specialty you decide on. Psych nsg is not for everyone & you will meet all types of pts. Look up about 10 different types of psych diagnoses & you might have all 10 different ones on a unit at the same time! Start reading, and you may find you might want to specialize in only one form of psych nsg....there are many! In 10yrs I have done acute psych, gero-psych and now MICA (mentally ill, chemically addicted). Good Luck w/your studies!!!:)

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Hi thanks for the answers.

Now I have a question or two:

1. What is a tech, is that a CNA?

2. Is an NA a nursing assistant, like a CNA?

Do they have specialized education for psych? And what exactly do they do. I've only worked as a CNA in home health and a nursing home and most of my time was spent helping with ADLs, what do the techs & NAs do?

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I work for the VA (federal) and the NA's are nursing assistants who are not certified. They get their training through the VA. They get training that exceeds most certification criteria in the civilian sector, but when they leave the VA to work civilian, they still have to get their certification (at least in NY). They also get specialized training dependant on the unit they are on, psych, geriatrics, med surg etc. We also have health techs, but they are usually only seen in medical and can do alot of what an lpn can do, minus meds. Thats a certificate type program. I think mental health techs are used in the civilian setting & I dont know what type of training or education you need to obtain that type of position. The NA's in psych where I work help w/adl's when necessary. V/S, tx.s, escorting pts who dont have off ward privleges, have recreational groups on the unit:movies, cards, bingo, holidays, fresh air groups outside etc. They do special observation, 1:1, w/pts who have been placed under observation d/t say suicidal ideation, and they get no more than arms distance from that pt., same w/someone who is in locked restraints. They do health & welfare cks, cking for contriband in the pts. rms, drugs/etoh, weapons, items they could injury themselves with etc. They are on the floor w/pts their entire shift. They really get to know the pts. and are usually the first ones who can alert the nurse that maybe someone isnt quite themselves that day, is more quiet, more agitated, dosent feel well medically etc. or that they seem to be doing better, are able to stay focused on task, not hallucinating, isolating as much, taking better care of their adl's w/o prompting etc. They are trained to respond to emergencies, psych or medical. They do alot w/the pts.! My NA's are great & I rely on their input!

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Specializes in critical care; community health; psych.

Most of my patient interaction is at the med window or in the process of administering meds. I try to make time to interact with and observe the patients and the mileu staff independent of meds. How can I ask for compliance when they don't even know me? Same goes for the mileu staff. How can we work as a team if we don't talk to each other? It's really just a few minutes a couple of times a shift.

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Specializes in telemetry, med-surg, home health, psych.

At our psych hospital the LPN's are the med nurses. They pass med and take off neww Dr's orders...

The RN's do interact with the pts. as they have to do all initial assessments, talk with them each shift in order to complete a 6 page nursing note, attend the treatment team meeting along with the Dr. and the therapist, some do group therapy, there is much pts. contact for the RN's but not so much for the med nurses. (LPN's)

Techs are MHT's, they do the vitals, q15 min checks (we are a locked unit) and notify RN of any vitals not WNL.Techs take the pts to the cafeteria for meals, do one on ones, and watch LOS (line of sights)

The RN's are in the middle of it all !!! YES, we do have much pt. contact. Hope this helps.........

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Specializes in Assisted Living Nurse Manager.

I am an LPN and do the med pass. Yes for the most part I do have the time to interact with my pts. There are times that I am the MHT and LPN so I get more interaction with the pts at this time. The RN's where I work also interact with the pts on a daily basis. When there is an escalation the RN and I are the ones who are called to talk the pt down.

To tell you the truth I do not know what I would do without my RN! She is my lifeline somedays!

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Specializes in telemetry, med-surg, home health, psych.

nd mom, yes my LPN's are the first I call on with a med question, or to help with a pt problem....we work together as a team for sure !!!!

At times, we are all techs, aren't we?? At a psych facility you must work as a team or it will not function....

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Specializes in Assisted Living Nurse Manager.

Absolutely aloevera! Team work is a must and boy do I love working as a team. It makes me feel so good, when we all come together as a team for the good of our pts.

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Thanks for all the replies. My therapist is a PhD in psych so I would bet he doesn't have the same experience a medical person such as an RN or LPN would have. I'll ask him though.

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Specializes in behavioral health.

not nearly as much time as i desire. Sometimes we have a LPN passing meds, but i insist that i do it myself because that is the most patient contact I get. While I pass them, I explain the meds and talk to the patient about their day and feelings. Now things are changing on the unit, and they want us to take admits in the middle of med pass *cries*. meaning much less contact and i have to rush.. im NOT happy about this.

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