hpcat

If you're interested, give it a try. I've been doing it for 3 years and love it. You will learn to recognize when patients are escalating and how to bring them down. A good rappor with your staff is essential, as mine have actually prevented me from being attacked a couple of times. It's so rewarding to watch patients who are paranoid, delusional, agitated, suicidal etc. become clearer, calmer and stable with your help.

Just an FYI, psychiatric nursing shifts are typically 8 hours instead of 12. That's because the patients are really rough on the staff. Don't assume psychiatric nurising is easier, in fact it can be much more difficult. Some of my coworkers left psych to go to medical positions because they couldn't handle it.

If you work inpatient in a state psychiatric hospital or short-term acute hospital unit or facility, you need CPI. Typically the hospital will give you the training in a class. I have worked for the state and short-term acute, you need CPI to protect yourself, your staff and your patients.

Try to present yourself with confidence, they will want to know if you can maintain your cool in an emergency.

For this type patient, you need to know crisis prevention & intervention (aka self defense for psych nurses), you need to be able to medicate with PRN and/or stat meds, over objection if necessary, and you need to be able to use seclusion and/or restraints. Violent psychiatric patients are not to be taken lightly, you can get very seriously hurt. Not telling you to leave, but I would, pregnant or not. Your facility is not prepared for this level of agitation/aggression.

I was taught in school to aspirate. But sometimes circumstances make it less than ideal. When medicating an agitated, adrenaline fueled psych patient who's being restrained by a half dozen staff, you need to consider the safety of the patient and staff.

I strongly believe that psych nursing has a huge "social work" component to it - the pt's social problems are the prime reason they become ill and the biggest barrier to getting well. The medical aspect to psych can be much lighter than any other kind of nursing but the therapeutic, communicative component is HUGE and is the difference in my opinion between a good or bad psych nurse. I find psych much tougher than other disciplines because of the emotional and psychological toll it can take on nurses, it can be frustrating to see pts relapse over and over, or languish in long term facilities, or constantly try to hurt themselves or others. The healing takes a long time and a lot of effort, with many relapses along the way. As a psych nurse, I can honestly say, if you want to do this cuz you think it's easy, it's not, you need to find another speciality.

I also started in psych which is the specialty I wanted, first a 13 week contract at a state facility, now at a small acute psych facility that used to have a prestigi0us rep but now on the wane and awaiting takeover from a hospital network. I work nights, so I savor opportunities to interact with pts since most sleep thru my shift. There are people there who have been doing this too long but never had any other job and do many petty lying things to make others look bad and themselves look good. They rarely spend time with pts unless they have to get some work done. There's a lot of paranoia about the takeover, and some of my coworkers have more boundary issues than the patients. I have a preceptor who does nothng but give negative feedback and nitpicks, yet I see her make huge mistakes.The other day my preceptor told me I am too social with the patients, I need to be more medical (FYI she does not socialize with the patients, she's kind of cold). She saw me talking to a detox patient who was anxious about 1) coming off meds, 2) wants to quit smoking and 3) is anxious about discharge and fixing the mistakes he made when he relapsed. Call me silly, but I think it IS A MEDICAL ISSUE to talk to an anxious patient - DON'T WE MEDICATE FOR ANXIETY???? She said I sound like I want to be a social worker. Get a patient with unstable VS and she's in her glory. Get a patient who wants to talk she she sends them off. Another FYI - when I was interviewed, the nurse administrator wanted someone who WOULD INTERACT with patients, I guess the preceptor didn't get the memo. Not for nothing, although I love psych patients, I am done with psych nurses who don't interact with the patients. Yes. the pts can sometimes be dangerous and unpredictable, but if you're too scared then switch to another specialty! I have learned to keep myself safe AND enjoy a positive therapeutic relationship with even the most dangerous patients. You can't help them if you don't talk with them!

