I can't take one more day of psych!!!!

Flo., BSN, RN · Jun 4, 2017

It sounds like you need a break. I only just switched into inpatient psych and I can understand your sentiments about the addicts. It is hard to deal with them and it sounds like you are at the end of your rope. Can you afford to take a few weeks off?

Davey Do · Jun 4, 2017

Honestly, I deal with very few true psych patients and more with drug addicts. I have zero respect for these people. They lie, steal, manipulate, have no appreciation for anything

I appreciate and understand your frustration, edisonnurse. It's like hopelessly shoveling sand against a tide. I also appreciate you expressing yourself and seeking others' perspectives and support.

Working in inpatient chemical dependency treatment back in the 80's taught me some valuable lessons. One lesson I learned was that others' abuse of chemicals affects us as caregivers, much in the same way that a family members' chemical abuse affects others in the family. We were encouraged, as employees, to attend at least one Al-Anon meeting a month.

I took the encouragement and for quite some time, attended weekly 12 Step Meetings such as Al-Anon, open AA meetings, and Emotions Anonymous (EA). For various reasons, I found that I could best identify with EA.

In the past several years I had grown away from actively working a program and have like you, edisonnurse, have experienced frustrations with my job. A couple of months ago, I began working a program again, and although there hasn't been any profound illuminating revelations or significant changes of consciousness, I'm feeling a little more patience and abilities at understanding. "Baby Steps" they are called in the Program.

We, as professionals also need to be able to deal with our stressors. Working a 12 Step program has helped, and is currently helping, me perform my professional duties.

The very best to you, edisonnurse!

Workitinurfava, BSN, RN · Jun 4, 2017

Try med-surg and you will sign up for another 10 years of psych no questions asked. Those patients are sick and I still treat them like people despite it all. Try detaching yourself from all of the stress of it all. Find some healthy things to do outside of work.

--Former med-surg nurse who loves psych :)

Insperation · Jun 5, 2017

Addiction is a disease in itself where the "symptoms" are often masked as behavioral defects..things that you might call laziness or manipulative. Working with these people all day would cause anyone frustration. I'm just curious though, do you do anything to actually try to get them treatment? Do you recommend rehabs, talk to them about the benefits of meetings, try to place them in outpatient centers? People don't just get the alcohol and drugs out of their systems and magically recover. No one chooses to be an addict.

The other day I had this heroine addict in the hospital for cellulitis of the arm. He was shooting up into his muscles cus he ran out of veins. He was getting 4 mg morphine Q4 and ativan 1mg. How the **** is that treatment? I didn't say anything but yah maybe I should have.

MHDNURSE · Jun 5, 2017

Definitely sounds like it is time to change specialties. I too have zero respect for addicts, and it is hard because I know that they didn't plan their lives thinking they would get themselves into this lifestyle, but they made a choice to begin using and I have no respect for that choice. I cannot imagine having to take care of patients that I had zero respect for. I would not be able to practice ethically I don't think. Maybe it's time to sit down and think about what would really make you feel fulfilled on a daily basis and see what specialty fits that. I have pretty much done pediatrics my whole nursing career and I can't imagine not working with kids. One of the nice things about nursing is you can switch to different areas. So while I have been in peds the whole time, the settings in which I have practiced have varied. Good luck.

Insperation · Jun 6, 2017

I know a lot of good people who have used narcotics yet they don't get addicted. Again, it's not a choice to become addicted to something. Do you have respect for someone with a personality disorder like borderline or someone who is bipolar? They often have very little insight into their affliction and cause pain and suffering to those around them, much like addicts do. Addiction is a disease and your lack of respect for someone who has a disease, as a NURSE, is highly questionable.

It's not a coincidence that alcoholism is highly genetic and heritable as it runs in families just like a lot of cancers.

The choice lies in recovery yet not all people can find it. I think that's where we as nurses and other health care professionals can at least assist people or guide them in the right direction. Ultimately it comes down to the individual though.

liathA, RN, EMT-B · Jun 9, 2017

Addiction is an inherently difficult topic and addicts are often difficult people to deal with. You may need to change specialty if you can't handle them anymore.

Something I like to remind myself of is that just because someone is addicted to pain killers doesn't mean their pain isn't real. Addicts of all kinds are often self-medicating for very real physical or mental pain, or other underlying conditions. It's no coincidence that people with chronic pain and/or mental illnesses often have comorbid substance abuse problems. It can be incredibly challenging to find and treat the underlying problem(s) and even if you do there's no guarantee that their new diagnosis and treatment will help them kick a well established drug habit.

I'm most familiar with substance abuse in a veteran context. Service members have stressful lives, and veteran culture encourages us to decompress with alcohol and thrill seeking. Many soldiers have chronic orthopedic injuries from doing things like jumping out of airplanes, carrying heavy things up and down mountains, and never seeking medical attention because they don't want to be seen as weak or "malingerers." For those who do get injured enough to seek medical attention, military docs hand out narcotics like candy (I was given 60 doses of Percocet when I got my wisdom teeth out. 60. I think I actually used/needed about 3.). It's all too easy for a service member to go from "I use x occasionally for pain, only as prescribed" or "I just drink to chill with my buddies" to a full blown life destroying addiction. Then, often, not only do their careers end, but they also frequently lose access to military healthcare and don't even have the benefit of the VA system if their discharge wasn't honorable. It's a mess.

