Hello Psych Nurses & Future Psych Nurses, Please Read

[little_miss_hulk]

HELLO EVERYONE! :wink2:

I just wanted to write this thread because I have some concerns that I hope you guys can elaborate on. :wink2:

I graduated in May 2008 and am taking my NCLEX very soon. :grad: Indeed, I had many responsibilities after graduation and also had to pass a hard HESI exam, so that is why it took me so long, but anyway....lol.. :sofahider

I have been head on about med-surg, because I know experience in that setting can bring you other future possibilities, but I know deep down inside I feel utter dread about having to work in med-surg juggling 5 or 6 patients, many many meds, clinical procedures, family and other visitors, consultations with the physician, lab work, phone calls, delegation, and when you go deep down, IVs, urinary caths, several dressing changes, turning patients, remembering god knows how many things (most which I've had experience in clinical but also a lack thereof)..... and I have began to think thoroughly about becoming a psychiatric nurse.

I have thought it over especially when I met a psych hospital hiring new grads with no experience... and I thought to myself how much I enjoyed my psych rotation because of the interesting patients, endless learning of variety of mental disorders, and having the ability to be therapeutic to their needs. I myself have suffered an emotional disorder, and I do seek therapy and other treatment for it... and I feel I can empathize with their needs. I always find myself feeling sympathy for these patients because I know they have no control over their thought processes, feelings, and actions. I also have been great with therapeutic communication and have used my communication to help others, during times of hardship....but anyhow....

I would like to know the pros and cons of psychiatric nursing? Somehow I feel that what I've learned in school might be wasted because I have seen that we don't utilize clinical skills in this setting besides medication administration, therapeutic communication, vital signs, adls and other duties specific to that field. As interesting as it is to get to know, interact with, and assess patients, I do get a fear of somehow being thrown across the room or getting stabbed in the eye by a patient, whether it be acute care or any floor for that matter.

I feel this is on a whim. I had decent grades in my psychiatric course, and was excellent in therapeutic aspect, but a little weak in meds, and I feel if I really want this, I must brush up on the various types of disorders (which is also what I'm doing now as I prepare for NCLEX). :typing

What are some other responsibilities of psychiatric nursing? Besides assessment, which I think I will enjoy, as well as interviewing patients, I feel very confident to interact with physicians and the staff about patients, and developing a plan of care for them. I would like to know other responsibilities. Ex. patient teaching, group activities, coordinating individual patient activities, and care---and if nurses in psych do clinical treatment when needed--- (are their IV meds in acute situations, O2 delivery, wound care for a patient harming self or another, treatment to side effects of certain meds on a patient)

Can this harm my future in other aspects of nursing? I'm concerned that if I try this first, I may miss out on opportunities I may pursue in the future. For example, say I do want to do med-surg, will I have a slim chance because I am far from years of having hands on clinical experience because I became a psych nurse, (unless I take a short RN refresher course or something). I also learned being a psych nurse makes you "less marketable" than nurses working in clinical settings. And say I wanted to be a forensic nurse or do another field of nursing, can psych count as valuable experience or criteria?

Last but not least and don't kill me please, and kind of relevant to above...the reputation of a psychiatric nurse? Whether it be a friend who is a nurse/nursing student or anyone else, it seems as if being a psych nurse is looked down upon by people and I don't know why. I keep feeling weird everytime I tell a classmate who is doing med-surg that I might wanna do this because they have this weird "Omg, she went through four years of hard work and hell to do that?" kind of response, but not in that way..or I get the usual "You should try med-surg first so at least you have background, or see if you like it first since it is the core component of nursing activity".... I agree on that second line in some form, but I don't think I will be happy if I do med-surg, yet I will feel sad having wasted what I have learned and could be learning more of. SIGH...I'M TORN. And why do some people think Psychiatric nursing isn't REAL nursing. Yeah it might not have all the clinical aspects, but psych nurses treat and follow the nursing process for patient care and well-being just like every other field and specialty. Psych nurses seem to be compassionate and caring to them just like any other nurse, and are simply treating a different need.:behindpc:

I want to know what it takes to be in this position. I think I can do well interacting with patients and their families about these issues rather than about cardiac disease, high B/P, or deteriorating kidney function. I want to know more, whether it be the pains and stress, or the joys and highlites...but I feel I'd rather stress in a setting I may love compared to one which I know I will hate. :w00t:

P.S....What is the salary? lol.

