Piper12

I think you will be surprised how much you know about psych from working in the medical world. Watch the other nurses that pts want to talk to, check out the nurses style of communicating. If he or she is good you can copy some of their methods until you are sure of your own. Read and learn about therapeutic boundaries, coping mechanisms both effective and ineffective. Your toughest pts will probably be the Personality Disorders (my specialty), these are the pts that all of the staff tend to "dog" during report. They are tough pts, but they can stabalize enough to be discharged. A great book re: borderline personality d/o is "I hate you, Don't leave me". How is it going so far? Good luck.

Two Rivers Psych Hospital in Kansas City Missouri

Regarding the chances of physical harm. I work in a state hospital where we used to put pts in restraints "to prevent harm to self or others". This occurred at least weekly. I will tell you that in the last 2.5 years we have not used restraints. It is our new attitude....we act proactively with our pts. We get to know them, treat them as we would want to be treated, understand a pt's trigger to anger or violence and prevent the situation from occurring. In 25 yrs I have only been attacked a handful of times and all of them could have been avoided, if I had worked proactively. I cannot imagine ever using restraints or seclusion again. And yes, we take care of very sick psychiatric patients.:redpinkhe

I am a psych RN of 25 years and it is my passion. The secret to learning the trade is to genuinely care about your patients, realizing there is a fine line between those that are diagnosed with a mental illness and those of us who are not. It may be helpful to shadow an experienced psych nurse to understand some very important principles:therapeutic relationships, emotional boundaries for the nurse and the pt, how to focus on the appropriate issue of the pt. Most psych hospitals are very short stay and the staff's role is to teach effective coping and stabalize the pt for discharge to outpatient services. Techs at our facilities keep a close eye on our precautions(pts on sucide watch, etc), do rounds to account for the pts, talk with the pts, monitor for safety, inform the charge nurse of any changes in a pt that the RN needs to evaluate. Gosh, there is so much more to tell you. Good Luck

:uhoh3:Please share how you inventory pt valuables at the time of admission. I need a method that can be utilized from adm TO dc....so when a pt needs a valuable during their hospitalization, it is accurately recorded as removed and again recorded when returned. This has been an ongoing issue. I am trying to keep it simple. Piper12

The great nurses that I worked with over the years were the nurses who knew on a very deep level that being a nurse is truely who they are. You sound very definite. It can be very difficult to get into nursing programs....I agree that you should apply to as many programs as possible and never give up. The more obstacles you encounter and then tackle--the better nurse you will be. Good Luck!!!! Piper12

In the last 25 years this has happened several times to me! It is so frustrating. Several years ago, I was "pulled" to a child and adolescent psych unit. A few minutes after going to the unit, I quietly called my husband and told him to call the unit stating there was an emergency from home!!! Since this was not the answer to the ongoing occurance, I found/did the following: 1. There is probably a clause or statement in your contract, at the time of your employment, that gives nursing administration the right to pull you as the need arises. "If you are a nurse, you qualify to work there" 2. I tried to fight being pulled explaining that I wasn't familiar with the unit but that didn't work for me. 3. So... I made it a point to talk to nurses that were familiar with the "dreaded" unit and got their perspective of nursing care, asked about their routine and took notes. I did everything I could to find positives about the unit. 4. I asked nursing admin if I could have a shift of orientation on the "dreaded" unit and I made sure I shadowed a nurse who knew the ropes. 5. After my orientation, nursing admin tried to pull me all the time, without rotating with other nurses. I stood for fairness and all us nurses had to take turns. Here's the best part, I ended up really loving the experience of the once felt "dreaded unit" and became their Nurse Manager for 2 years.