nursing students and behavioral health units

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At my unit, we have students once a week during semester clinical times. It is rough on the milieu as there are 10 students to 15 patients..but what are you going to do when the student-teacher ratios are so high? Anyway, I'm not sure if this is an Arizona thing, but at my facility and the one I had my nursing school clinical at do not engage students with the psych nurses. The students pretty much hang out with the patients and go to groups. I identify with the students and try and help them out, but they seem afraid of the nurses! They never ask any questions, the only info I add is the stuff I interject. I offered the instructor to allow one student to shadow me as med nurse as how are the students going to have any idea what a psych nurse does if they do not even interact? During all other clinicals you were practically attached to the precepting nurse and learned more than you did from your instructors if you were lucky to get a nice nurse. I am in the craphole with my manager for reasons I have made previous posts about, but I got impulsive and told the professor to ask my manager if she was interested. The professor's eyes grew large, looked pleased, and told me that it was unusual for psych nurses to want students. So well.. they were here again and I heard nothing about it. My manager probably told them I was an incompetant or something :cry: I figured as much because I am truly treated like poo around here so much that other people have commented about it and my first preceptor from another facility (switched to the sister hospital for a day shift) wants me to quit.

I think I am a good med nurse and could help get nursing students some valuable experience! dammit :smokin: The nursing students from last week were seriously hiding to the far sides of my med room, trying to watch me work without me noticing; that is kind of sad and a tad bit creepy. I know the day charge nurse appears sort of scary (I understand her and know to ignore half of what she says that she will apologize for in 5-30 minutes) and the night charge (she definitely has a mean streak and I hate working with her) gives these reports that sound like she hates all the patients. I wonder what these students think...... :bugeyes:

Specializes in behavioral health.

I definitely subscribe to the philosophy that the beliefs of a psychotic patient are so real to them that is might as well be actually true. I was just making the point that as a nursing student we truly had no idea about what was going on with any of the patients we were talking to until after the conversations.

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Specializes in Psych, ER, Resp/Med, LTC, Education.

Specifically why we don't hire new grads where I work-- they need to have at least a year inpatient......Many have wanted to come and work with us and don't quite understand why we say no. We had one girl who was a new grad of the same program I graduated from and this girls first bachelors was in psych so the nurse leader decided to hire her and give it a try as we were deparate for nurses.........yeah that did NOT go well. She really struggled....they made her transfer after like a month or so to one of the inpatient units. She is doing okay there I have heard but it was a disaster having her in psych ER. For EXACTLY the reason you are talking about--inablity to recognize what she was seeing....all due to lack of experience. It takes time to learn this stuff--stuff you don't really see or get in school.

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I'm just curious...as an upcoming new grad (universe willing!) in May, with a passion for psych, where would you recommend we get that critical/crucial year or two of experience? I'm not trying to be snotty -- just really concerned that I won't be able to get a year+ of behavioral health without having that year of experience in mental health. Get my drift?

I'm 40. I am making a major career change, and pretty much went into nursing school with the idea that I wanted to specialize in psych nursing, and my school experiences thus far have definitely confirmed that.

Any suggestions for how a new grad can "break in" to the world of psych nursing straightaway?

And as for the OP, I'm so sorry you're having a tough time at work, and I, too, thank you for your willingness to show eager students the ropes. Our psych rotation was a bit of a joke. Half our class was at the second-largest state psychiatric hospital in the country (my half), while the other half spent their time on a regular hospital inpatient psych unit. Very different settings, but pretty much the same experience -- talking to the patients (residents....do you call them something else in a psych setting?) for a half hour or so, then going to various groups/therapies, etc., to observe. A friend and I who were on the same rotation and both have an interest in pscyh nursing STILL say to each other, "Did we even SEE a nurse on that rotation?" How can we say we'd like to specialize in psych if we don't even fully understand the nurse's role in such a setting? KWIM?

Incidentally, the facility where we did that three week rotation (too short, in my opinion!) DOES hire new grads and above-mentioned friend and I are going there this week to pick up application materials.

Does anyone have any thoughts on how an older new grad who is 99% sure she wants to be in psych can get a job in the specialty right out of school?

Thanks, everyone.

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Specializes in psych, addictions, hospice, education.

I was an older grad (I was 42 when I finished nursing school) and wanted to go into psych right after graduation, and did just that. I totally believe if you have a specific love in nursing you should go for it rather than putting in the "year of med/surg" that's often recommended. It worked for me anyway. I think as an older graduate, thinking of getting into a speciality sooner rather than later has its benefits too, since time flies and some time has already flown for older graduates.

As for getting that psych nursing job, as an older graduate I think you have a better chance of getting the job, since you have life experience the younger graduate might not have. Talk to unit directors, human resources, and make yourself known as one who wants to work with them. Be the squeaky wheel. It does sound like the facility where you had clinicals is a good chance though!

