New Grad in psych nursing. Need advice.

Gooselady, BSN, RN · Dec 24, 2014

Not silly at all. I have some advice about something you haven't asked (and wouldn't know to!)

I did mostly psych nursing, 17 years worth before I got a hair in my bum and tried something new. I did chronic long term, acute "ICU" psych, and chemical dependency. I worked with mostly great staff, but did have one or two jobs where the staff and patients were difficult to distinguish

In psych, teamwork takes on a whole new meaning, and I'm saying that after working six and a half years in hospital medical nursing. In psych, the whole staff gets together for interventions, as in putting someone in restraints or seclusion. We operated as a single entity otherwise. So in your new job, keep in mind how important it is you become a real team player. Even if you aren't overly fond of some other staff members, you stick together, always. This is important for too many reasons to list, but the biggest reason is SAFETY.

So, make it a point to 'go along' with the team, pretty much no matter what. They know far more than you how to handle situations. This was hard for me cuz I had all kinds of ideas about being a psych nurse. Sometimes the staff seemed so dang cold, insensitive, even mean. Sometimes they truly were, but most of the time, they were operating out of EXPERIENCE that I didn't have. I came to understand over time.

Many 'professional' personality disordered patients will be well known by the staff. You being new, the patient may make a beeline for you, and they are SO compelling that you can get sucked in, and then the proverbial 'staff splitting' occurs. This is another example of why staying with the team is so important.

I'd say how well you fit in with the team over time will make or break your job satisfaction. Much more than anything else.

When you get on the job, ask your preceptor what your role will be in an emergency. It could be different wherever you work. That part is very much 'on the job training'.

As for losing your skills, I don't have a good answer. I seriously doubt your manager will have any resources or want you to even 'go there', as you need to focus on learning how to be a psych nurse. In today's psych nursing, a patient must be medically stable with NO indwelling lines (IV, foley) or else they are on the medical floor. In the beginning of my career, there was more of a mix of medical and psych, but that has changed. I 'lost' my skills for 17 years, so to speak, but I took an RN residency position with more intensive on the job training to get into hospital medical nursing. Honestly, a lot of nursing is like riding a bike. It will all come back to you. That was my experience, and all my worries over the years were put to rest.

The charting will differ from unit to unit, and you'll have plenty of time to develop your charting AND assessment skills once you are on the unit. The charting was different in every place I worked, to be honest. Ask your preceptor what the nursing priorities are in patient assessment. Nurses remain holistic even when in psych so you are assessing their overall health (medical stability is implied), with special focus on psychiatric symptoms, response to medication, patient teaching about meds and side effects.

Keep up your wide-eyed and very motivated attitude! Don't 'stick out', seek to become part of the team, follow the team, don't go off by yourself when you think a patient is 'misunderstood'. LISTEN and WATCH, and later ask the staff about what they did.

They won't expect you to know ANYTHING when you start :) Be a grateful, competent and interested NOVICE. Ask for feedback before you take the initiative, at first.

You'll do fine :)

RN_Incredible · Dec 26, 2014

THANK YOU SO SO MUCH! For your advice =) I really needed it. I will definitely keep this in mind everyday! Merry Christmas and Happy Holidays! :cat: