Needing Advice --- Work Environment?? Possible Switching Specialties??

[carls23]

Hello! I'm new to this site so thanks for having me ? I'm 23, a new grad RN -- May 2018. I could REALLY use the advice/guidance from experienced nurses with my situation... Sorry for the length.

In nursing school, I LOVED psych and babies. I decided to go pysch b/c I have empathy for mental health and believe they need all help and advocacy possible.

I work at an inpatient psych unit, stabilizing those experiencing psychiatric crisis, which I was so happy about. I love the patients I work with and find the work rewarding, however my job is beginning to make me miserable.

It's an 18 bed unit and my manager staffs under-grid. Often we have 2 RNs (one being charge), and a tech on the floor. So 9 patients/ nurse plus charge duties, pass own meds, and doing admissions/discharges. Management has been unsupportive brushing off concerns us saying the under-staffing is dangerous with these types of patients, their most common response is "you'll be fine." Is this normal?

Also, my manager schedules us extra shifts without consent, and we don't have hospital policy requiring this. I emailed saying I don't appreciate this and want courtesy of being asked which days before just being scheduled extra. The unit head said I owe her an apology for emailing, calling me disrespectful and harsh. It just feels like we have no support from upper management. I was assaulted at work by a patient leading to a wrist injury and management said they've been "more than accommodating" finding me light duty work during my healing process and they compliment me for doing good work, so I should be more appreciative and think of that before voicing complaints. Is this normal? Or am I being a brat?

I feel burnt out and think about leaving the unit daily. I can't sleep the nights before work. My coworkers hate management, so it's negative complaining all day by everyone. Plus verbal and sometimes physical abuse from patients all day to top it off. It's not a happy place to work.

Now I wonder if psych is for me or if I just work at an unhappy unit. Thoughts of finding a new psych unit or even switching to L&D or postpartum (my other interests) cross my mind A LOT. Then I think maybe I'm being dramatic and should suck it up and stick it out. My mind and emotions are all not knowing what is right. I constantly question myself and I just need some help/input from others. TIA!

[FolksBtrippin, BSN, RN]

Sounds like my first nursing job.

I went to an ACT team and love it. Now I am moving on again to get my psych NP.

Go ahead and start applying for other specialties that interest you.

Also look outside the hospital environment, which is often toxic.

If you have your bsn, check out nurse family partnership, since you are interested in psych and OB.

Also consider corrections.

PM me anytime.

[carls23]

Thank you so much!

[Davey Do]

No, carls, you are not being a brat and this is not "normal".

From what I read, psych is for you and it sounds like you work under administrators who are not only uncaring, but are narrow-minded bureaucratic bullies who utilize an intimidation supervision technique.

You have a couple of options: You could shake the dust of this inpatient psych unit off your shoes and attempt to find employment where your caring talents will be appreciated and supported or you can fight the machine.

Having done both in my career, I can tell you both options have their benefits and pitfalls. When I worked at Anomaly State Hospital (ASH) in '91 and '92, I chose to leave. I fought the machine at Wrongway Regional Medical Center (WRMC) and have been there 16 years.

To fight the machine requires dedication to objective documentation, informing those responsible in following the chain of command, and a willingness to go to outside entities if wrongful practices are not rectified from within the institution.

Even though I did leave ASH, I did pursue having the wrongful charges of patient neglect/abuse dropped and expunged from my record with the help of the Illinois Nurses Association. I was also monetarily reimbursed, 1 1/2 years later, for lost work time due to a suspension.

At WRMC, when patient safety/care was being compromised and I believed that I was being harassed, I followed the objective documentation/reporting thing and have had no problem with administration in years.

In whatever you decide, carls, I wish you the very best!

[Emergent, RN]

Let me just chime in. Scheduling someone for overtime without their consent is totally unacceptable in my book. Management at your place sounds incompetent, desperate, and heartless.

[TriciaJ, RN]

Part of your problem is being new and having nothing to compare this to. I worked psych for 15 years. 18 patients with 2 nurses and a tech might work for longterm psych although such facilities barely exist anymore. For acute and crisis psych, those numbers are a dumpster fire. Add to that the fact that your management is completely callous and despicable, and I fear for your physical safety. I'm also surmising you have no union. If you do, please make contact with them.

You can try NICU or any other area that interests you. Just make sure before you take the plunge that you'll have better staffing and actual human beings for managers.

If I were in your shoes (I actually have been) I would scout about for another psych job before trying a new specialty just yet. You're just developing some beginning competence and you'll have something to compare the new job to. That's my take. I do wish you the best, whatever you decide.