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Thanks, Whispera!

So you graduated at 42 and have been doing psych for 16 years with no regrets? You're my hero! LOL. I'm pretty darn sure it's for me. What types of facilities have you worked at? The place where I did clinicals is a little intimidating. It's huge -- 700+ beds -- with all types of folks including a criminally insane ward! And it's a creepy old hospital. From time to time you hear news stories of nurses being beat to a pulp by residents, etc. Not sure if it'd be a good place to start, but it might be the ONLY place to start, KWIM?

Do you ever wish you'd done the med/surg thing? Or that you hadn't pigeonholed yourself in psych? Thanks so much for your response!

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Specializes in behavioral health.

Before I became a psych new grad, I had a year or so of infrequent behavioral health tech experience. I also have some personal experiences and affiliations with a mental health advocacy group. However, I think the learning curve in ANY new nursing job is very high. Your first day as a new grad psych nurse is not going to be harder or more stressful than your first day of med-surg. I knew I wanted to do psych nursing and followed the want versus the should. I have a very personal distaste for "should". If you browsed the new grad nursing forum, you would see how many new grads went into med-surg because they 'should' and are hating it. The medical learning curve is very high for me because of my lack of experience. Psych patients have tons of health issues and I fumble a bit with this. I've been getting through it by asking a lot of questions, breaking the books and looking stuff up, and well..you certainly don't forget everything you've learned in nursing school =P

With the economy, I'm going to be a bit screwed if I lose this job. I'll survive and I'm sure I will work out something (the persistent succeed eventually). I'm hoping to be starting psych NP school in the fall and then go to PRN status.

May is quickly approaching (really it is =P) and it is time to start job hunting! A state hospital would intimidate me as well. I really like the voluntary-only population of my unit. Even after I get a patient complaining that he has no private TV in his room. :chuckle

As for being an older graduate, I don't see why that would be a problem. To be honest, my older graduate cohorts were always treated with more credibility by their patients than me "How old are you?.. you couldn't possibility be old enough to be a nurse.. Are you going to go to college? I have a grandson your age who would like you..are you my tech? I didn't know that the techs give meds" etc. lol.

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Specializes in critical care; community health; psych.

I admire your desire to engage the students. There's a natural fear of the psych unit for the first timer. Usually I see them during report standing quietly in our small conference room. Usually it's me who says hello and breaks the ice. And it's usually me who the students consult with questions after I tell their instructor they can approach me. It's a role I enjoy. It's a win-win.

There is always HIPPA to contend with though and for that reason, we do not allow access to the MAR or allow them to watch us pull meds. There are more than the usual off limits places in non-psych facilities.

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Specializes in Psych, ER, Resp/Med, LTC, Education.

You certainly have a good chance to get a job on an inpatient psych unit--acute I would suggest as oppose to more the LTC psych facilites if you are interested in psych ER-- I'm sorry if my post was not clear. To work PSYCH EMERGENCY you need psych floor experience.......that you CAN get into if you desire........one of my friends on the inpatient unit I started on after medicine graduated late in life--like late fourty's or early fifty's I think and she started right on the psych unit on was on out of school. She did fine. She was wonderful with the patients. So if that is what you want go for it-- that need psych experience thing was specifically for psych ER.

We need all the psych nurses that actually LIKE psych patients we can get!!! LOL....... So a nurse who loves it....god if I was a manager I'd hire ya!! LOL

Good luck to you!!!

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Thanks so much for the clarification! I must've missed something in the reading somewhere.

Thanks, too, for your words of encouragement about starting right in psych. It's definitely my number one plan. You all are a great bunch of people!

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Specializes in behavioral health.

Off topic, but I just got accepted to my psychiatric DNP program!!!

:hpygrp:

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Specializes in critical care; community health; psych.
off topic, but i just got accepted to my psychiatric dnp program!!!

:hpygrp:

congratulations! very exciting news.

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Specializes in Psychiatric Nursing.
"delusions" are simply another perspective on life.

Most often I find that psych patients get written up as deluded just for having a different perspective.

If you talk to God you are religious

If he talks back you are Schizophrenic

I think this is a really good point but where does one draw the line. I really do agree that we often times are not as openminded with our psych patients and religion as we should be. Creating a really non-theraputic and judegmental enviorment because of it. But I have a patient who uses the light fixtures to talk to God (which light=God is a very common connection I get that) and God talks back... Still all great and wonderful except that because of this time with God the patient is unable to keep up with his ADLs or interract much with the rest of the world. While I want to help him engage in the world and care for himself I also want to be careful not to be too unaccomodating with his religious experience. Other staff simply turn off all his lights to redirect and this seems a little harsh... but maybe it isnt. Any thoughts????

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