very little patient interaction

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.

Posting in general, as the psych thread can be a bit slow. Plus there may be old psych nurses who don't follow. Anyways... I just started in psych. I was wondering how common this is. I have noticed that there are nurses who rarely leave the nurses station, which is in a locked room. So they don't really see the patients. If they are doing med pass, they will see them when they come to the window for meds, or if they knock on the door to ask for something. But essentially they come in the nurses station in the morning, and don't leave except for break and to leave at the end of the shift.

I am coming from an entirely different area, so this is a whole new world to me, so not judging. Just curious as to how normal this really is? They give report the patient was cooperative, calm, etc. But they never really interacted. I guess this is just coming from the MHA??

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Specializes in Complex pedi to LTC/SA & now a manager.

Not experienced in this area, but these nurses sound the like the nurses that were at the physical rehab hospital my father was in. They didn't even know if a patient had visitors. Though I am sure psych visitation is more limited that physical rehab visitation.

The funny thing was the one Sunday my son & I visited my dad, and we took him for a "walk" around the grounds in his wheel chair. I didn't bring my cell. My mom didn't know when we were going up & found his room empty when she arrived. she said the nurses couldn't have been more embarrassed that they had NO IDEA where my father was nor if anyone had visited him. Though when my mom went to the car to get her phone she did spot my car & then us walking up the pathway with my dad. I have no idea how they know anything about my father as we rarely if ever saw a nurse. (And there would be days where my mom would be with my dad for 10hrs straight and saw the housekeeper more than the clinical staff. Dad was nonverbal)

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My hospital seems to value perfect paperwork over real interaction with patients and they keep adding a new form almost monthly, so it gets harder and harder to break away and be with patients. Having said that, I think a nurse can be out on the unit with patients as much or as little as he or she CHOOSES. I see some who use the overwhelming charting as an excuse to hide out in the nurses station, making me wonder why they chose psych to begin with. I encourage you to spend as much time interacting with patients as you can. Don't be the nurse who gives report based on what the techs tell you, as opposed to your own observations. I know that I sometimes have a different take on a patient than my techs do.

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Specializes in Psych, EMS.

This is common in psych. The nurses at the psych hospital I did clinicals at in nursing school had very little pt interaction. It seemed to be that this is a choice though..why do more when it is acceptable to do less?

However, there are psych facilities where nurses are integrated into the milieu. The place I work is like this. I have about 8 pts that I chart on every shift. I thoroughly talk to these pts, find out how they are feeling, what concerns/fears/hopes they are having, and implement interventions with them if indicated. I also try to touch base with as many other pts that I can.

If possible, leave the nurses station and check in with pts..more nurses may follow suit and your facility could eventually evolve into one that provides pts with the nursing assessment and interventions that they deserve :)

Whew..sorry long. Good luck and welcome to psych!!

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Specializes in Med/Surg, Academics.

I have some difficulty judging anything about your post without knowing the different team members associated with care on your psych unit. I'm a student, and my psych rotation definitely had a team atmosphere. There were counselors with a BS in psychology who ran some of the activities, assistants who kept watch over the milieu, nurses who ran some activities, did med pass, and charted.

One day, the milieu was relatively calm, and the nurse had more time to spend with me. I talked to her about the patients that I had spent time with, and she was able to speak very intelligently on their behaviors and give me an explanation for them. She knew EVERYTHING that I had noticed. I'm just a nursing student, but I have noticed that even I am becoming more attuned to patients without spending a lot of time with them.

Don't underestimate the assessment abilities of experienced psych nurses. :)

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It really depends on the unit. Similar to a medsurg unit - if the psych nurse has 8-10 patients then it is unlikely s/he will spend much time interacting beyond medications, treatments etc as a great deal of the shift is taken up with paperwork, team rounds, pt and family meetings, orders, etc. I've been on psych units where this is the norm...where the philosophy and policies of the unit don't really support a great deal of patient interaction. I've seen the same in medsurg, where the nurse comes in to the pt room only a couple times a shift to do vitals/meds.

I have also worked on psych units where the nurses are at the forefront of patient care and spend most of the shift out on the floor with the patients. I love being able to do this but it requires staffing levels and management that support that model of care.

In your case the nurses may be leaving and returning to the office without you noticing. Or it could be they are lazy or that it is a very medical model unit and they are instructed to leave the assessment and therapy to other professionals.

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Specializes in Trauma Surgery, Nursing Management.

I can't speak to this in a professional way, but when I was in school, we did our psych rotation at a federal prison for psych inmates. I won't sugar coat it-I was terrified. Had we done our psych rotation at a hospital, I don't think it would have bothered me as much. But these were patients who had committed some pretty heinous crimes. There were several high profile inmates at this facility. But...I digress.

I saw A LOT of interaction between nurses and patients. Unless charting had to be completed, it was very much frowned upon to hang out in the nurses station. I witnessed most of the nurses and physicians sitting and drawing, talking, playing games, doing crafts and the like with the patients. Despite the fact that these were inmates, I never once saw anyone get out of hand. Nobody was inappropriate with us, and most of the inmates were pretty sharp-meaning I did not notice them being over medicated, although I suppose it could have been true.

