How dangerous is Psych nursing?

[Asklepios]

I'm starting NS in September, so I'm spending the summer trying to learn about the different fields available and one thing that I wonder about with Psych nursing is how dangerous it is. Are you accompanied into rooms when you work with patients? How often do nurses get assaulted? Has serious injury resulted from attacks any of you have witnessed? How distracting is the potential for danger on your job?

I dated a girl who wound up checking herself into a facility for depression (no, I'm not that bad a date! She had issues before I met her that i found out about later). I visited her once and everyone seemed pretty laid back. The patients had access to a snack room for fruit and drinks during the day, and they spent most of their time in group sessions.

[MrChicagoRN, RN]

Worked inpt psych for 7 years, starting again tomorrow.

Generally pretty safe. Contraband is taken, patients are assessed for safety. Precautions are instituted as necessary. Coworkers back each other up as needed.

Remember, People with mental Illnesses are no more likely to become violent than the general population.

[spaniel]

My first inpatient experience was in l969. (Yes, I was really really young and not a graduate yet!) I have worked in outpt.,inpt.,med-surg.,CCU/ICU, developmental disabilites, and so on.

I have worked in "back-wards" and in posh places. Frankly I have had very very few mishaps. A bit more in the adolescent units-chiefly things like breaking glass (that was supposedly unbreakable, but obviously not). Once there's decent medication oversight/decent staffing, violence really was not a major issue on INPATIENT. Now with this said,I feel that psych ER is a different matter. I see a trend of cost-saving where the nurse or "tech" does the eval with not enough security at hand. Anything can happen in the ER and indeed one of the docs did receive a permanent head injury. However, I don't,once again, see this as the major issue in decent inpt places.

[rkrs6673]

Thanks for the information!

[Atl_John]

I'm currently in my Psych rotation. We had two students get attacked by one of the patients. The patient has severe dementia with agitation, and snaps for no apparent reason and without warning (save the quivering upper lip). She slapped, severely scratched two students. Today we had one patient that security was called on, PRN Haldold/Ativan IM was given/restraints used. The staff there is usually very close, and they usually protect you very well. There is always staff out with the patients where I'm at, but they are unpredictable, and things can happen. I do get scared, and when you get report it will scare you even more. However, for the most part things are fine and you learn a TON

[smiles04]

Psych is a very interesting field. I dont think its as strenuous as say med surg these patients are healthy physicaly and back a long time ago we did not have some of the wonderful drugs for them we now have. Students get attacked because they are still learning and still too green period I dont think students are a good example of average issues. I worked at a state hosp and it was a pretty easy job. Yes sometime the pts get agitated but you get to know them and can tell mot of the time when issues are arising then you go grt help or get aprn med. good luck.

[Atl_John]

While yes that does happen I'm sure.....these students who were attacked were doing nothing but sitting there. They weren't talking to her just sitting there. It was witnessed not only by the MD but also by the NP whos our clinical instructor. Her dementia is worst case the MD had ever seen. The reason for her being in the psych ward.....she was transfered from the NH because of agressiveness/outbursts. So.....yes it can happen and has nothign to do with the students being green and not knowing what to do.

[drmorton2b]

Worked inpt psych for 7 years, starting again tomorrow.

Generally pretty safe. Contraband is taken, patients are assessed for safety. Precautions are instituted as necessary. Coworkers back each other up as needed.

Remember, People with mental Illnesses are no more likely to become violent than the general population.

I couldn't say it any better. Most patients are their worse when being admitted, most of the Code Green's I respond too are with new patients. Always remember where you are, and don't let your guard down. But remember to treat the patients as people. Unless you work at a criminally insane like you read about nut house, generally you have nothing to worry about.

[giedre11]

I sort of have to disagree with the above postings. I have worked psych for the past 11 years and there have been times I've really been apprehensive, mostly because of not enough staff to back you up with potentially dangerous patients. I have seen some pretty serious stuff happen. Doctors getting hurt...enough to not return to work. Patients acting out who are pretty big...and there's not enough staff to assist. I find you always have to be on guard. That said, I go by my philosophy of treating psych patients as if there is nothing wrong with them. In other words, treat with respect and dignity...always. Never lie and never make promises you can't keep. No matter how "out there" you think someone may be, in the end they always remember how you treated them. Oh, and make sure you work in a facility with adequate staffing!

[AUMPsychRN]

there have been times i've really been apprehensive, mostly because of not enough staff to back you up with potentially dangerous patients.

[mouse] generally pretty safe. contraband is taken, patients are assessed for safety. precautions are instituted as necessary. coworkers back each other up as needed. [/mouse]

i have done psych for 6 years and have been personally attacked (in my 1st month of nursing) by a male patient who was a vietnam vet that was experiencing flashbacks. i learned very quickly to always be aware of my surroundings, especially where my co-workers were located. even now when i go to check on a patient i do a visual sweep of everything the moment i step out of the nurses station. also we let our co-workers know where we are going and they either accompany us or watch for us. the general rule is if you aren't visible in a minute they come looking for you.

always, always keep yourself between the door and the patient.

i am not sure if this is a federal law but in ms there are fines and/or jail time for patients who assault healthcare workers.

[rkrs6673]

I know I wasn't the Orignal thread starter but thanks everyone for this information!

[angel75]

I had my psyc rotation this past fall. We were always told to keep 2ft distance from the clients. We never gave them baths, feed, or give them meds. Our experience was to only communicate with these individuals. Also, we were never aloud to enter their rooms by ourselves. Most of the time communication was made in the common room or during group.