[3ringnursing, BSN]

OMG. Girl, welcome to nursing - under appreciated and at times psychologically abusive ("Thank you sir, may I have another?" - if you have no idea what this means watch the movie Animal House).

No, you are not being a unreasonable, this is designed to make you feel bad for standing up for yourself, which you have every right to do, and did it appropriately as far as I can see. You may be enlightened to discover many management positions are reimbursed at the end of the year for operating under budget - which means you and your co-workers pain means bonus money to someone else. Perhaps going elsewhere is in your best interest (i.e., Leave!).

[guest1048932]

On 2/8/2019 at 6:15 AM, carls23 said:

Hello! I'm new to this site so thanks for having me ? I'm 23, a new grad RN -- May 2018. I could REALLY use the advice/guidance from experienced nurses with my situation... Sorry for the length.

In nursing school, I LOVED psych and babies. I decided to go pysch b/c I have empathy for mental health and believe they need all help and advocacy possible.

I work at an inpatient psych unit, stabilizing those experiencing psychiatric crisis, which I was so happy about. I love the patients I work with and find the work rewarding, however my job is beginning to make me miserable.

It's an 18 bed unit and my manager staffs under-grid. Often we have 2 RNs (one being charge), and a tech on the floor. So 9 patients/ nurse plus charge duties, pass own meds, and doing admissions/discharges. Management has been unsupportive brushing off concerns us saying the under-staffing is dangerous with these types of patients, their most common response is "you'll be fine." Is this normal?

Also, my manager schedules us extra shifts without consent, and we don't have hospital policy requiring this. I emailed saying I don't appreciate this and want courtesy of being asked which days before just being scheduled extra. The unit head said I owe her an apology for emailing, calling me disrespectful and harsh. It just feels like we have no support from upper management. I was assaulted at work by a patient leading to a wrist injury and management said they've been "more than accommodating" finding me light duty work during my healing process and they compliment me for doing good work, so I should be more appreciative and think of that before voicing complaints. Is this normal? Or am I being a brat?

I feel burnt out and think about leaving the unit daily. I can't sleep the nights before work. My coworkers hate management, so it's negative complaining all day by everyone. Plus verbal and sometimes physical abuse from patients all day to top it off. It's not a happy place to work.

Now I wonder if psych is for me or if I just work at an unhappy unit. Thoughts of finding a new psych unit or even switching to L&D or postpartum (my other interests) cross my mind A LOT. Then I think maybe I'm being dramatic and should suck it up and stick it out. My mind and emotions are all not knowing what is right. I constantly question myself and I just need some help/input from others. TIA!

While it's not great being scheduled for extra shifts, find out if your policy, or contract, allow for this. Some places will use and abuse fine print that no-one reads, and will force people with no seniority to stay past shift. This is not right, but it happens far too often. Don't feel bad for not taking it. You are not being dramatic. DO NOT suck it up! You are completely within your rights to suggest that management asks before scheduling you for shifts. That is common courtesy. You are not being a brat! Like other posts have said, management gets a bonus when they go "under budget". Remember that. It is not worth your health and sanity just to make someone's wallet fatter.

You are in the early stages of burn out, and good on you for recognizing it! You've already confronted management and they have no support for you. That will not change, no matter what you say to them. They will always make it feel like things are your fault or that you're asking too much or being a "bad employee". Don't worry, you are none of those things! You are looking out for you and your patients.

I say move on. It's not that inpatient psych is not for you, it's that inpatient psych management is poor and is forcing you out. When a hospital has a high turnover rate in one area, management is eventually investigated and then things will change, but by the time this happens, you will be burnt out and will have moved on.

Try out different areas of nursing, like L&D. I can tell you from experience that supportive management makes a HUGE difference to your health. Treat your employees well and they will treat you well.

[carls23]

I just want to thank everyone SO MUCH for your responses! I truly appreciate every single one of you for taking the time to respond. You all gave me so much peace of mind and gave me courage to move on. I will definitely be exploring and pursing different opportunities. Thank you again!!!

[umbdude, MSN, APRN]

Sadly, in regards to the unsafe staffing ratio in inpatient psych, it is pretty commonplace (at least in my area). It's incredibly hard to find an inpatient hospital that pays you well and have good staffing in psych. I love psych and I left inpatient for outpatient and NP education because I need to be in control of my career. There are many other settings in which you can work with psych patients. Most hospitals simply don't give a ?.

I went into an outpatient crisis unit and I love it. I make a difference with less stress, and my hourly rate is much higher.