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Discussion

LTC.. will working here eventually help me in psych?

Hi friends!

I am a new graduate RN (yay!). and I just got my first job offer (yay!) Times are really tough where I live, and I would ultimately like to work in psych, but for now I have to go with what I can. The position is at a facility that does both LTC, dementia/Alzheimer specialization LTC, and sub acute/rehab for the elderly. I have NO idea what unit they will put me in- I wont know until after orientation.

I wanted to know if you psych specialists think that working in this kind of environment can help me eventually work in psych. I'm thinking geriatric psych is huge, and especially if I can work in the dementia/alz unit it could help. At least becoming familiar with the meds these pts are on might help.. also, what do you think managers would think from a hiring point of view? Is LTC to Psych a change that makes sense?

thoughts please?

Thanks so much for your help. :)

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    cherubhipster:

    What a cool name you gave yourself. Congratulations on your new job offer. And, yes, you're merely a stepping stone away from Inpatient Geriatric Psych. In our neck of the woods, we call it "Older Adult Behavioral Health Services".

    The majority of our admissions are probably recognized as being classified as some sort of dementia; Alzheimer's or such. However, this population of patients are often admitted under the diagnosis of "Psychosis nos (not otherwise specified)". Dementia-type conditions are not considered to fit the Axis I Mental Health diagnosis criteria. I think it's all a political thing.

    Your exposure to the routine medications will definitely help. There are, of course, a vast array of medications that this population utilizes for medical needs. Two other classification of meds typically used with this dementia-related population are the acetylcholinesterase inhibitors and antipsychotics; the dopamine antagonists. If you haven't already, get familar with: Aricept, Namenda, Abilify, Risperdal, and Zyprexa, to name a few.

    So, in summary, cherubhipster, I think Managers will believe your experience in a LTC facility would be an asset to the type of program you wish to transition into.

    Good luck to you and keep us posted.

    Dave

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    I would think LTC would be GREAT experience if you're wanting to get into psych.....sometimes the families have more issues than the residents!! :clown:

    Seriously, you will see just about every sort of mental illness there is. Not all LTC patients have dementia, and those who do often have coexisting mental illness aside from their memory deficits, One lady we got from a local assisted living facility recently is not only demented, but she has a lifelong history of bipolar disorder and schizophrenia, PLUS alcoholic psychosis. I've learned a whole new vocabulary of swear words from working with her, and here I'd thought I knew 'em all. So yes, LTC is chock-full of psych issues and meds, and you will have very few outside resources to help you deal with them so you'll learn quickly to rely on your instincts and training.

    Good luck to you!

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    • Author

    I really appreciate your responses to my post. I needed some encouragement so that i can work this job and know that it will eventually help me be where I want to be. Thank you so so much.

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    Hi cherub, When the state hopitals were closed during the Reagan era alot of people went home, to residentail care or became homeless. The lucky ones had family willing to assist them either in their homes or independent living with family or state assistance. As a long time nurse(40 years) and case manager I did get experience from working in nursing homes, a state correctional facility, (which by the way, alot of the mentally ill ended up in) residential care and inpatient psychiatric hospitals and clinics. I was hired as a new graduate into a state hospital in 1970, worked in a 50 bed med-surg ward for mentally ill and when I complained about the care given the administration sent me to work in a outpatient clinic. Basically this was done to shut me up. My Case Management in home care involved "difficult" patients as they are called when they have mental health issues. I worked as a home health Psych Nurse part time while Case Managing and felt this was my calling. I met a male RN who owns his own company that contrats to other hh agencies to do the psych part under Medicare. To do this you have to send a resume in to Medicare and be certified as qualified by experience. I would suggest you either volunteer to boost your resume in some form of mental health care or actually work in an inpatient hospital. You would be surprised how easy it is as there is such a need but realize you will be put in some positions you may not like. I always acted as the advocate for patients and sometimes it was not to my benefit. Nursing itself is a calling but working to help mentally ill is a special calling. Kindness, honesty and non-judgemental attitude toward psych patients are qualities the patients look for and soon you will build a trust relationship essential to this specialty. Many nurses are afraid to do this work but when you think about it every person has a family member with some form of mental illness that you deal with every day anyway. I am so happy to hear a new grad is interested in helping these patients that need it the most. There is a very good website called Westernschools.com that offers accredited CEUs in psych nursing. You should consider also continuing youir formal education even on a part time basis to get a Masters degree in Psych Nursing as your ultimate goal so you can practice independently and make the money you deserve.

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    I've worked in psych/mental health for over 20 years and LOVE it. I've worked adult, adolescent and geriatric and have my certification in it. You'll get some experience under your belt at your LTC facility so that will help you with any speciality but especially psych. As the others have told you, there is lots of dementia but also other types of mental illness that have been covered up for years. Patients may self-medicate to hide a wide variety of illnesses from depression to bi-polar.

    Get familiar with your meds and use your time to really learn medications, symptoms etc. The other nurses have given you great advice so try to follow it and go for it. Psych nursing doesn't always get the respect that it deserves because many people don't understand how complex it is. The patients can't express themselves the way a "normal" person can, so you frequently have to be a detective. Same goes with some geriatric patients. Trust is a huge issue too, along with respect and compassion. There is still a huge stigma attached to mental illness.

    You can never get too much education. There are great suggestions here plus I've joined www.rn.org. They have unlimited CEU's for under $20 a year and they have some great psych subjects. I've been really happy with them.

    Good luck with your LTC patients. Take great care of them while you pursue your love of psych. We need you. :yeah:

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    This post makes me sooo happy because I have been having the same struggle.....I want to get into psych nursing but love the geri population...it is nice to know that I can do both :)

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    You guys are so encouraging! :D Thank you!!

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