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Got the job! Now help me refresh my memory...brainstorm!

Psychiatric   (4,161 Views | 9 Replies)

mingez specializes in Psych, Ortho, Stroke, and TBI.

6,180 Profile Views; 238 Posts

Okay, I got the job at a local state psych facility! Yeah! I have always loved psych and really feel like it's what I was meant to do.

But all of my past experience was with peds and adolescents, and over 3 years ago as an LPN. Since then, as an RN, I was working a very med-surgy stroke and orthopedic acute rehab floor. We were totally electronic, and of course, the work flow very different.

For this job, I'll be on an adult admissions unit. There will be a 30-day orientation, but I want to be prepared. Going back to paper charting will be a challenge, and the nature of the workflow (as I recall) is very different. What else?

So...please help me refresh my memory! What skills, things do I need to revisit? I really want to be prepared going IN to my orientation. I realize not all psych hospitals are the same, but I'm hoping you all can give me a few "oh yeah" moments so I can brush up.

Thanks!

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mingez specializes in Psych, Ortho, Stroke, and TBI.

238 Posts; 6,180 Profile Views

Really? I thought the floodgates would open up!

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Meriwhen is a ASN, BSN, RN and specializes in Psych ICU, addictions.

2 Followers; 4 Articles; 7,907 Posts; 60,452 Profile Views

Well, start brushing up on common psych medications and their side effects. You'll probably recognize a few med names from your last job, but you really want to be on top of how they work, adverse effects and what are the warning signs of serious complications such as neuroleptic malignant syndrome and EPS.

Start reviewing psych conditions but realize that it's rare that the presentation you will see in the textbook is exactly the same as how the patient will present. You're going to see such a wide spectrum...also keep in mind that the patient isn't going to always be as receptive and recover as fast as in the textbook either. The rate of relapse in psych is up there.

Know how to do a good mental status exam. And definitely get your therapeutic communication ready.

Congrats on the new job!

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chevyv has 20 years experience as a BSN, RN and specializes in Gero Psych, Ortho Rebab, LTC, Psych.

1,645 Posts; 17,116 Profile Views

I would brush up on psych meds and therapeutic communication. Paper charting is ....well paper charting. Observe how seasoned nurses respond to escalating pts. You will be doing a lot of de-escalating. Never find yourself in a room with only one exit and the pt is standing in it. I truly love Behavioral Health but it is very different. Congrats and good luck!

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redddy has 7 years experience and specializes in Neuroscience.

18 Posts; 1,526 Profile Views

Review the nursing Clinical Practice Guidelines for Psych disorders, and practice accordingly.

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aloevera specializes in telemetry, med-surg, home health, psych.

861 Posts; 7,652 Profile Views

Remember to maintain a calm demeanor at all times..........and above all........Don't take anything personal that may be said to you by a pt. !!!!!! Remember, these are not pts. that always know what they are saying !! Do, as already noted, brush up on side effects of the psychotropic medications..........Many, many are given and it is common to catch these side effects.

Progress is slow, so don't expect immediate improvement...........takes time but you will see pts. getting better !!

You will also see a lot of returns, as pts. don't always stay on their meds once they leave.

Be a good listener, and be patient.............GOOD LUCK !!!!! we love psych nurses !!!

The paper charting will come back to you........no big deal............

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mingez specializes in Psych, Ortho, Stroke, and TBI.

238 Posts; 6,180 Profile Views

Thanks for all of the suggestions. Keep them coming!

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alfa-sierra has 18 years experience as a BSN, RN and specializes in Psych.

45 Posts; 2,315 Profile Views

Get familiar with charting format: B(behaviors)-I (interventions)-R(responses to interventions)-P (plan) or some variation, or P(problem)-I-R; describe behaviors in clinical language, know what is affect, mood, Axis I and II disorders, read the abbreviated latest DSM IV to become familiar with those disorders and the clinical language; know about GAF scores (global assessment of functioning in life);know about the care plans and revisions; practice from a humanistic perspective with generosity, patience, compassion, joy, empathy and knowledge; do 90% listening and 10% talking; keep your promises;treat all patients as VIPs and you'll never have fear clouding your decisions. Go forth and heal!

Okay, I got the job at a local state psych facility! Yeah! I have always loved psych and really feel like it's what I was meant to do.

But all of my past experience was with peds and adolescents, and over 3 years ago as an LPN. Since then, as an RN, I was working a very med-surgy stroke and orthopedic acute rehab floor. We were totally electronic, and of course, the work flow very different.

For this job, I'll be on an adult admissions unit. There will be a 30-day orientation, but I want to be prepared. Going back to paper charting will be a challenge, and the nature of the workflow (as I recall) is very different. What else?

So...please help me refresh my memory! What skills, things do I need to revisit? I really want to be prepared going IN to my orientation. I realize not all psych hospitals are the same, but I'm hoping you all can give me a few "oh yeah" moments so I can brush up.

Thanks!

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1 Post; 614 Profile Views

After 3 years on a med/surg unit, I am going to a state psych facility as well..and I have to admit..I'm very nervous..and excited. I am going to brush up on my psych drugs for sure.

Good luck to you!

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8 Posts; 764 Profile Views

I've been full-time in Psych for 12 years - now I teach it. I'd suggest psych-appropriate assessment and documentation, as they are very different than you're likely used to.

There's lots of other stuff but it takes time to learn and you don't need it ahead of time. I've put considerable study and practice into one point - if you treat your patients like people, all the same courtesy, respect, etc you offer everyone else - you will be much more successful. You'll stand out from coworkers, likely, and they may tell you you're wasting your time being so nice or folks will take a mile if you give an inch - nonsense, it improves cooperation, makes every task with patients easier and quicker, and reduces both the frequency and severity of behavioral emergencies. It enhances your influence in the neighborhood that every inpatient unit is. You need a spine, and you need to be tough, but never confuse that with mean, cruel, callous, or lazy.

If you send me an e-mail, I have some assessment and documentation references I should scan anyway, and I could send you PDFs.

I'm at grchealthcare@hotmail.com, and a blog: grchealthcareblog.com

One more tip: if you feel uncomfortable giving a total stranger your e-mail (as you should - you're begging for spam), the solution is simple: get a second email address and forward mail from it to your mailbox. I do it - hence the hotmail. It's easy, gives you control and protects your privacy.

Good luck and welcome to Psych!

- Greg

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