Psych/Mental Health nursing questions?

[NICU_Nurse, BSN, RN]

Hi, ya'll.......

I'm getting ready to graduate with an ADN in a few short months, and I've found myself really stuck when thinking about what aspect/area of nursing I want to work in. I am passionately leaning towards psych/mental health nursing, but am unsure of my career options. I won't be able to return to college for an advanced degree right away (hubby's turn to go to school!), but that is in my long-term future. In our program, we did a rotation on an acute psych unit at a local hospital. I LOVED it, although I'm not sure what I was doing then would be what I would be doing as an actual, real-life nurse. Mostly, we talked to the patients, learned about their meds (didn't actually pass them, for some reason), ran groups, etc. I learned a whole lot there, and I seemed to have a real knack for what we were doing. The patients on that unit were mostly schizophrenic or manic/bipolar patients (probably 80%/10% with the rest made up of various other illnesses). Now, here's the problem. I'm sitting here, trying to evaluate my job options and figure out a long-term career plan, and I really don't know what that will be! What are my options in this field? What do actual psych nurses DO? At this particular facility, they didn't seem to be doing what we were doing; as a matter of fact, we barely had contact with the nursing staff- if they weren't sitting at the nurses' station, they were god knows where. I'm not suggesting that they were not working, it's just that we never really saw them around the unit. Furthermore, I'm not sure that I want to work with a mostly schizophrenic population; I'm considering something a bit different, like adolescent psych or something like that. I just don't know exactly what!! I'm beginning to think that I should have become a therapist instead of a nurse. Someone help me! I think I would be better at a long-term facility, rather than an acute unit; it seemed like all we were doing there was medicating and shipping them off to day programs/partial hospitalization/group homes. I know that that is necessary, but it's not really where I feel I would do best...anyone know what I mean? Another problem I'm discovering is that my fellow nursing students don't seem to appreciate psych/mh nursing as a REAL nursing career! How disappointing! Most of them absolutely hated our psych rotation, and when I'm asked which area I want to work in after graduation, I'm given anything from looks to actual comments like, 'Oh, that's not real nursing' or 'You're going to lose all your skills!' or 'Hmm..psych is horrible. Why would you want to go into psych?' or such things. It's so frustrating! For the first time, after class that semester, I would come home to my husband and RAVE about my day, so much in fact that he is now preparing to go to college to become a psychologist or something in that field. I'm looking at job opportunities in our area, and I"m seeing lots of openings for ICU/Critical units (which I DO NOT want to do), but not so many for psych/behavioral health. Furthermore, I'm not sure that I want to work in a hospital setting; I'm more the type of person who does best in a community setting or something similar. I'm so LOST! Someone give me some advice, please, before I drive myself crazy!! I feel very confused and unsure right now...I always felt drawn to nursing, and ever since my psych rotation, I've felt drawn to that area, but what can I DO there? Where can I work? What will I be doing? Anyone with experience here, feel free to email me or respond. I feel like I'm hitting brick walls. Thanks.

[WriteStuff]

Hi,

I just read your post, and it was a wonderful "trip back" for me in time, thirty years ago when as a new grad I was confronted with the same questions. I never could "narrow it all down" though and it was a period of time when Nursing Specialties were not yet as well defined as they are today. That is simply because the hospital settings were also not as specialized....i.e., having separate and distinct units for certain diseases, illnesses, medical and surgical problems. As a result, over the years, I've literally "done it all" in terms of bedside Nursing.

Let me say this: I'm now 57 years old, with 30 years in Nursing "under my belt" (now expanded with middle-age spread), and am in a position to share "wise" and wonderful thoughts with a New Grad such as yourself. :0)

First, do your best to quiet the "swirling confusion" running rampant, rent-free, in your head. You are young, have many years ahead yet, and now is the time to be very smart about your initial "choices." And it sounds like you are headed in the right direction in that respect.

I would say to you that the greatest gift you can give to yourself (in ALL things in your life, not just your career), is to LISTEN TO YOUR HEART. You obviously are "driven" by a passion for this field, Psychiatric Nursing. Also "listen" to your "gut" - that place inside of us that gives us "visceral" confirmation that something is true. When your heart and gut "line up" in respect to your desires first, then your next "choices" for yourself become the footwork around that. End of confusion!!

The passion and desire you feel for this field is your "gifts, talents and potential - coming alive - so to speak." Don't deny yourself the expression of your own special gifts to this field. Even if, after you enter it, you find it is "not what I expected", there are enough "sub-specialties" within this discipline, that you will eventually "find your nitch."

One other thing........as a New Grad, it is highly recommended that you obtain a minimum of one year of clinical experience in a hospital setting (perhaps on a Med-Surg unit) to reinforce and enhance your beginning skills, before launching into your planned career in Psych Nursing. This will also provide you with a time period to make your plans in that direction.

There is much more I could and would like to say to you, but it is probably too "lengthy" for this kind of forum. If you would like, you can e-mail me privately at: [email protected] since I see our "e-mail" capabilities on this site are temporarily caput. :0)

Best of luck to you, and I enjoyed sharing.

Bonnie Creighton,RN, MHCA

Mental Health Consumer Advocate

[NRSKarenRN, BSN, RN]

Bonine has given you excellent advice. Some hospitals have a dual psych/medical unit. This would give you some experience in Med/Surg , so you''ll be able to recognize when someone MIGHT be having a medical problem; how to change colostomy appliance, diabetic instruction/complications vs just mood swings, wound care, IV"s, dialysis grafts etc.

Had mygirlfriend with 20+ years Psych send me STAT email re patients coming to her state mental health facility with PICC line, IVAB and new dialysis graft needing advice since she'd been so long awayfrom Med/Surg and they are now getting clients with more acute medical problems.

I've had 2 Psych Nurse Therapists teach me alot re maintaining the Mentally ill at home and when to hospitalize. Those that love the job really influence how a unit is run and can get the patient stabilized quickly. Best of luck.

[donmurray]

Excellent advice! Think of that year as consolidation, putting into practice what you have learned. (and adapting it to reality!) Also , it won't hurt to have a little more life experience, making you a more rounded person. I think it was in a US textbook that I came across a definition of Psych nursing : "The use of one's self as a therapeutic tool"

[nrsbaby2be]

One of the best nurses I've had the pleasure of working with is a psychiatric nurse. He is the coordinator of a continuing day treatment center in New York. At first appearances, he appears gruff and cynical, but he cares soooo muuucchhh :) for his patients. He's the best!