I Hate Psych

Couldn't agree more I work with behavioral adolescents. I actually love where I work. The only problem is I feel like I'm losing a little bit of knowledge every day :/. That's the one reason I'm job searching. However, if you love psyche peds may be the best thing you can do in the psyche field. The big thing with peds is there is no secondary gain for pediatric psyche cases.

OP - I feel the same way. I work inpatient adult psych. When I have a legit psych patient and watch them get better, that is so rewarding. Unfortunately that's the exception and not the rule on our unit. Most of our patients are repeat frequent flyers who are homeless and need a place to crash until their next check. Many come in because they've got a hot urine and have a court date or probation visit coming up. I'm not just saying that, I've actually had people tell me that their reason for admission is "I need a place to stay" or "I have court tomorrow." We've had people return in less than 24 hours. It gets very frustrating and I guess it happens everywhere.

Again, I don't get this "legit" psych patient stuff.

Humor me, and please explain the difference between a homeless guy with a hot urine and a court date as opposed to a "legit" psych patient.

Again, I don't get this "legit" psych patient stuff.

Humor me, and please explain the difference between a homeless guy with a hot urine and a court date as opposed to a "legit" psych patient.

Far, as a former school nurse, this may help...

You know the difference between the student who comes to you for a headache because they were cutting class and want a note to avoid an unexcused late/absent and a student who has 103 fever and is upset that he is being sent home?

So I think that it is similar to the frustration we feel when a patient knows the magic words to be admitted in order to avoid being arrested or even a fight at home.

I think that both can be seen in psych/mental illness. The difference is that inpatient psych admission is really for acute stabilization and safety. If someone has a need for treatment, I'm all for IOP/outpatient/group therapy/job coaching/ACT team etc. However, these patients are being admitted to psych because they say the magic S word even though all we can do for them is 3 hits and a cot.

Far, as a former school nurse, this may help...

You know the difference between the student who comes to you for a headache because they were cutting class and want a note to avoid an unexcused late/absent and a student who has 103 fever and is upset that he is being sent home?

So I think that it is similar to the frustration we feel when a patient knows the magic words to be admitted in order to avoid being arrested or even a fight at home.

I think that both can be seen in psych/mental illness. The difference is that inpatient psych admission is really for acute stabilization and safety. If someone has a need for treatment, I'm all for IOP/outpatient/group therapy/job coaching/ACT team etc. However, these patients are being admitted to psych because they say the magic S word even though all we can do for them is 3 hits and a cot.

Good talk, friend.

Just so you know...some people who "get a note claiming they're bipolar so they can get disability", really are disabled to the point of needing it. And not all of us are malingerers.

Agreed. That's why we have a multitude of tests to determine the people in need of care and actually provide notes for them. That being said, those tests have been know to weed out many malingerers.

The big thing with peds is there is no secondary gain for pediatric psyche cases.

Sorry gotta disagree there. Sometimes there is MORE secondary gain with adolescents. Sooooooo much attention seeking behavior. Whats a better way to get attention from a distant, hninvolved parent than to keep yourself in hospital after hospital?

Anyway, not to jack this thread.........yep, psych is like that. There is a very high burnout rate. Tis the season for frequent flyers on my unit and I just tell myself, "Terp, obviously there is a major problem with this persons functioning if they would rather be stuck in a psych ward rather than out in the world". Yes even the homeless person with hot urine. I think sooooo many hospitalizations could be avoided if a lot of these pts had stable housing but who am I lol. Maybe those state hospitals werent such a bad thing after all.

Re-reading this, I'm a little embarrassed that I sound like the nurses whose attitudes I frown upon. I have nothing against the "3 hots and a cot" thing, that just shows a major flaw in the structure of society, but the frustrating part is when we get calls for actively suicidal people (there is a major shortage of Psych beds everywhere), but we never have beds available because they're occupied by someone who wants to skip jail for a few days longer. It's frustrating. I think maybe I'll choose another area, I'd hate to have my attitude affect my care.

There is no area of nursing where you won't find patients with the same game, different setting. Psych patients, who truly need assistance, may not be the majority, but they need the assistance of knowledgeable and compassionate psychiatric nurses. I like psych, just like I liked burns -- it takes a little extra something to care for patients who have a lot going against them and I want them to know that someone cares in a sometimes very uncaring, painful and dismissive world. Takes no more effort to smile and listen than it does to smile and empty a bed pan -- just has to be something you want to do. Hope you find your place, where your talents and strengths will shine!

So I'm on my third psych job, in 3 different states. My travel job in New York city was like you described; I had 7-10 patients, some were very gangsta-like, gamey, etc. I had so many patients that it was really hard to do more than give pills and chart if they were suicidal or not. I was very stressed and chose not to renew my contract, though they paid well. I'm now in a facility with a max of 4 patients, and the whole culture is much more high level that I can really give better care. But it is my nature to kind of help people on the psych level, I know people that the thought of doing psych just scares them.

I just started a psych job recently and it is different from what I expected. I think I am more annoyed by my job duties and the facility than I am the patients, though. It is completely paper charting, which I sort of hate. I am spending my whole shift doing unnecessary paper work that could be done in 2 hours with a computerized system. I'd rather have more time to interact with my patients and get to know them on a different level. I am mainly a medication nurse so I feel like the "bad guy" at times. I enjoy teaching about the meds, but I find there is hardly any time to do that thoroughly as a night nurse handing outs meds to 25-30 pts. There are a number of med seekers here. I also work PRN as a med-surg nurse, and you will find many med-seekers there are as well.

I like psych, for the most part, but there are some things I need to work on and that is the med seekers and the very aggressive/rude patients. I come from a med surg background. They are very customer service oriented at my first job so I am finding it hard to be nice/respectful but firm at the same time in psych. I will tell you one thing, so far my psych job has taught me that it is okay to be firm with patients and set limits. It is rewarding to see my patients get better - no matter why they are there. I just wish I had less patients and more interactions with them. I had a really agitated woman, who is normally nice enough to me, get really frustrated with me because I would not give her ALL the meds she could possibly get. I was annoyed by her outburst, of course, but then I thought about why she was there and her background. She had a daughter who committed suicide. I thought about being in her shoes and how she must feel. Medication might be her way to "escape." If I am not mistaken, her daughter OD'd on drugs and maybe she wants to do the same to be with her. Of course I won't allow her to do it, but I can emphasize with her. The best I can do is to be honest with her, be respectful, and be firm in the rules.

I can totally understand your frustration, but maybe if you think about why/how they became that way, you might be less stressed and annoyed by these patients. You will find the good and bad in all nursing specialties. You will find med seekers in all specialties. When I was in my early 20s, I dabbled with some alcohol issues, although I was highly functional. While I do find med-seekers annoying, I realize that I

was once that person - in a lesser degree. I, thankfully, overcame those issues but these people might not be there yet. Now I can see why my family was so pissed/annoyed by my behavior. These people need care, too.

We have a bunch of bitter people at my work, too. Screw them. Don't become that. I have quite a few patients say they were happy to see me on my day back, that I was the best med nurse, that I was one of the few who told them what their meds were (which is preposterous!), and that they were even scared to ask some other nurses for meds. Revel in the appreciation you receive from these patients. Many others are probably appreciative of you, too, but can't put it into words.

Bitter folks are everywhere. BE better and maybe it will rub off on them. And if it doesn't, at least you will feel better.