New Grad offered Pediatric Psych Position

Specialties Psychiatric

Published

Hi all,

I am a new grad recently offered a position at a residential chid/adolescent psych facility. There are kids with various neuro/behavioral issues, and they do restraints frequently on the younger children, from what I have been told. Apparently some units are fairly laid-back while others are the "fastest-paced" in the psych world. They badly need RN's, hence why they want to hire me. I hear that the staff is great, however.

Psych is not my passion (not sure what IS my passion..I think it may be public health), but I did like psych in school and I like kids. I have experience with kids, but nothing extensive, and no prior experience in psych. I would describe myself as a "gentle soul", I am a sensitive, thoughtful individual and not sure if I'm cut out for any area in nursing that is "fast paced". I don't like adrenaline rushes. After only 2 weeks of orientation, I will be expected to be the sole nurse on a unit in charge of 2-5 patient care techs, 10-30 kids, managing mileu safety, communicating with doctors/parents, giving meds, etc. I see this as a positive in one sense, because I would like to really learn some managerial skills, but I would much prefer to have another nurse on the unit. I'm not sure why there is not more orientation, but 2 weeks is the standard at this facility. I have heard that the staff is very supportive and I can call a nurse on another unit at any time, but I am hesitant.

I want to give it a shot, but I feel like I have NO idea what I am getting myself into. Any thoughts?

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where is this facility at? I've been a psych nurse for more tha m 3 yrs now and i loved it.

it's good to have psych experience as a new grad but you

really have to think about it because not everyone is cut out for

mental health nursing. goodluck!

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

I have worked peds, adult/CD and geropsych. Peds is a whole different ballgame. Not my cup of tea, but it may be yours. That is a really large unit to only have one nurse on duty. Sounds badly understaffed to me. If your census is 30 and you only have techs on duty with you, that leaves you to do all the meds, all the charting, all the orders, deal with visiting families, plus discharges, admissions and crisis situation management. I wouldn't accept that job, and I have almost two decades of psych experience.

I went into a charge position on an adult/CD unit right out of school. It was tough enough on a ten-bed unit dealing with adults and having an LPN to handle the med pass and some of the intake paperwork. That is an awful lot to take on with no experience in the field, IMO. Even an experienced nurse would struggle under those conditions.

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Two weeks sounds like awfully little orientation for a new grad to an area as demanding and specialized as child psych.

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I agree with Orca and elkpark. I'm a charge nurse on a 16 bed child/adolescent unit. We always have 2 RNs on - one to pass meds and the other is charge. With only 16 kids - some shifts are beyond crazy with admissions, discharges, medical issues, restraints/seclusions, family concerns, etc. I can't imagine being the only nurse responsible for everything plus having more kids. Child/adolescent is a HUGE liability if something goes wrong and it's definitely a specialty that requires good training and orientation. Good luck to you! Keep us posted!

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Specializes in Hospice, corrections, psychiatry, rehab, LTC.

Based just upon what I have read, that facility is trying to do things on the cheap and squeeze every last dollar out of it by skimping on nurses and trying to do everything with techs. You can bet that if something goes wrong, they will sacrifice you to save themselves. That sounds like a dangerous work environment, one of those "check your license at the door" type places. I would think long and hard before accepting this position. You have put too much time and sweat into getting your license to risk it in a place like this. There are better options out there.

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Hi everyone, thanks for the input. I think 30 would be extreme, I think on average there may be about 12-15 kids per unit? That is still a lot for one nurse. I definitely do not want to risk my license. I know a few other new grads who have already started working and they seem to be finding the experience 'ok' so far, some even enjoy it. I think I will give it a shot but I am trying to be wise about it.

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I know a few other new grads who have already started working and they seem to be finding the experience 'ok' so far, some even enjoy it.

The experience is always okay, until the shift(s) when the doo-doo hits the fan ... :)

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Many of our new grads use psych as a foot in the doorway. They stay for a year and transfer into another department. We loose about 3 or 4 a year. Now we are trying to only take new grads who want to stay in psych.

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Two weeks is inadequate in my opinion to orient to a facility, especially for a new grad and one who will work alone. This sounds very unsafe to me. You did indicate it's a residential facility so I would think admits and discharges aren't as frequent as an acute unit however 1:30 ratio seems unreasonable. Trust your gut instincts. If you see red flags, leave. It's not worth your license or your safety.

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Specializes in Psych.

I see some big red flags here. 2 weeks of orientation is nowhere near enough, esp for a brand new nurse. I got 4 and I was coming in with a year experience. Second one nurse for 30 pts, holy geese that is so unsafe. Kids in RTCs can be just as acute as kids inpt, I would never want to be in charge of 30 kids AND have to do the whole med pass. We usually have 4. One unit nurse and one med nurse on the adult side, same for C&A. Kids can get hectic for just those 2 nurses. I love kids, but yes, many, many time outs. We try not to go hands on with the kids, but I think it happens a lot in RTC. One of the only real interventions to keep everyone safe when you aren't in the protective bubble of the hospital. You will at some point probably get hit, kicked, spit on or bitten. Where I work, if a pt is gonna swing on you, 4 times out of 5 its a kid. I love em though. It's my favorite assignment.

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I wanted to update everyone. I tried making this job work but before orientation is finished, I am quitting. Less than 1/2 of the 2 week orientation is on the unit, and the nurses are too overwhelmed to teach anything. IMO This place has major problems and I'm getting out. I think I could make a great psych nurse, though. The kids don't scare me, neither do the (bunches of) codes. It's the fact that there's inadequate, poor, unorganized training, understaffing, and barely any education on policy and procedure, and the fact that nobody is actually following the policies. I feel that my license is at risk if i stay. My gut is telling me it's not a "trustworthy" situation. Outta there.

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