Mental health.....telehealth.....

[78diho]

I worked on the floor as a psych nurse for enough years to become a pretty effective psych nurse.

Then I decided I wanted to give telehealth a go.

I don't know what the hellO I'm doing.

So I call people up if I see a response from their machine that seems a little worrisome and do further assessment. Ok. Not too different from inpatient.

Most of the time, the patient just wants to talk. Ok. That's also what I'm there for. Therapeutic listening and support.

I work from home. I'm a single mom and the kids being able to spend more time with mom has been clearly beneficial. AND I have time to take them to their activities. I get to do more things with the kids.......Sweet deal is it?

I feel like this is the most unfulfilling job ever. The Telehealth program is not supposed to be a lifelong thing. We are supposed to educate. The ultimate goal is to condition the patient. This is so hard to do. I am supposed to reinforce their coping skills. I'm supposed to knowledgeable about their illness.

These patients have their own multidisciplinary team. They have a PCP, SW, MH provider, primary RN, and then me as a "supplement". So I know their progress depends on the effectiveness of their team and me. But I feel like I do nothing to improve their life other than listen to them and act as a liaison if their primary nurse is too busy (I don't envy them). I sit at a desk. I alert the provider via documentation, not phone call or page, if something needs to be addressed and hope that that provider cares enough to address a concern.

Many people think this job is a sweet deal. Sit at a desk. Minimal stress for some people. Work from home.

But I feel like I do nothing to help my patient's in the long run.

I love that I am so fortunate to be able to spend more time with my kids, especially since they have a single parent. But at the same time I feel like I am unable to be an effective nurse to make a long term difference in someone's life. I remind myself that I am a "supplement" to their care. But I still want to be able to make some difference.

Yet, I feel that I do have a "sweet deal" with regards to it balancing work and family. ]

To be honest, I don't see telehealth as an effective program at all. My saying this is like saying that it's "quiet tonight". But I truly feel it is a really pointless program.

I would totally go back to inpatient psych if there was an opening but at the same time this would take away time from my kids.

What can I do to be more effective?

What would you do?

[oceanblue52]

I think Tele health is useful when you have clients that don't have easy access to a behavioral health center, it is gaining traction in rural areas out West. Do you ever have inter-disciplinary meetings, or a supervisor you can talk to? Maybe they could offer some suggestions for addressing these frustrations.

It sounds like you are dealing with mostly stablized out patient clients, correct? Treatment is a bit different with this setting as opposed to inpatient, it's easy to feel ineffective when you don't have control over their schedule and other stressors. If you are academically inclined, look into joining a Community health/Ambulatory nursing association, treatment theories and approaches are very different from traditional inpatient nursing. Some of the CEUs offered might give you some insight and tips.

Having worked in clinical Psych for about 5 years, I've realized one thing that separates the staff members that get burned out from the long termers. People in all fields of nursing get burned out when they get too wrapped up in thinking that they themselves can change a patient's course of treatment. You can provide all the suggestions, education, empathetic listening, etc., but ultimately it is up to the client to develop coping skills and direct their course of treatment. You are a facilitator, it is not your sole responsibility to make the client get better. Community health is about the long haul, not short term crisis stabilization.

It took me a long time to realize this, and some other posters might disagree. Ultimately the most effective people I have worked with in Psych understand their limits, stay present and use humor and empathy in their interactions, and then clock out and don't give their work a second thought. Not sure if this applies to you, but you clearly care enough about your work to seek out advice in your free time. That is awesome, but perhaps reflecting on your work-life balance would help?

At any rate, I don't know if any of these thoughts are helpful for your situation, it might just be that inpatient is a better setting for your personality. Nothing wrong with that, ultimately it comes down to what will make you most happy :-)

[hrnurse]

Excellent post . What telehealth company do you work for might I ask ?

[hrnurse]

May I ask how did you find a telehealth job as an RN ? I have a few ideas to share but its more case management focused . Thank you .

[oceanblue52]

Right? Sounds like my dream job.

[Laurean]

I am nearing the end of my psych nursing career and I believe that a telehealth job would be the perfect wrap up to a great career. Suggestions anyone?