TO EVERYONE WHO READS THIS, THANK YOU..AND THANK YOU FOR ANY REPLIES I MAY RECEIVE!

Much Love :redbeathe,

little miss hulk :hlk:

[aniutka]

OMG are we working at the same hospital? same unit maybe?

[ScarlettRN]

I strongly suggest that you do the med-surg thing first. As well as reinforcing what you learned in school, you learn something that is invaluable to a nurse in any setting. ORGANIZATION skills.

All of the things you listed about med-surg basically means that you have to learn to juggle. Once you go into psych, you have to be organized. I think I spend most of my time managing things or people. I am in charge most of the time, so that means I have to make the schedule and assign the techs. Depending on the acuity of the patients, I may have up to 12 techs that need assignments and breaks assigned. Then you are having to manage the patients. On an acute psych ward, you aren't really doing therapeutic stuff as much as you are redirecting them.

I have only worked psych in state hospitals, so I don't know if the population in a private psych hospital is different, but in my experience, there is a lot of behavioral stuff that you have to deal with. The majority of the patients have been to jail at some point and there is a mentality associated with the jailhouse that is difficult to deal with. Common basic manners, or simple things like attention to ADLs, and especially the substance abuse are issues for them.

In an adult psych unit you are going to have a broad spectrum of personalities. You could have young guys with a chronic mental illness who have been in the system since they were kids, then you could have older ones who aren't old enough to be on geriatric ward, but are in a wheelchair and have a laundry list of medical problems. Having that med-surg background will just make you a better well rounded nurse. I know that sounds like something your instructors would say, but it is the truth. I despise med-surg but would not trade that experience for anything now! Give it a lot of thought before you commit to a specialty like psych without a solid foundation.

[K8TLittleone]

Hello! I am a May '08 grad and after working on a neuroscience floor of a big teaching hospital decided a few weeks ago to get a job at the local state mental health hospital. I will tell you that I am VERY glad that I did my time doing hospital nursing because it gave me the opportunity to refine my clinical skills, really learn to interact with attendings, fellows, and residents alike, and learn how to organize and prioritize my patients and time. Now that I am in the middle of my orientation at my new job, I am actually complaining because I don't feel like the RNs at my facility are doing enough RN work, but are more like unit managers.

I'm not sure where you are looking for a job, but civil service benefits are hard to beat, so that is one thing to keep in mind. Also, yes there is the possibility that a patient can come after you and you could be hurt. You also have to remember that a patient's verbal assaults on you cannot be taken personally. To boot, you will probably be dealing with forensic patients if you work in an inpatient setting, and you have to be okay with that (some of the crimes that you learn that the patients committed sometimes makes it hard to give compassionate care. . .) I hate to say it but we are all human and it's natural to have an emotional reaction to dealing with a child rapist- you just have to learn how to cope with that, put it aside, and continue to give good nursing care.

Honestly, I am using this as a stepping stone to getting my psych nurse practitioner. I am also considering getting a per-diem gig at a hospital just to keep up with my clinical skills.

Concerning any sort of outside perception of psych nursing- most scoff at it because they don't understand it. To imagine that someone could be called "lazy" when instead of 4-6 patients I am now responsibile for 30 on my unit. . . well. . . that's just silly. Yes, you do have to have a certain mindset to deal with this patient population because you can't just tell these patients to follow a certain medical regimine and expect that they comprehend what you are telling them. They wouldn't be hospitalized if they were able to take care of themselves. You will find that a patient just getting out of bed and taking a shower without being told can be a major achievement for that patient. Yes, it is stressful to be dealing with a medical emergency in a hospital, but it is also stressful to be dealing with a whole unit of patients when two or three have psych emergencies at the same time.

Good luck with whatever decision you make. That's the wonderful thing about nursing- lots and lots of options!!