Opinions please about adolescent psych job offering

[zephyr9]

Hi All, I interviewed for a job at a large residential facility for adolescents. The nurse spends shifts in an office separate from the kids' living area, the residents come to the office get their meds. There is a lot of managing primary care issues and a lot of paperwork. So much information was coming at me while the supervisor was explaining the job, I didn't get a really clear view of everything the nurses do. The kids' daily activities are facilitated by mental health technicians who are in their houses with them.

Ideally I would like to be in an acute psychiatric unit in a big city where a lot of the patients have medical issues. This job is not that. It doesn't really even sound like psychiatric nursing to me, it sounds like primary care/school nursing, and other team members manage the milieu and have the majority of interactions with the kids. The nurse is not the manager of the residents' care, they are a small piece of the large team.

I don't know if a job like this can get me to where I want to be. I know it has some learning value, but I am starting to explore the idea of a psychiatric NP program in my future. I don't know if this job description qualifies as psychiatric nursing to put me on track for that in a year, or for any other acute psych job. I would love to work at the state hospital. Psychiatric nursing jobs in my area ALL require a year experience minimum, many of them 2 years or even 5.

Thoughts appreciated... I don't know whether to take this job or keep looking. Nothing else is on the burner for me at this time and I am 9 months out from graduation looking for first nursing job.

[Davey Do]

Ideally I would like to be in an acute psychiatric unit in a big city where a lot of the patients have medical issues.

In my experience, there are not a lot of medical issues, generally speaking, with the Adolescent population. We get some brittle Diabetics. We had one with an external orthopedic fixation device. That's about it to my recollection.

If you really want to do Medical with Psych, try Geriatrics.

I'll let Safety Coach RN know of this thread and maybe he can give you more info. He primarily works Adolescent Psych.

Good luck to you, zephyr9!

[Safety Coach RN]

Davey Do pretty much covered it. Diabetes is a common medical issue but beyond that, you're better off on adult or geriatric acute psych. I'd go into acute psych care and stay out of residential altogether because residential really doesn't qualify on an acute psych care level in my humble opinion.

[zephyr9]

Just because I'd like to be there doesn't mean they're banging down my door. I am applying for acute positions, but no responses. That's why it's so hard to decide whether to take the job. Do I take it to get a paycheck and the satisfaction of being employed with the title RN while learning little of what is most important.

The supervisor was frank about how different the nurse's role is here from most nursing jobs and the difficulty experienced nurses have adapting to it.

Yeah, an acute setting is the place to be but I only have a residential offering in hand. How the hell do get hired in pscyh as a new grad. I don't think they hire new grads in psych around here. My resume has private duty and LTC patient care assistant and a lot of volunteer work with homeless/addict population and hospice, plus tattoo artist. I don't think I'm poorly qualified as new grads go.

[elkpark]

Who was this "supervisor" who was explaining the RN role to you? A nursing supervisor? The head tech? When I've worked in adolescent residential settings, the RN was fully responsible for the milieu and the activities of the techs, same as in any other psychiatric treatment setting, and the techs were often somewhat jealous of this and felt they shouldn't have to take direction from or be responsible to a nurse. I'm not saying this facility doesn't do things differently, but I've worked in more than one adolescent residential setting, and the RN sure wasn't sitting in an office somewhere; we were out on the "floor" (in the living areas), directly involved in all the daily activities of the kids and what was going on with each of them personally from day to day, in addition to giving meds and dealing with the medical issues, same as in an inpatient psychiatric setting. It was just a lower acuity client population. In the residential settings in which I've worked, if something went wrong with one or more of the kids and the RN was "sitting in an office" somewhere at the time and unaware of what was going on, that RN would be in just as much trouble as an RN in that scenario in an acute setting.

I agree that working in a residential program would not be considered acute care psychiatric experience, because of the lower acuity. I'm just somewhat suspicious of the job description of sitting in an office, giving meds. I suspect you may not be getting the full story.

Best wishes!

[zephyr9]

This was the nursing supervisor for that unit who interviewed me. The "units" are groups of dorms, there are 4-5 dorms to each unit. The office is housed in a small admin-type building with the kids' dorms clustered around it, but the buildings are separate. Each unit has an RN office I guess. If it was described to me as you described, I would be less hesitant about taking it.

The job could meet some of my needs with a couple big drawbacks. I was told I am being recommended for job but haven't received a formal offer yet. This is only the 2nd (presumptive) offer I've gotten in 4x as many months.

Thanks for your comments!

[aspiring42]

Hey Zephyr, just to confirm, I beleive I worked at the facility to which you are applying. If I am right, they primarily work with clients on the autistic spetrum, but have a severely emotionally disturbed division as well. I was a tech and my clients saw the nurse in the morning for their meds, and if they were injured or restrained throughout the day. Otherwise, nurses would sit in on staffing meetings and provide insight into how allergies and chronic medical conditions could affect clients' abilities to meet their treatment goals. Otherwise, I have no idea how they filled up the rest of their day. The positions did seem to be more like school nursing to me, and the nurses did seem to sit in offices and always be working on paperwork in between administering medication from one morning to the next.

[elkpark]

This was the nursing supervisor for that unit who interviewed me. The "units" are groups of dorms, there are 4-5 dorms to each unit. The office is housed in a small admin-type building with the kids' dorms clustered around it, but the buildings are separate. Each unit has an RN office I guess. If it was described to me as you described, I would be less hesitant about taking it.

The job could meet some of my needs with a couple big drawbacks. I was told I am being recommended for job but haven't received a formal offer yet. This is only the 2nd (presumptive) offer I've gotten in 4x as many months.

Thanks for your comments!

Ahhh. That sounds like a very different set-up than anything with which I've had experience. Based on what you and aspiring42 described, it doesn't really sound like a psych position at all.

[zephyr9]

I agree. I didn't accept the position, it was difficult to turn down...I would not have knocked it based just on this assessment of the role, but there were logistical issues with distance from my home. I have to find something closer to home.

Aspiring 42, it must be a unique setup if you recognize the description. It was so hard to decline, I think it would have been a valuable experience not to mention job in hand. It's tough getting a job in the big city, the search goes on.