Practicum Placement - Psych ED?

throwaway26 · Feb 28, 2017

Not a psychiatric nurse yet, but have been a BHT in multiple settings. For any psych employee, patience, empathy, and assertiveness are key. You need to be compassionate, but know sometimes that means saying no and enforcing boundaries. In my experience, adolescent psych will be more suicidal ideation, anxiety, depression, eating disorders, self-injury. They are very concerned about familial and peer pressures. You will probably see less psychosis and forensic patients. The ED can be boring at times and crazy at others. There you will see a lot of psychosis...people brought in off the street by law enforcement, people in withdrawal, lots of ranting and raving. I like that environment but the downside is that you transfer the patients elsewhere and don't get to develop relationships with them like you otherwise would.

All of them would be good prep, IMO. Just go with whatever sounds more interesting to you, keep an open mind and open heart, and you will do great :)

umbdude, MSN, APRN · Mar 1, 2017

I think it's great that your school can place you into something so specialized. I did my practicum last semester on an adult inpatient psych unit, but I've also worked on the unit before and during nursing school. I don't know much about Psych ED though. Most of the jobs that I've come across in my area are Adult Inpatient Psych, and the ED jobs I've seen require more experience. So I think if you're looking for an experience that would help you as a new grad, it's probably adult inpatient psych. My guess is you won't see as much meds in adolescent; and in ED you would probably see only the emergency psych meds.

During my practicum, I saw the whole gamut: mood stabilizers, antipsychotics, benzos, and other meds either for comorbid conditions or for side effects. The place I was at was very med-heavy so there's a lot of titrating/tapering going on at all times. There's also a lot of other skills such as assessments, giving reports in rounds or to other RNs/Techs, care plans, fall risks, and delegation etc. Those skills should come easier for those of us who already work in psych. Also, if possible, try to get placed into a teaching hospital with strong reputation in psych. I think that can possibly make a difference in your experience.

When I started looking for a job last month, the hiring managers talked a lot more about my psych tech experience than my practicum experience. I have to say that I found a job much quicker and easier than I thought. Part of that is the fact that psych is one of the least-desired specialties. I got multiple offers, and I'll be starting my new job next Monday on an adult psych unit and I'm thrilled.

Good luck!

verene, MSN · Mar 2, 2017

Thank you both for your feedback! I really appreciate it. I think I'm going to go ahead and say I'm okay with any of the placements. I've done a lot of thinking about it, and there are things that appeal to me and do not appeal to me about all of the units, but I really do believe that I'm going to learn a lot no matter which one I end up on.

I don't have the option for a teaching hospital for psych placement but both of the hospitals my program places students at for psych are reasonably well respected in the community and have a history of hiring students out of their practicum placements. In all honesty, I'm not particularly worried about finding a job when I graduate. Pysch positions, both inpatient and out, are exceedingly plentiful in my area and for far too many of them an RN license and pulse seem to be all that are required (we have a severe shortage of workers in all areas and levels of psych care), given I did work as an aide in a community mental health setting before nursing school and will be graduating with a BSN, I'll likely have my pick of possible jobs. I'd really like to use my time in practicum to grow my confidence and skill set, and to learn more about my own feelings and capacities for inpatient care as my prior experience with with a relatively stable population so I didn't see a large number of mental health crisis and acute episodes.