New Psych Nurse Advice

[marsbar37, BSN, RN]

Hello! Ive been working in a psychiatric hospital for a few months now and I wonder how do nurses deal with a patient who screams at you and rattles you? I'm afraid of this patient because she starts trouble a lot but any advice on a how to develop more of a steel spine when dealing with them?

[hppygr8ful, ASN, RN, EMT-I]

Are you working long term or short term. I work in a short term stabilization hospital and it helps me to know that the patient will be gone in 5 to 7 days.

What has been the biggest thing for me is to always remember that no matter what the patient says to me; it's not about me it's about them. The second is to become very familiar with trauma informed care which will guide your practice appropriately and may mitigate or eliminate some negative interactions with patients.

I don't have a steel spine but a very flexible one that bends with the flow of patient behavior.

Hppy

[Heylove, BSN, RN, EMT-B]

You can also rely on coworkers for help. Sometimes particular staff members seem to upset a patient, so others step in to help de-escalate the patient. If you don't have helpful coworkers that do this, then I don't know what to tell you. My coworkers are fabulous in this way.

[19Kristin]

It is important to be tight with your staff. When you trust and have a great relationship with your staff you feel more secure and protected, at least I did. Also, it isn't about you, this is their issue. They are mentally unstable and whatever they are projecting onto you has nothing to do with you. Sometimes patients will target and focus on certain staff, in these situations, our hospital wouldn't assign that staff member to care for them and if need be that staff member would be pulled to another unit until the patient was gone. There will be many instances however where patients will make you uncomfortable, you will develop a thick skin to it over time and a psychological wall so to speak will be built up and it won't bother you as much, because it will happen over and over from different people and you will begin to see it as a regular part of certain untreated mental illnesses and behaviors. Always be safe and have appropriate patient boundaries. Be aware of your surroundings, don't put yourself in a vulnerable situation especially if you feel like you are being singled out by a patient. Depending on the diagnosis there are different ways to address every escalation in a patient. For example, the way you deal with an escalating borderline will be different than how you will handle an escalating schizophrenic. Find a good preceptor, seasoned RN and learn how they handle situations and interact with each patient. Your communication skills and ability to deal with these situations will develop with time.