mental health

KelRN215, BSN, RN · Aug 5, 2012

What are you scared about? People have the wrong idea of mental health/psych nursing the majority of the time I find. My psych clinical consisted of checking in with one patient and observing patient groups. Many psych patients are not that different from you and me... I once ran into a classmate who was a patient on the floor I was doing my clinical on!

~passionateSN~ · Aug 5, 2012

What are you scared about? People have the wrong idea of mental health/psych nursing the majority of the time I find. My psych clinical consisted of checking in with one patient and observing patient groups. Many psych patients are not that different from you and me... I once ran into a classmate who was a patient on the floor I was doing my clinical on!

I'm scared because my friend got pinned down at our psych hospital by a patient.. Maybe I'm scared more now because we haven't studied how to handle things yet of course because school hasnt started yet. maybe I will be more comfortable once we he lectures.

lovingtheunloved, ASN, RN · Aug 5, 2012

Psych patients are just people...I'm a lot more afraid of a baby in the NICU than I am of a psych patient. Not all psych patients are aggressive...in my experience, most of them are not. Treat them like human beings. Talk to them. My last psych hospitalization, I made a point of talking to the nursing students, sharing that I'm a nurse. I think it showed them that anyone can have a mental illness. And that not all of them are scary.

PlumeriaSun · Aug 5, 2012

Try to reorient the patient as best as you can.

KelRN215, BSN, RN · Aug 5, 2012

I'm scared because my friend got pinned down at our psych hospital by a patient.. Maybe I'm scared more now because we haven't studied how to handle things yet of course because school hasnt started yet. maybe I will be more comfortable once we he lectures.

The vast majority of psych patients are not violent. I never saw a violent patient in my psych clinical... I was on an acute care unit and the typical patients were: patients with bipolar who self-discontinued their meds and came in with a manic episode, unsuccessful suicide attempts, patients with schizophrenia who self-discontinued their meds and were delusional and then the occasional newly diagnosed who presented with either a psychotic or manic episode. I never worried about being attacked. The other girls in my clinical were on two other units: a women's unit which was primarily patients with PTSD and borderline personality disorder and a substance abuse unit. No one was ever attacked.

Treat the patients like people who happen to have a mental illness rather than as a crazy person who is possibly going to attack you.

allnurses Guide · Aug 5, 2012

Try to reorient the patient as best as you can.

Reorientation depends on your pt.

While reorientation may work with some pt's, others will not be so receptive to being "challenged" on their beliefs.

I'm talking about some actively psychotic pt's.

You just need to be thoughtful in your responses, including facial expression and body language.

Yes, most pt's will pose no threat (nor will they be psychotic), and YES they all should be treated with the respect we would give to anyone else... absolutely!

But "try to reorient the pt the best you can" is much too broad of a statement that-- if this advice is applied to all pt's-- is fraught with peril... especially in the hands of an inexperienced student.

No offense, PlumeriaSun, I'm sure you know all of this.

I am directing this to the OP who is a student and, most likely, unaware of the nuances of communication re behavioral health.

Overall, psych is not the big bad scary beast many people think it is.

In fact, some students find themselves very very disappointed (bored!) that there was no rubber room or straight jackets... and no pt running around swearing he is George Washington... *eyeroll*.

Just remember to listen to what you are being told about your pt.

Follow directions and you should be okay.

My friend was classmates with a student who was assigned to the forensic unit and who was explicitly told not to interact with a particular pt on the floor.

Well, she didn't listen.

I guess she thought she knew better, like she was so smart or charming... I don't know.

She got the living far beat out of her.

Listen, utilize communication techniques, use your common sense and be mindful and alert, but don't exude fear.

Chances are, you will have no issues and will leave with a whole new level of understanding for a very misunderstood area of healthcare.

