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Just curious about people who have worked in psychiatric nursing. I am very interested in working in it but my husband is worried about the safety issue since I am only 4ft 11. Have any of you ever encountered a safety issue and what precautions are taken?

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Don't be afraid to use your panic alarm. It could save your life. You should have appropriate holds and restraint courses completed once qualified. Always practice these holds with your colleagues. There is a right way and a wrong way to restrain a patient, always alert another colleague unless your in a community setting (someones home) where you may have to defend yourself.

I have never been attacked personally in a psychiatric setting, but have worked in challenging behaviour units in intellectual disability settings were its a given you will be attacked. If the organisation has a no restraint policy you have to use non-violent crisis intervention and observation- but that is completely different.

You can hold a person in as dignified a way as possible when you work as a team. Always practice holds every month or so; even if your in a non-threatening environment.

Sometimes is the staff you should be worried about not the patients!

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Specializes in Dr of vet med, ER/ICU/Vet Anesthesia/Practice.

I wish we former patients and nurses could somehow form a code - like an honor code that all us patients agree to sign- no one goes near any nurse....for any reason.......It breaks your heart to think some nurse has to worry about her safety......and sometimes it is hard to deal with........so so sad........she has to worry about her welfare while trying to comfort the people in shock and pain......so wrong .......we should all carry a card in our wallets to let the staffs know we will comply no matter what we are saying (we can hear you and can and want to comply no matter what we are saying verbally- we want you to feel safe). Protect all nurses........is what I carry in my wallet. I hope someone finds it if I ever have another problem. I think the nurses would say...the best way to protect us is to not come back.......well said.

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Specializes in Dr of vet med, ER/ICU/Vet Anesthesia/Practice.

why can we not work to organize all patients with experience to agree on protecting the P nurses......a simple code of protection and honoring them.......proper distance, proper courtesy etc........as a sign of respect and safety to them.......carry a card in our wallets......agreeing to this code...........

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Specializes in Psychiatric.
why can we not work to organize all patients with experience to agree on protecting the P nurses......a simple code of protection and honoring them.......proper distance, proper courtesy etc........as a sign of respect and safety to them.......carry a card in our wallets......agreeing to this code...........

That is a very noble thing to do, carry a card saying you want to protect nurses. Thank you for bringing your lived experience as a psychiatric patient to this forum. It is very insightful and appreciated. Yes, a code of protection agreement would be wonderful, however a lot of assaults against nurses are committed by people who are either psychotic (delusional and hallucinating which impairs their cognitive thought processes) or they are in the extreme throes of withdrawal and nothing else matters unless they get a fix and relieve their pain/withdrawal symptoms. We've just had a patient who violently assaulted an elderly woman who was collecting donations for a guide dogs for the blind at the local shopping centre. He thought she had the devil inside her and she was morphing into Satan in front of his eyes. Having signed a 'protect nurses' code would not have protected this woman nor prevented his extreme delusions and hallucinations. As I said, it is a very nice thought however nursing staff already have a zero tolerance policy on violence. I know we have anyway.

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Specializes in Dr of vet med, ER/ICU/Vet Anesthesia/Practice.

Yes - hear you and understand and respect what you are saying........I have been there unfortunately due to a doctor giving me corticosteroids..........fortunately I had a remarkable nurse who basically said ....its ok mr bear I know you wont hurt me ....come this way and I will take care of you...........thank goodness for her insight........as I abhor the thought of a nurse getting hurt. I work with autistic people and while the majority are very nice, some are less than gentle shall we say........and I think the example of the nurses taught me it wasn't personal and he really cant help it. I know the code would not work on many cases but somehow we patients have to find a way to protect our nurses.......or spread the word through the mental health community and sign up as many as possible......something. I have worked for 25 years to bring recognition to our P nurses .......not exaggeration but..........factual witnessing of the comforting and caring these nurses give to smashed and traumatized people..........yes I do understand psychosis and etc.......I get that and I am sorry the nurses have to go in harms way........but time after time have I seen nurses comfort scared people and scared kids......and that is no exaggeration..........and not attempt to win points or any of that kind of nonsense.........we know the nurses have a job to do.......and we know it is strictly professional..............its different when one is a patient.............and you wathc how expertly they work with people and encourage them back to health.............the apna doesn't care ........no one does...............9000 patients remember and care........they aren't crying when they say good bye for nothing.......Excuse me while the men and women of the floors............stand in your honor.

