KYPsych

I'll be relocating to Northern Virginia at the end of this month and I have an interview for NVMHI for a RN position. Just wondering if anyone is familiar with this facility or is currently working there. Any info would be greatly appreciated.

Hi Bunny. Sadly, your facility sounds strikingly similar to mine. The trend over the past 5 years has been for group homes and smaller psych facilities to close and their patient populations are stuffed into the larger, long-term psych hospitals. It was a rarity to have MR patients on my ward a few years ago. Now there's as many as 13 severe MRs crammed into a ward with substance abusers, personality disorders, dementia patients and the chronic mentally ill. The most frustrating part is that each category of these patients have completely different needs in terms of treatment. Over time it seems like we've become more of a warehouse for the unwanted than actually a psychiatric hospital and no population is getting the treatment they need. Violent MRs and dementia patients should NEVER be mixed with a general psychiatric population. Their needs simply cannot be met effectively when you have 20-30 other kinds of psychiatric patients on a ward. Restraint/seclusion rates skyrocket when you mix these vastly different kinds of patients. I feel your frustration. I'm a "seasoned" nurse and sometimes I feel like pulling my hair out and running for the hills. If you decide to stick it out at your facility, you might consider going before your administration and suggesting a separate ward for geriatrics or MRs. If your facility is anything like mine, your restraint/seclusion data would show that MRs and dementia patients are driving up your rates dramatically.

I worked with a nurse who was Bipolar (and a rapid cycler) on my ward. She was an excellent nurse with lots of empathy for the patients and usually had fabulous rapport with them. She was always quite honest with her coworkers and the management about her illness. There were times (usually when she was going through a depressed cycle) that she admitted to feeling overwhelmed on an acute psych ward and she'd usually take a day off or switch to an off shift where patient contact was limited. I would suggest talking to your nurse manager about your illness. I have found that psych nursing in general is very open minded and accommodating. I hope you enjoy psych nursing for many years to come!

In private hospitals you're typically going to find patients with health insurance. In my experience, the diagnoses most seen in private institutions were depression, substance abuse, anxiety disorders, a few bipolars, and a couple personality disorders. Lengths of stay at private facilities are generally short and the facility itself is usually plush. Now in a state instition you're typically going to see folks that have no insurance. At the state institution where I work, the diagnosis seen most often is schizophrenia. A lot of state run facilities are run down and these facilities truly look like asylums! (The hospital I work is 175 years old with some of the original buildings still in use and the newest building being a mere 60 years old.) You're going to find a rougher brand of patient here. Felons, the chronically homeless, hard core polysubstance abusers, violent MRs, habitual malingerers, and of course - lots and lots of antisocials! Both state and private will be short-staffed, though private hospitals in general pay more...at least where I am. State hospitals will have a larger census. It is common on my ward to have 30 patients with 1 RN, 1 LPN, and 2 aides. Private hospital census is typically 10-17 beds. I hope this helps!