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Discussion

How do you know when you're ready for more responsibility?

I currently work in psych. I am also a new grad as of sept 2015. I love working in psych and sometimes I have days where I think "Hell yeah, I got this!" And then other days when I feel like I have no clue what I am doing.....

I am currently a charge nurse on a female adolescent psych unit. I am the only RN on the floor, I have an LVN and 2-3 techs. We have good days and then there are days when I think I'm the one who belongs on the unit because I'm about to have a nervous breakdown. Especially when the girls have riots on the unit (Yes...they plan riots and attack staff and destroy property) On the surface I look calm but then I think I'm just a terrible RN and if I knew what I was doing this would never happen. I don't want to be a floor RN forever, I want to be a director of nursing one day. But how does anyone know if they're ready when there's so much unpredictability in psych nursing? People say that the girls have taken over and that there's no structure but I am only one person and I work on the highest acuity unit....The unit nobody wants to work on.

Does being ready for more responsibility mean I should rule with an iron fist and never have a code green on my unit? I feel like unless I throw everyone in seclusion and give haldol and zyprexa shots all day that I'd never be seen as a competent nurse. But I know that that's not even ethical to act like that. I know it's early in my career but I just wonder.....

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    Some of moving up administratively is working with the rest of the hospital. Are you on any committees. Is there a quality improvement project you could take on in the hospital or for your unit. Who does your unit staff schedule? Could that be improved. Are there any interdisciplinary initiatives to increase effectiveness of treatment or to reduce the need for chemical or behavioral restraints? Maybe post in the nurse manager sections of all nurses.com for more ideas.

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    It looks as though you only graduated in September 2015, so you will have very limited experience to date within this environment. Have you ever asked the patients what might change to improve their hospitalization. I'm sure that the response would be more seclusion or medication!! It is important that you think outside the box and engage the patients in positive changes within your environment. Most people don't like being told what to do, rather they prefer to be part of the solution and be taken seriously. If you want to be a DON in the future its really important that you invest in improving your interpersonal skills, accept feedback readily and consider others point of view, as well as engaging in positive quality improvement.

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    Ruling with an iron fist will lead to codes, in my opinion. Your a relatively new grad and you sound about right where I was back in the day. Working with all females is a challenge for sure!

    If your able to join a committee, do so if you feel ready. For some reason, management loves that. They've been hounding me for years and I'm actually considering it this year.

    It sounds like you work in a tough unit! Be safe. I can't imagine an all female unit....

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