PlumeriaSun · Aug 5, 2012

Reorientation depends on your pt.
While reorientation may work with some pt's, others will not be so receptive to being "challenged" on their beliefs.
I'm talking about some actively psychotic pt's.
You just need to be thoughtful in your responses, including facial expression and body language.
Yes, most pt's will pose no threat (nor will they be psychotic), and YES they all should be treated with the respect we would give to anyone else... absolutely!
But "try to reorient the pt the best you can" is much too broad of a statement that-- if this advice is applied to all pt's-- is fraught with peril... especially in the hands of an inexperienced student.
No offense, PlumeriaSun, I'm sure you know all of this.
I am directing this to the OP who is a student and, most likely, unaware of the nuances of communication re behavioral health.
Overall, psych is not the big bad scary beast many people think it is.In fact, some students find themselves very very disappointed (bored!) that there was no rubber room or straight jackets... and no pt running around swearing he is George Washington... *eyeroll*.
Just remember to listen to what you are being told about your pt.
Follow directions and you should be okay.
My friend was classmates with a student who was assigned to the forensic unit and who was explicitly told not to interact with a particular pt on the floor.
Well, she didn't listen.
I guess she thought she knew better, like she was so smart or charming... I don't know.
She got the living far beat out of her.
Listen, utilize communication techniques, use your common sense and be mindful and alert, but don't exude fear.
Chances are, you will have no issues and will leave with a whole new level of understanding for a very misunderstood area of healthcare.

I agree with you. The reason why I didn't broaden out my response was because I peruse this forum with my phone generally. I agree with what you're saying. In my experience I was never bored, but that was because the location I was at had some severe psychiatric cases. The reason why I said to reorient the patient was because as a student I had difficulty doing just that. But I do agree that not all patients can be reoriented.

eleectrosaurus · Aug 5, 2012

Agree on all points with HygeneQueen.

Listen, intently. These folks are used to being dismissed and ignored.

Be sincere. Like anyone they can sense if your being phoney, even if you dont say the right thing 100% of the time, often you'll be forgiven if you're being sincere.

Patti_RN · Aug 5, 2012

I'm a psych nurse and know that it's not for everyone, but it's a passion for those of us who love it. As others have pointed out, psych patients can be just like you or me. Because of stigma many people never admit suffering from mental health issues. It's more common than you think, and chances are a few of your classmates, friends, neighbors or even family members suffer from some type of mental illness. Just like with medical problems, there are varying degrees, and the ones with serious problems are inpatients--the rest you pass and interact with on a daily basis as you and they go about their daily lives.

Eleectrosaurus is right: listen to them. Mental heath nursing is as complicated as L&D, critical care, or other specialties. Don't work outside your scope of practice just because it's 'talking' instead of a physically invasive procedure. Your best bet is to listen empathetically; don't offer advice, attemt to redirect them, agree or disagree with them. Simply listen. Be empathetic (not sympathetic) and be genuine. Don't ever make promises you can't or won't keep. You will not be able to 'cure' patients of their delusions, nor will you be able to end their depressions, or moderate their bipolar swings. Medication is their best ally, and trained mental health professionals will work on 'curing' them. As a student nurse, you have time to devote to one or two patients, a desire to help patients in need, and a caring heart. This is all you need to do your mental health rotation.

~passionateSN~ · Aug 5, 2012

I'm a psych nurse and know that it's not for everyone, but it's a passion for those of us who love it. As others have pointed out, psych patients can be just like you or me. Because of stigma many people never admit suffering from mental health issues. It's more common than you think, and chances are a few of your classmates, friends, neighbors or even family members suffer from some type of mental illness. Just like with medical problems, there are varying degrees, and the ones with serious problems are inpatients--the rest you pass and interact with on a daily basis as you and they go about their daily lives.
Eleectrosaurus is right: listen to them. Mental heath nursing is as complicated as L&D, critical care, or other specialties. Don't work outside your scope of practice just because it's 'talking' instead of a physically invasive procedure. Your best bet is to listen empathetically; don't offer advice, attemt to redirect them, agree or disagree with them. Simply listen. Be empathetic (not sympathetic) and be genuine. Don't ever make promises you can't or won't keep. You will not be able to 'cure' patients of their delusions, nor will you be able to end their depressions, or moderate their bipolar swings. Medication is their best ally, and trained mental health professionals will work on 'curing' them. As a student nurse, you have time to devote to one or two patients, a desire to help patients in need, and a caring heart. This is all you need to do your mental health rotation.

This really helped me a lot thank you!

lovingtheunloved, ASN, RN · Aug 5, 2012

Just because they're a psych patient doesn't mean they're disoriented.