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Specializes in Long term care.

Hi, I am currently working in outpatient and for many reasons, it is not a good fit. I have recently had the chance to interview at an inpatient psych facility. I am a relatively new nurse. I received my license last November. My interview for this new position was via zoom and it seems like an interesting job. I will be the lead, as I am an RN, and will be lead to LPNs and CNAs. LPNs would be med administrators and CNAs would be doing mouth checks and any type of care related things. 

I got somewhat of a sense of the job- what day to day will look like and what expectations of me will be. It seems like it may be a better fit than my current situation. Currently, I'm working in outpatient and I am bored. As a clinic we are not seeing many patients, and the services we provide are repetitive and unchallenging. I feel super undervalued at my current job, and I really started off on the wrong foot with one of my supervisors (I really get the sense she does not like me).  For reference, my job before that was great. I worked in long term care and rehab and I loved it. I had to switch because my family and I moved across the country and my current position was the best offer I could find. 

So I asked if I could tour the facility before any additional steps were made in the hiring process. My question is: what should I be looking for as red flags that this might not be a good place to work? I want this to be a good career move, and I would like this to be a job I stay at for 2y + at least. I know there is no perfect job- I am mostly looking for something where I can be busy, continue to learn, develop more nursing leadership skills and feel as if am meaningfully contributing to the care of my patients. I am also entertaining the idea of potentially becoming a PMHNP in the future... like maybe in the next 5 years going back to school (so a more distant possibility). 

 

Thanks for any guidance, this forum has really been a great place for me to get advice and run through ideas. 

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Specializes in Mental health.

On your tour look to see if the patients are clean and their rooms are clean. Find out what happens if a patient gets combative. Do you have backup from other units? Do you have security guards? Where is security located. On another floor? Do you have panic buttons? Is there a supervisor present in the facility that can help u when u have codes? Are u responsible for finding staff when there are call ins? We were mandated when staff called in. (If we couldn't find staffing.) Meet the people u will be working with. Are they engaging with clients. Or are they in the back office on their phones. What are the diagnosis, and legal status. Are they NGRI, ITP ? What shift will u be working? Day shift u can have the Dr., social workers, rehab available to assist with helping the other residents when a code is called. The worst time of the day for acting out was after their evening meal so don't give breaks to staff until after 7:00 if your working the evening shift. There is so much more I can say but will leave it for other responders. In conclusion I just want to say that nursing is a sisterhood and u will meet some great people and patients in this journey.

 

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Specializes in Pediatric Private Duty AND Child/Adolescent Psych.

 " Are u responsible for finding staff when there are call ins? We were mandated when staff called in. (If we couldn't find staffing.)"

I second that. I work overnight at a residential psych facility for children and teens. During the day and evening there are 5 nurses scheduled (one for each unit except unit 5 which is smaller and under a different license as a "group home" vs a "hospital" but the nurse on unit 4 is responsible for unit 5 as well.  On the overnight shift 11p-7a we have 3 nurses scheduled for the most part, now if we have a call out then there are only 2 nurses for the campus ... ( currently at 125 clients ) but we are required to have two nurses on campus at ALL times so on the nights we are short we are unable to take a break off the campus at all.  When the day nurses run late and I really have to go at the end of my shift its frustrating waiting.  Also if someone calls out for the next shift during my shift on the nights I am charge nurse I am responsible for trying to find coverage which is usually impossible. It's then expected I stay past 7a to do the 8am med pass on whichever unit the call out was on. Then for the rest of the shift they are short the other unit nurses have to figure out who will cover what med passes on the unit with the call out and who will handle the restraints and walkie calls from staff for that unit. I was told the nurse manager would help in these situations but after working here since April I have yet to see that happen. It's a huge strain when we have call outs and there seems to be no consequences for those who frequently call out. 

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Specializes in Pediatric Private Duty AND Child/Adolescent Psych.

Also ask what the usual census is plus what the max # of clients/patients you could  be responsible for. Look to see if there are enough staff/ MHT ( here call DCPs) for patient/client safety ask what the ratios are supposed to be. 

Also the person giving the meds should be doing the mouth check. On our mars there are mouth check boxes with med pass times and we must initial for  each med pass just like we initial out each med given .

Are there cameras ?  With the  population I work with accusations from clients are pretty common. For my safety from physical harm and from false accusations  I make sure each interaction with a client is either in view of a camera or if I have to enter the clients room or the unit bathroom I always have a DCP come in with me or at least come stand in the doorway. CYA  

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