New Psychiatric Support Technician..HELP!

[kingvonnBSN2017, BSN]

Good evening nurses!

I am a nursing student in a BSN program, I am graduating in May and decided I wanted pursue a career in psychiatric nursing. I just accepted a position as a psychiatric support technician in a 38 bed behavioral health unit. I just recently finished my third day on the unit but I am already feeling so insecure. My last shift, I had a male patient that kept coming on to me and trying to flirt with me and was making sexual remarks. I tried my best to politely tell him that it is inappropriate but obviously it wasn't good enough and he tried to touch me so security came and he started becoming very violent towards the security guard, eventually the nurses administered a cocktail of haldol, benadryl, and ativan.

I felt really bad because I feel like I could have handled the situation a lot better. Sometimes I feel as I am too nice to work in psych, I try to be as kind as I can to the patients but I don't want to be taken advantage of. Later on that day, I had two other female patients flirt with me. One asked me to contact her when she gets discharged for a date and the other female wanted to give me her number to hang out with her because she was being discharged that day. I guess I just need help knowing how to set boundaries, but still being as nice as possible. I just want to do well in this position so eventually I can make a good psychiatric nurse. Any advice for a tech who wants to eventually be a psych nurse?

Thank you for reading.

[LessValuableNinja]

Have you tried approaching experienced staff with your concerns? It helps to have someone who knows the patient who can simply say, "She's just trying to make you uncomfortable. This is what I do..." Or whatever their advice is. Boundaries are important, but they vary by patient and disorder(s).

[Davey Do]

I admire your endeavor to be professional and therapeutic, kingvonn. Nicktexas gave some great advice. Learn from both your good and not so good coworkers. Avoid the techniques of the not so good, and emulate the good.

Do some self-examination. We may come across certain ways without being conscious of it. I have a tendency to be somewhat aloof when I first come in contact with a patient. I am civil, social, and to the point. I give appropriate leeway as the relationship progresses.

It's much easier going in either direction, if we start out neutral. Starting out in neutral allows us to become the hard-core business type, or the pleasant professional. As I've informed new, difficult patients: "I can be your best friend or your biggest stumbling block".

Good luck, and the best to you, kingvonn!

[Ofcnay]

I work as a security officer now at a hospital (I start nursing school in may), my one advice when it comes to psychiatric patients is to never shower any insecurities. Once a patient knows your scared or you feel uncomfortable, they will mess with you. I see too many nurses who show fear and the patient toys with them like a game but once Security comes, their calm and collected.

I would also also ask if their are classes for self defense that Security can provide. There's a training I teach the med students and nurses call CPI that helps them feel more confident in serious patient vs nurse altercations. I would ask other nurse or your manager on ways to better yourself for that unit.

[kingvonnBSN2017, BSN]

Have you tried approaching experienced staff with your concerns? It helps to have someone who knows the patient who can simply say, "She's just trying to make you uncomfortable. This is what I do..." Or whatever their advice is. Boundaries are important, but they vary by patient and disorder(s).

I have spoken to a few staff about the situation and they just tell me to ignore them, they are always like that. I would like to be a little more therapeutic if possible. I would like a more appropriate way to set boundaries.

[kingvonnBSN2017, BSN]

I admire your endeavor to be professional and therapeutic, kingvonn. Nicktexas gave some great advice. Learn from both your good and not so good coworkers. Avoid the techniques of the not so good, and emulate the good.

Do some self-examination. We may come across certain ways without being conscious of it. I have a tendency to be somewhat aloof when I first come in contact with a patient. I am civil, social, and to the point. I give appropriate leeway as the relationship progresses.

It's much easier going in either direction, if we start out neutral. Starting out in neutral allows us to become the hard-core business type, or the pleasant professional. As I've informed new, difficult patients: "I can be your best friend or your biggest stumbling block".

Good luck, and the best to you, kingvonn!

The thing that I really fear is that I am too nice sometimes. I have heard that from multiple people. When I see the nurses and the techs on this unit, they seem very stern and have no problem raising their voice to the patients. I just can't see myself doing that, I feel as if there are other ways to communicate with them and set boundaries. I just fear I may be too nice for psychiatric nursing, which I hope is not the case.

[LessValuableNinja]

Advice #1: Join APNA as a student member. It's $25 per year. They have member boards like here, but it's all psych nurses. The discussions are very active. They also have mentor match, which will help set you up with a psych nurse (who wants to be a mentor) as a mentor.

[LessValuableNinja]

The thing that I really fear is that I am too nice sometimes. I have heard that from multiple people. When I see the nurses and the techs on this unit, they seem very stern and have no problem raising their voice to the patients. I just can't see myself doing that, I feel as if there are other ways to communicate with them and set boundaries. I just fear I may be too nice for psychiatric nursing, which I hope is not the case.

I don't think it's the case. Everyone has their own methods once they find their Zen. You can set limits and be firm while being nice.

[LessValuableNinja]

A good introductory bit of reading, with recommendations:

De‐escalation and limit‐setting in forensic mental health un... : Journal of Forensic Nursing

Let me know if you can't access it, but I think this one doesn't require a log in.

[Jules A, MSN]

The thing that I really fear is that I am too nice sometimes. I have heard that from multiple people. When I see the nurses and the techs on this unit, they seem very stern and have no problem raising their voice to the patients. I just can't see myself doing that, I feel as if there are other ways to communicate with them and set boundaries. I just fear I may be too nice for psychiatric nursing, which I hope is not the case.

Or maybe you are just too beautiful for psych nursing? 3 sexual advances in one shift? lol

[LessValuableNinja]

I once had 3 women in hospice flash me their netherbits in a flirtatious manner in one shift. Does that mean I'm beautiful too?

[Jules A, MSN]

I once had 3 women in hospice flash me their netherbits in a flirtatious manner in one shift. Does that mean I'm beautiful too?

Heck yeah! You must be and if you repeat it several times you are most definitely too beautiful to work in psych or possibly have something of the cluster b persuasion going on.

I'm probably just jealous because thinking back I have only had 2 flashes in one shift although the truth is thats a stretch also. One was a full on flash but the other was floridly psychotic and basically flashed the entire milieu as a group experience, lol. So really I have only had 1 definitely not too beautiful and no one's accusing me of being too nice for psych. :)