New grad in Psych nursing and your experiences?

[denicola.c]

Hi guys! I'm asking for some advice or opinions. I accepted an interview for a mental health nurse position. The company works in the community. I'm trying to learn as much as I can about it. I am a new grad, so I am wondering if this kind of position would be good or bad for me?

I am only 20 and being a small female, my biggest fear is visiting a client and being taken advantage of. The company says on their website they commonly care for addictions, homelessness, and cognitively impaired. I love the idea of the job- I think mental health is so important and overlooked. I would love to make a difference. I have no idea what kind of nursing I am suited for since this will be my first job, so I don't know what kind of job I could even fit into!

All that being said, I'm still remaining open minded. I emailed my professor/clinical instructor for my psych rotation and asked her about the specific company and job to see what she thinks so I'd like to take her advice into consideration.

Addirionally, if anyone could give me a "run down" of what a typical day looks like that'd be great. Of course I'll be asking tons of questions at the interview and hopefully ask to shadow a nurse in the field.

Thanks in advance!

[Davey Do]

I am wondering if this kind of position would be good or bad for me?

You certainly have the right attitude, denicola:

I think mental health is so important and overlooked. I would love to make a difference.

Additionally, if anyone could give me a "run down" of what a typical day looks like that'd be great.

This is an oft discussed area, so you could use the search option near the bottom of the forum page and find what others have written.

Good luck in your endeavor, denicola, and please let us know what pans out!

[Meriwhen, ASN, BSN, MSN, RN]

Since you say "visiting a patient," I'm going to guess that this is home health.

New grads should NOT work home health...and this is doubly true for psych home health. You need to have an established knowledge base of psychiatric conditions, medications and treatments, as well as therapeutic communication and deescalation techniques, before you attempt to do psych home health.

That's because in home health, it's just YOU. There's no senior nurse that you can run down the hall to ask a question of, no coworker that can come in to give you their opinion, no team of staff to come in to help should things go south. You need to know how to handle this all on your own. You need to be able to assess a patient and know the difference between normal/baseline and abnormal. You also need to know when a patient is decompensating or their condition worsens, because such changes are not always as obvious as textbooks make it seem. Sometimes those cues are very subtle, and the inexperienced nurse may not catch them. And if a patient is escalating, you need to know how to try to defuse the situation to get yourself out of there safely (and ideally the patient safe as well).

Oh yes, you also have to stay abreast of your medical knowledge as well. No, you're not the medical nurse...but what are you going to do if your patient gets SOB while you're there? Or you're doing a BP check and it's in the 180s? Or if they're slurring their words and confused: is that intoxication, overdose, EPS, hypoglycemia, or a side effect of a med...or any combination of the above?

If you insist on doing psych home health, try to get as much training as possible. Also be sure that you can contact the agency/organziation at ANY time while in the field. And do not practice without your own malpractice insurance to protect you.

Though to be honest...if you really want to do psych, I would suggest applying to either a hospital's psych unit or a freestanding psych facility. Work a couple of years inpatient first before you attempt to work in the community.

Best of luck.

[ChildPsychRN]

I agree with Meriwhen. I have worked in an inpatient psych hospital for a year, and I wouldn't consider doing home health at this point. I have seen many patients escalate to the point of violence. I am happy for you that you were offered a position, but I would strongly consider getting some experience in an inpatient setting or clinic before going into homes.

[daisylouhoo]

I worked inpatient psych for 5 years before going into home care. Definitely agree with previous posts. Wouldn't have gone straight to home health w/out prior experience and own malpractice insurance is very important.

[Whispera, MSN, RN]

I agree with the others. Don't do psych home nursing as a rookie. Experience in psych in school is so minimal that you only get a tiny taste of it. Truly, you will not know what to do most of the time, and you'll be on your own to do it, if you take the job.

[thekid]

I'm going to agree with the others as well. I did case management (psych) recently and there were many situations that could have been dangerous. There was a high turnover rate at the company I worked for. Try to get some experience in a facility first. Best of luck.