I am about to leave a job at a psychiatric facility (my decision, got a job offer:yeah:). This was my first job out of school. The facility got a great rating from JCHAO. I had a contract position weekends double shifts and have floated to many wards there and find their ancient MAR books scary as hell. Lack of consistency in formatting/punctuation that mean you have to reread the order for clarity, many many handwritten changes that are often sloppy or unreadable, orders d/c and changed several times, pages out of order or in the wrong patient's section, even white out! I worked 2 days in a new ward. A patient had been having some behaviors when I arrived that the psych aides said were different for him, more disoriented and confused than usual, making strange vocalizations. Priority bloodwork done on my shift was wnl. MD and psychiatrist gave no new orders. Pt continued to deteriorate thru the next day. I called the MD because he was unsteady on his feet and appeared to be tensing up and moaning, he is noncommunicative and I believed he may be in pain. MD had him lie down and take Tylenol. Pt came to dayroom later and seemed a little better, still tensing a bit though. After dinner he was more unsteady. Tensing took on the look of a mild seizure. Called MD, he said pt has hx of sz disorder and is on sz meds but he could not change them as he is weekend coverage, weekday regular MD would have to change. He ordered close obs for fall prevention and for regular ward dr to see pt in AM. Pt was taken to bed, seizure activity made him flail arms and legs, then get up and walk the hall, where he would nearly fall down and had to be helped back to bed. I called MD again, he stood by pt bed for about 10 minutes shaking his head, then ordered 1 mg Ativan IM. Gave med, pt seemed ok for about 20 minutes then starting trying to get out of bed again after seizure activity continuing. MD finally agreed to send him to hospital. Upon reviewing the MAR for his sz meds, it seems his Depakote was d/c by someone who drew a penline thru that entry in the MAR at end of September. No new order in its place. Of course whoever did it didnt sign their name or initial. He is also on Phenobarbitol. No one had been giving him Depakote since end of September, including me. I can't access computer due to my contract status, so I did not know it was still an active med. I can only go by the MAR. No other nurse since end of September has signed out the med. The Depakote is in his drawer, but I have seen d/c meds in other carts on other floors that didn't belong there (as well as meds missing that were ordered but not obtained by other nurses and therefore not given but thats another story). Complete mess, hoping I don't become the fall guy cuz it's easy to blame the person leaving. FYI if you're wondering why it took so long to send pt to hospital, it's cuz they dont like sending pts to the hospital on weekends, drives me crazy, I had another patient with a bowel obstruction that I had to fight to send. I hope this is not an indication of what nursing is like elsewhere.

I used to work for a case management dept of a hospital (nonnursing position) and saw what happened when families had to face loved ones whose health was declining and/or they could not be placed safely back home and needed LT care. #1 problem is denial. Many family members want to believe the pt will get better with time, or that the family can meet their needs at home (even though explained that pt needs 24/7 care) or that a "better" doctor or hospital can help. We had families virtually turn the hospital upside down trying to find a way to save their loved one when nothing more could be done than what we were doing. Anger was another problem. Frustrated people feeling helpless will lash out at anyone, nothing personal. We had one mother suing virtually everyone who came into contact with her son -he had extensive brain damage from meningitis and his long term prognosis was poor. She was clearly grieving the loss of her son's health. No one could talk sense to her, and as a result she created more problems for herself because healthcare providers were afraid of getting sued. She ended up limiting her son's options to a scant few. Re-familiarize the stages of grieving. People grieve loss of life, health, function, independence, family role, etc. I think it's a huge part of nursing - for both patients and families.

Don't overlook the value of anything you've done, even for a short period, that is healthcare related. I did some volunteer work with emotionally disturbed children, did flu clinics, had a non-nursing job at a hospital, trained adults adjusting to disabilities for office work in a vocational rehab program and was an aide in an adult home while I was in college years ago. Everything I could put in the resume that might help. I have gotten my foot in a couple of doors thanks to it, and now I'm getting some experience. Focus on things from your past experience that sounds like something a nurse might do or a quality a nurse might have.

I had a major neck injury at age 35 but fortunately my then employer gave me long term disability insurance. I couldn't work or drive even for a year and a half. Short term disability and saved personal/sick time runs out fast - I was so happy to have that protection. You may not be permanently disabled but you could have an illness or injury that puts you out of commission for a long period.

My daughter's nurse practitioner has bipolar disorder. She also has 2 MSNs (nurse practioner) in behavioral and peds, and is considered an expert on children with ADHD. You can do this.

Must be a "frenemy"

you can douse a room with buckets of blood and diarrhea, one ill-placed loogy can send me retching...