Also a RN case manager in psych home health. One of the biggest challenges is establishing the therapeutic relationship. Overall, Once you get to know your patients it's not so bad. And of course with certain patients you have to take it day by day. As PP said, the second you don't feel safe, leave. I honestly only felt uneasy about two or three times in six years with patients I didn't know. The only downside is that It is a tremendous amount of charting with all the oasis paperwork ..But I too make so much more money than I did in the hospital... With much better hours. Good luck!