Do you like being a psych nurse? I have often wondered what it would be like. Please let us know what your experiences are as they happen. I am interested to hear what you learn.

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
I have some difficulty judging anything about your post without knowing the different team members associated with care on your psych unit. I'm a student, and my psych rotation definitely had a team atmosphere. There were counselors with a BS in psychology who ran some of the activities, assistants who kept watch over the milieu, nurses who ran some activities, did med pass, and charted.

One day, the milieu was relatively calm, and the nurse had more time to spend with me. I talked to her about the patients that I had spent time with, and she was able to speak very intelligently on their behaviors and give me an explanation for them. She knew EVERYTHING that I had noticed. I'm just a nursing student, but I have noticed that even I am becoming more attuned to patients without spending a lot of time with them.

Don't underestimate the assessment abilities of experienced psych nurses. :)

I was more or less asking if it was common for the nurse to pretty much stay in the nurses station for the entire shift. In the week I have been there, I have seen nurses who literally DO NOT step foot out of the nurses station. If Another nurse does med pass, then except for the random person knocking on the door that they may answer, they will literally not see the patients.

I know alot of the people are repeat patients, so they see them frequently. Or if they work 5 days a week, they do tend to know them well. Plus I have only been there a week. BUT my clinical educator also commented that there are nurses who never leave the nurses station, and she hoped that I don't become like that. We record report, then the MHA's do the rounds. So they don't even do an initial round to check. It just seemed odd to me.

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
It really depends on the unit. Similar to a medsurg unit - if the psych nurse has 8-10 patients then it is unlikely s/he will spend much time interacting beyond medications, treatments etc as a great deal of the shift is taken up with paperwork, team rounds, pt and family meetings, orders, etc. I've been on psych units where this is the norm...where the philosophy and policies of the unit don't really support a great deal of patient interaction. I've seen the same in medsurg, where the nurse comes in to the pt room only a couple times a shift to do vitals/meds.

I have also worked on psych units where the nurses are at the forefront of patient care and spend most of the shift out on the floor with the patients. I love being able to do this but it requires staffing levels and management that support that model of care.

In your case the nurses may be leaving and returning to the office without you noticing. Or it could be they are lazy or that it is a very medical model unit and they are instructed to leave the assessment and therapy to other professionals.

Well being that its a small unit, and there are only 2 nurses for the on average 18-20 patients, I am right there with them. So I know they aren't leaving without me realizing, lol. But I did just start, so maybe it was just off days while I was there, or just those particular nurses.

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Specializes in Med/Surg, Neuro, ICU, travel RN, Psych.
I can't speak to this in a professional way, but when I was in school, we did our psych rotation at a federal prison for psych inmates. I won't sugar coat it-I was terrified. Had we done our psych rotation at a hospital, I don't think it would have bothered me as much. But these were patients who had committed some pretty heinous crimes. There were several high profile inmates at this facility. But...I digress.

I saw A LOT of interaction between nurses and patients. Unless charting had to be completed, it was very much frowned upon to hang out in the nurses station. I witnessed most of the nurses and physicians sitting and drawing, talking, playing games, doing crafts and the like with the patients. Despite the fact that these were inmates, I never once saw anyone get out of hand. Nobody was inappropriate with us, and most of the inmates were pretty sharp-meaning I did not notice them being over medicated, although I suppose it could have been true.

Do you like being a psych nurse? I have often wondered what it would be like. Please let us know what your experiences are as they happen. I am interested to hear what you learn.

So far I really like it. I've always had an interest in doing it, I just now made the switch. There is a county hospital in the area, so they take the county patients. Ours are mostly private insurance patients. No one has gotten out of hand during the time I've been there, but I know it does happen.

I know we have counselors that are there, and they run groups and such. Then they have the OT people who come in. Since I"m in orientation, and following someone else, we really just were in the office though. So I didn't actually see any of the therapies. I still have 3 other units to orient to as well, I've only been on the one. So I am not sure how it really will be.

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Specializes in ICU (all), ER, PACU,Psych, Mother/Baby.

Although this is rather common in a lot of psych units, I find what you described particularly disturbing; especially during the day. As a traveler I worked in different specialty areas including psych. I admit that it can be hard but that is why we are there. To help these patients. Can you imagine being that sick an completely isolated from the world, including the people who are sworn to help you? I can't. I think it does less good to the patient's overall well being. Perhaps that's just me. I wouldn't pick up on such extreme bad behavior if I were you, although i suspect you care - since you are concerned.

A nurse ought to be prudent at al time, judicious with their time and words, and above all else, be caring. What part of that is unclear to that nurse?

Try asking her for advice on how you should interact with patients. Perhaps Queen Bee will get her butt off the chair and show you the correct way to do things. I'm so ashamed people like her are in our profession!

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I work MS and unfortunately I don't get to spend as much time with my patients as I'd like to either. This seems to be quite comment in a lot of different departments these days due to low staffing ratios and tons of paperwork. We are so busy that some days a quick squeeze on the arm or a minute holding a hand is all I can get in as I am running around. I would love to spend more time with my patients to chat a bit and comfort them more but time just doesn't always allow for it. It really isn't for lack of trying on my part. It's a shame it's come to this for so many. Patients deserve better.

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