Is this really psych nursing??

[Satori77, ADN]

My mother just started working at a psych facility this week. She has been an lpn for about twenty years, and help two jobs. The first one was 11 years at a dr's office (family practioner), and the second at a nursing home. She started out as the night nurse, moved into the DON position (they have a hard time retaining good nurses there, it is usually an RN that does that) then she actually became the director. She has a business background before nursing....anyway, she became very stressed out working 60 hours a week, being on call 24/7 etc, so she left. She had a hard time finding a position right away, around here RN's are in big demand, not lpn's. She didn't want to go back into LTC, so she applied for this position thinking it would be an interesting switch. Well so far she hates it! She is training with about 12 other people (mostly nurses). She thinks most of the people are cruel. Joking around about the patients, saying "oh if they even look at me funny I will do this to them" talking about drugs, even physical violence. She said one nurse was talking about electric shock, and how it used to be more "fun" back in the day, they would have major seizures, etc...now they have to give them valium beforehand and you barely "see them twitch". Do they even still do that?!? I had no idea, and my mother was quite appalled listening to this guy talk about it. Yesterday they learned self-defense maneuvers, how to take down patients, etc. I understand why this is necessary, since many can become violent. But she thought it was really extreme. They tried moves on all the new staff, and she said some were quite painful. Plus, they have a restraint room....she didn't describe it much, but said it looked like a barbaric torture chamber. All these tables they can strap people too, leave them there all day long if they are trouble. And how they used to have head restraints but had to get rid of them because one woman strangled herself trying to get out of it years ago (?). Now, I wasn't there, but my mother is not prone to exaggerations. She was very upset when I talked to her last night....she said she felt physically sick all day. She wanted to walk out but was afraid of finding a job (it took her several months to get this, and thinks it might be her age, she is 60). So anyone who works in psych, please tell me how it really is. Is this normal?

[PMHNP10]

not so much my experience where the nurses are cruel; seems they wouldn't be nurses for long if they acted on their thoughts; now i do know psych nursing humor can seem quite inappropriate to many, and in fact it is twisted and on occassion, dark, but, again, I've never seen a psych nurse physically mistreat a patient. The examples you provided don't seem like jokes, but since I wasn't there, I can't really judge. And the other thing--it sounded like the trainees were the inappropriate ones, not the staff nurses; maybe their comments were a consequence of nervious energy, rather than actual malice.

As for ECT--yep, it's an excellent treatment for major depression that has been resistant to therapy, meds, etc. (i.e., not the gold standard for depression treatment because of the nature of ECT, but some studies show a success rate of mid-90%).

As for restraints--I think every psych floor has a room that can be used to restrain a patient, but as a psych nurse it is imperative to try every other route of diffusing a situation (e.g., redirecting a patient, talking, offerring PO/IM meds, etc.) before strapping them in.

[Satori77, ADN]

Thanks for the reply. Maybe most places aren't like this. My mother is now done with her group training and is following another nurse around. She is supposed to be watching him, have him do the job so she can see what is involved, then she will be on her own. He tells her what to do, then disappears for hours. She will go to the RN in charge about how to do something, she can't find so-and-so, and that nurse will just tell her she needs to find him. She is really stressed out and so far the nurses she has worked with don't do anything. My mother doesn't like to give up (her last two jobs were almost ten years each) but she hates doing this. She feels alone and doesn't want the responsibility of these patients when she doesn't know what she is doing and doesn't feel comfortable yet. She feels like she can't do this job because no one will train her, and she can't care for her patients safely. I feel so bad for her and wish I had some advice. Psych was one of the few areas in nursing I was interested in, now I am not so sure. I know I would never want to work at this place though!

[IMustBeCrazy]

It sounds like she accepted a position in a unit with poor management and a poor orientation program.

The unit I work on is not like this at all, and our training is quite good. I am blessed to also work with a supportive staff.