Published Oct 30, 2017
caren19
21 Posts
Hey, thanks for taking the time to read this, and hopefully offering your input...
I've worked in a PICU for 14 years, and have developed some bone spurs in my neck and lower back. I'm in an office position right now, but it's just not for me. Nursing was my second degree, my first is in psych, and I had taken a few couses to get my masters in psych, until I changed my mind and went to nursing school for nursing.
For the past 3 months I've been pouring my thought and heart in getting a post-masters cert in psych specializing in peds - we did a terrible job in the PICU dealing with issues like PTSD, suicide attempts, molestation, etc.
ANYWAY: BACK TO ORIGINAL QUESTION: I want to get back into bedside nursing - how physical is psych nursing (excluding patients with psychotic breaks, etc, where you're going to get your butt kicked regardless)? Would I be turning and changing the patient every 4 hours, etc? Thanks in advance for your input, sorry for the rambling..
pixierose, BSN, RN
882 Posts
Depends on the unit.
We don't do a lot of turning every 4 hours on my floor, but I do have several patients whose Braden scores are such that positioning et al is a biggie -- But no where near what you'd do on an ICU. I work with ages 50+ population; kids/adolescents and younger adults -- this would be different.
But yes ... I'm on my feet a lot. And unfortunately we seem to be doing a lot of restraints lately. In terms of getting your "butt kicked," that should be pretty minimal with proper training (nonviolent crisis intervention, like CPI) and staffing. One of our patients is an ex-professional football player, 54 years of age, and sadly he has unfortunately been getting restrained almost daily (new to the unit, new med regime, etc). Even with this angry, burly fella ... this 5'1, 112 lb female hasn't had her ass kicked yet, and I've had him 3/5 of my last shifts.
I say give psych a shot.
Hygiene Queen
2,232 Posts
I do not recommend gero psych if you have neck or back issues. It's very physical there and it's like a miniature cross between a nursing home and med surg.
B52, ADN, BSN, MSN, RN
231 Posts
I work with adults and it's not too physical. On the geri unit it's rare that we get a patient who requires q4h turns. The geri unit has hospital beds, but on the other units the beds are low and bolted to the floor, so you would have to bend over when administering ETOs. We encounter violent patients frequently, but in my 2 years at this hospital I recall only 1 incident that resulted in injuries to staff. Restraints are a rare occurrence, but sometimes very necessary.
On the geri unit it's rare that we get a patient who requires q4h turns.
Not so bad on the turning q4h, but quite a bit of lifting into bed, helping patients on and off the toilet, bending and kneeling for dressing, etc. At least that was my experience on my unit.
Just depends on the unit. I very rarely do toileting and dressing, even with my 70+ patients.
I think some Geri units also have a wing for dementia patients; this is where a lot of physical care happens from I've seen.
My floor, lots of comorbidities ... so definitely a good dose of med surg. but just enough not to be complete care.
Maybe an adolescent unit, OP?
TerpGal02, ASN
540 Posts
If you work on inpatient child/adolescent, things can get quite physical. You will find, especially with kids under 12 that they are in the hospital for behavior problems/aggression along with ADHD. Pediatric patienfs simply do not have the impulse control an adult has.......that whole prefrontal cortex thing. If they want to act out, they will. You are more likely to see aggressive acting out from a 9 year old with ADHD than you ever will from an adult expereincing psychosis. Most psychotic patients tend to be more isolative than anything in my experience.
GeminiNurse29
130 Posts
In my facility, the geriatric unit is more physical than the other units. Those patients are very aggressive and no other facility wants to or is able to handle them. Imagine trying to help your techs/CNAs do cares on a patient while they are trying to slap, hit, kick, and bite you. Or screaming the whole time.
The other units are forensics and most patients are ambulatory. But there's always a (high) risk of getting assaulted and harassed, verbally and physically. After all, they aren't there by choice.
dream'n, BSN, RN
1,162 Posts
I work inpatient with adolescents. Don't think I've ever had to do any ADLs or lifting at this job. The adolescents can get very physical and aggressive, but I've found that most of my patients won't ever lay hands on me for some reason. I think they understand my age and usually target each other or the bigger and stronger staff members. This happens even when I have to get between two of them that are fighting. I find this especially with the escalated males in psychosis. They seem to not want to assault an older woman. Though none of them have any trouble calling me out verbally :)