Ultimately, these people are your patients. As a nurse, it's your job to provide care, and also to advocate for your patient(s) if you don't think the care they're getting is adequate or even safe (if you think their prescribing docs are killing them then that's a problem someone should investigate). Some of them may benefit from substance abuse rehab, some might need a different form of pain management, or a more holistic approach to managing their psych symptoms. Many of these patients may never achieve an optimal state of health or full societal function ever again. It's not a perfect world and that comes with the territory.

If your view of your patients is interfering with your ability to do your job, then yeah, find another speciality - preferably one with patients you think are deserving, and docs you respect.

allnurses Guide · Jun 9, 2017

Addiction is an inherently difficult topic and addicts are often difficult people to deal with. You may need to change specialty if you can't handle them anymore.
Something I like to remind myself of is that just because someone is addicted to pain killers doesn't mean their pain isn't real. Addicts of all kinds are often self-medicating for very real physical or mental pain, or other underlying conditions. It's no coincidence that people with chronic pain and/or mental illnesses often have comorbid substance abuse problems. It can be incredibly challenging to find and treat the underlying problem(s) and even if you do there's no guarantee that their new diagnosis and treatment will help them kick a well established drug habit.
I'm most familiar with substance abuse in a veteran context. Service members have stressful lives, and veteran culture encourages us to decompress with alcohol and thrill seeking. Many soldiers have chronic orthopedic injuries from doing things like jumping out of airplanes, carrying heavy things up and down mountains, and never seeking medical attention because they don't want to be seen as weak or "malingerers." For those who do get injured enough to seek medical attention, military docs hand out narcotics like candy (I was given 60 doses of Percocet when I got my wisdom teeth out. 60. I think I actually used/needed about 3.). It's all too easy for a service member to go from "I use x occasionally for pain, only as prescribed" or "I just drink to chill with my buddies" to a full blown life destroying addiction. Then, often, not only do their careers end, but they also frequently lose access to military healthcare and don't even have the benefit of the VA system if their discharge wasn't honorable. It's a mess.
Ultimately, these people are your patients. As a nurse, it's your job to provide care, and also to advocate for your patient(s) if you don't think the care they're getting is adequate or even safe (if you think their prescribing docs are killing them then that's a problem someone should investigate). Some of them may benefit from substance abuse rehab, some might need a different form of pain management, or a more holistic approach to managing their psych symptoms. Many of these patients may never achieve an optimal state of health or full societal function ever again. It's not a perfect world and that comes with the territory.
If your view of your patients is interfering with your ability to do your job, then yeah, find another speciality - preferably one with patients you think are deserving, and docs you respect.

I love this answer because it so eloquently address the addiction question. I started working psych when I was newly in recovery for alcoholism and quite frankly no one else would hire me due to the restrictions on my license. The community of psych nurse not only accepted me but pulled me into their culture. I have stayed there for 15 years (10 years longer than I needed to. I left for a two years thinking the grass was greener but ultimately came back. While I find working with detoxing addicts and alcoholics challenging I find that it helps to view them as people first, addicts second. I treat every single one of my patients with compassion. Still about a year ago I needed a break and went to run the adolescent unit. I love the kids though self harm epidemic in this country can be almost as hard to deal with as those addicted to substances.

All that being said - if the OP truly hates the job they should consider leaving. What I found however is it can be difficult to transition of psych because as a general rule we don't do many of the skills floor nurse take for granted. Employer's want a nurse who is ready to go, especially if they are not a new grad.

Hppy

RunnerRN92 · Jun 18, 2017

You are exactly right, I am a float nurse and every unit I go to I have addicts/psych patients every single shift and they are the same way, manipulative, abusive, drug seeking, its the new norm for the patient population in this country.

Psycho-APRN · Jun 19, 2017

Addicts can really suck the empathy out of you. Self care is super important. What I have a hard time with is the doctors or NPs who continually feed these addictions, not the addicts themselves. I work inpatient and get frustrated when I have to cover for a doctor who will take someone we just detoxed from benzos and put them right back on a benzo and not low dose but 2 mg of klonopin at bedtime. It goes against everything I was taught about prescribing. I think if every prescriber could get on the same page all of our patients would be helped.

smcRN2592, ADN · Aug 15, 2017

I havent started working in psych nursing yet but I too had similar views as you when it came to addicts. During school we attended a few AA/NA/Al-anon meetings and it completely changed my perspective. It's important in my opinion to see them as humans 1st and remember that nobody grew up wanting to be an addict. They are people who had/have dreams and aspirations. They have families being affected as well. They just need alot of help to recover, which may be difficult to get.