I'm about to be in my last semester of nursing school and its getting to the time where I have to make up my mind on what I want to do.
I went into nursing school really wanting to become a psychiatric registered nurse with the intention of later becoming a psych NP.
I had a lot of experiendes that really led me to want to help people with conditions like schizophrenia, bipolar disorder, depression, and drug addictions. (Though in general I like helping people with their mental health)
My psych clinical was in a long-term facility for patients mentally incompetent to stand trial. I did not love the clinical if I'm being honest, the nurses hardly ever left the computer and had very little involvement with patients if any other than handing them their meds. I also felt very awkward in general talking to patients there and I often found myself having a difficult time figuring out what to say, the anxiety didn't help. I'm usually anxious in new environments but quickly adjust to them after a bit and become comfortable.
I really don't want to judge psych based solely on this clinical experience though. I did a presentation on acceptance and forgiveness for the patients there and felt like I really connected with them and they were so engaged with me! I really loved that feeling and felt passionate about it.
Do you think my experience may have been affected because it was a long term facility with most patients already having been there for a long time? Or is psychiatric nursing maybe just not meant for me?
Im at a crossroads because what if I go into psych and I don't like it? I've hears its so difficult to back to medical units after starting in psych.
I was one of those nursing students that fell in love with psych and have only done psych, even after a L&D position was offered to me contingent on me getting my nursing license some 12 years ago. I love psych but in retrospect I wish I would have gotten a few years of at least med-surge first. The prevalence of medical issues amongst our patients is extraordinary. I feel having that medically focused foundation will make anyone who loves psych a better psych nurse. I recently started a second job as an ambulatory float RN. I'm learning so much medical that I'm applying when in my psychiatric setting.
I work in a twenty bed inpatient med psych unit, a little different from what you describe because we must interact with our patients. In my state, there is a shift assessment where we ask if they're suicidal or homicidal, to rate their depression on a scale of 1-10, their anxiety on a scale of 1-10, and when their last bowel movement happened to be. Some nurses do that and the pill waitress thing, then spend the rest of their shift charting by checklist and shopping for shoes. You've met the patients/clients/guests we refer to as feeling "jailicidal." (I think psych nurses have a twisted sense of humor.) We see "homelessidal", "rageicidal", "drugicidal and drunkicidal", "boredicidal" etc in addition to those suicidally depressed and/or cripplingly anxious that we are hopefully able to help. Not as much psychosis as I fist expected and feared. Way more dementia. Everybody who comes to us IMHO needs to be helped (or "helped") by us. Most people who come see me are there only three to five days so there is always someone new with different issues. Our purpose is primarily for stabilization - to keep them safe - until they and the psychiatrist feel like they are able to cope without overdosing, slitting their wrists, shooting their loved ones, leaping off a bridge, running into traffic, etc. or (God bless them) holding their breaths until they just die. We are nurses, not therapists. I think a heart is a heart is a heart, but a mind, a mood, a personality, I find ever so much interesting. We see your cardiac patients when they have had to make lifestyle changes and are wondering if life is worth living. We see the wrist lacerations, the poisonings, the people from ICU who have tried to die I have seen the "real" nurses in the ER/ED/floors send us patients who are not medically stable. Diabetics ... lots of diabetics, courtesy of psych meds. I tell all the nursing students doing their clinicals that *every* nurse is a psych nurse. If it's not their patient, it's the patient's family. It's their co-workers, or their own families, or (dare I say it) themselves. My hospital allows prospective psych nurses to shadow one of us and see how our day goes. May want to try that. NP's have clinicals where they follow an NP. Maybe do med/surg or nursing home nursing briefly, so you will have a medical experience reference if you find psych is not your thing. I spend time listening to the patient before charting, which actually makes my narrative charting much easier and takes about the same amount of time. Don't worry too much about coming across as anxious. They are way more so, and tend not to notice. Best of luck in whatever you decide to do. Sorry about the stigma some departments and institutions have towards psych nursing. Where I work, psych has its own building in the parking lot of the main hospital, as if our patients need to be quarantined. Nurses who transition to psych without knowing what we do don't seem to stay long. It's perceived as "easier" but it's not. Just "different".
You don't need a medically focused foundation. You need a patient focused foundation. I've found that there are peers or managers or supervisors from med/surg or ICU always willing to help you out if you are willing to learn.
JuanabePHNurse
22 Posts
I was one of those nursing students that fell in love with psych and have only done psych, even after a L&D position was offered to me contingent on me getting my nursing license some 12 years ago. I love psych but in retrospect I wish I would have gotten a few years of at least med-surge first. The prevalence of medical issues amongst our patients is extraordinary. I feel having that medically focused foundation will make anyone who loves psych a better psych nurse. I recently started a second job as an ambulatory float RN. I'm learning so much medical that I'm applying when in my psychiatric setting.