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Specializes in Dr of vet med, ER/ICU/Vet Anesthesia/Practice.

yes the units I have been on- all had a non violence code.......thankfully and respectfully. I worry about the entry point........what will I come as ......I could be on four levels again.........saying one thing but guarantee you.........I can hear you somewhere inside and will do anything not to scare a nurse or patient........they can be so vulnerable........at that point..........I know.......stay well and stay out of the hospital. You have a good point.

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Specializes in Dr of vet med, ER/ICU/Vet Anesthesia/Practice.

thank you for taking the time to post your response......the first time in 25years of writing on behalf of our nurses.......

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Specializes in Dr of vet med, ER/ICU/Vet Anesthesia/Practice.

truthfully we are very protective of our nurses......who else would want to be with us....and we know it isn't personal its just who they are.....a different cut of the cloth. No one wants to hear about it but that is pretty much the truth. I have met one that was a nightmare but in the main they were exceptional people......unreal how patient they were with the patients.........very caring and very tactful and patient.....I thought people would talk to us and take our histories as this is important in my business but I see now they have a different job....and this stie has been very helpful. More often that not it was the nurses who deduced the patients histories just by being around them......pretty impressive.

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OP -- your employer will provide you with training and certification in the crisis de-escalation program that is used at your facility. Being successful in dicey situations in psych is about your attitude, your communication skills, and the relationships and impressions you have already formed with the clients, not about size or physical strength. Some of the most effective psych nurses and techs I have known over the years have been tiny. Working in psych often means telling people stuff they don't want to hear, or requiring them to do things they don't want to do, but you can still treat clients with respect and courtesy, and never pass up a chance to build a little positive rapport with them; you never know when that is going to make the difference between a good outcome and a bad outcome in a difficult situation. It's important to be aware of what's going on around you on the unit at all times, so that you can intervene and defuse situations before they get out of control. It's always better to keep things from getting physical in the first place.

Best wishes!

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Your coworkers make a big difference in your safety along with using your gut feelings. If there is trust, working in psych is no more dangerous than working on a medical floor. At least on a psych unit, they have a diagnosis. I work as a psych nurse and I have been through two pregnancies, working on the floor with each one up to the due date.

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I probably wouldn't want my wife working on a psych unit, but that's the male protectiveness in me. It's hard to say. I've worked psych for a few years now and only had one major problem. I personally have never been attacked, nor have I seen an outright assault on a staff member that wasn't already out of control. I do know of several who have been assaulted though regardless of size or gender. It does happen. I've only been uncomfortable a couple of times.

The one instance a female staff member on my team was badly injured during a takedown. The patient was extremely agitated and looking to cause harm to anyone. We had already placed him in seclusion and given an injection. It did not phase him. He was very antisocial and pretended to pay nice to be let out. Unfortunately he would begin an assault as soon as the door was opened. On a second attempt to give him an injection he managed to kick a girl on my team in the chest so hard it fractured her sternum. She couldn't breathe right for months. I felt terrible as the nurse, and it bothered me for a long time.

Overall my work has been uneventful. Obviously you'll do takedowns, but I personally won't get near someone if I think I could be seriously hurt. It's not worth it. The key is to have good techs and supportive staff. Also helps to recognize building agitation in a patient and try to medicate. The problem is, most providers are paranoid about medicating and think Vistaril is your best option. It often gets to the point where you're calling the provider more than once because the original order didn't work. You'll find with experience that you can anticipate when a weak med isn't gonna cut it. It's a shame really, and a lot of attendings lose respect for the field after see how emergency psych patients are dealt with, or aren't dealt with rather.

You have to decide for yourself what you're comfortable with. Some facilities are staffed with excellent techs and helpful staff. Others will expect you to manage with too many patients and no real help. Finding the right facility is important. I wouldn't say it's any more dangerous than similar jobs. ER patients assault and hurt staff, ICU/Med-surg patients same.

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