Nervous about new job!!

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Specializes in Case Management.

Hi!

I've just accepted a job at the state impatient psych facility and I'm very nervous about it!! I've always had an interest in psych. Upon graduating in May, I was offered a home health/mental health psych job but turned it down because I was nervous about going to these pts houses alone as a new grad...so I started a job on a cardiac stepdown working nights/weekends...needless to say I hate it! I hate that I can't carry on a conversation without my phone ringing. I'm totally not interested at all in cardiac and while the pay is amazing-the schedule sucks!

So still keeping psych in mind I decided to apply to our state hospital and I got a job offer. The pay is amazing and the shift is awesome 7-3, alternating weekends! They want me to start orientation beginning in January. I'm not really afraid of psych pts. I really enjoyed my clinicals and I know that most psych pts arnt as violent as people make them out to be, but my job offer is for the Forensics program so they'll be coming from the CJ system. I'm not really sure if that matters. When asked about safety, the interviewers talked about training in deescalation techniques and stuff. But I can't help but wonder why they would offer me (an inexperienced nurse) such great pay and a great schedule.

They say the minimum nurse to unit ratio is 3 with the RN (me) charging. I guess I don't really have any specific questions about it but I'm hoping if anyone has had any advice or good/bad experiences they'd like to share, I'd appreciate it. I guess my fear of the unknown/safety issues is making me hesitant about it.

Thanks!

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How many patients will be on your unit? Or what is the maximum amount of patients that the unit can hold at one time?

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Specializes in Case Management.

From what I've been told the Forensics program has 3 units-secure 1 ( maximum security), secure 2, secure 3 (that's the one I'm on) totalling 130 beds. So I'm guessing 43ish per depending?? I guess I should've asked for more details because I don't know the exact per unit.

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Is that 43 patients with only three RN's or will there be additional staff provided? Three staff members for 43 patients sounds seriously understaffed to me.

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Specializes in Case Management.

There's also techs on the unit too but I just asked them about nurse to unit ratio and she said minimum of 3.

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Specializes in Forensic Psych.

I work forensic psych and I love it! Sometimes the lack of freedom can be annoying - there are downsides to working on a locked unit and dealing the with extra rules/restrictions that go along with working with that population - but I mostly enjoy it.

Safety is always a concern, but you learn to keep your distance, always know your exits, and to never turn your back on a pt. You also learn how to de-escalate and when de-escalation isn't going to happen and it's time to take other actions. The most important thing to me is trust in your coworkers. Your lives can depend on each other, so it's important to work in an environment where you all have.each other's backs.

Our ratio is 1 nurse and 2 MHTS for every 20 patients.

The benefits are good because the job can be tough and undesirable for a lot of people. Staffing would be atrocious if they couldn't lure people in with what I consider to be "hazard pay."

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Specializes in Case Management.

Awesome! Thanks for sharing your positive experience!

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I absolutely love psych...congrats and good luck. Some great information, never turn your back, keep safe distances ALWAYS, no matter how harmless a patient seems, and therapeutic communication is a great friend indeed in this environment. However to echo 2011RN, the nurse to patient ratio sounds dangerous. I work on a 18 bed unit with 2 RNs, and 3 BHTs, if that can give you idea of staffing.. And why would they make you Charge with less than a year experience? I would question that.

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Specializes in Case Management.

Thanks for the info! I asked in the interview would I be expected to charge and her response was not right away but eventually yes we want you to charge.

Also she just told me the minimum to nurse to unit ratio was 3 but that they try to staff more depending on how full the unit is and there are techs also to help with vitals etc but didn't go into detail as to how many. I assume since it's during the day 7-3 that staffing is better but I could be wrong.

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What I've found to be very helpful on the units I've worked is to be consistent. A lot of children and adults appreciate a structured environment and it helps them to feel safe. In my facility we have one person for every five patients. We usually have two RNs on every unit.

Congratulations on the new position. I have only been in psych since graduating with my RN in August of this year. I worried about what to expect as well, but I have loved every minute of it. I hope you enjoy it as much as I do.

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Specializes in Case Management.

Thanks! I hope so too :)

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Specializes in Case Management.

Its been about a month now since I started this post. I'm almost done with classroom orientation and found out a lot about the units. 40 individuals (residents) is the max we can allow on the unit. We have on day shift a nurse manager, a shift supervisor, charge nurse, RN and LPN for each side, and the ratios to FSTs is suppose to be 1:8. So "suppose" to have 3 on each side but staffing apparently isn't good in that respect. The place sounds adequately staffed in case a crisis happens. I start on the unit tomorrow!! Thanks for all the comments and support!

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