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I just accepted a position in North Carolina with a travel agency. I start in early January. I've been a psych nurse for 18 years and can't imagine doing anything else. I took a HUGE pay cut when the psych hospital I was working at closed and I need to do something to recoup the $$. I'm looking forward to the adventure. Good luck in your endeavors.

In my experience with child and adolescent psych units (I worked one for about 6 years), 7pm to about 10pm will be very busy getting evening meds doled out and getting the kids settled down to sleep. After that it's extremely quiet, barring a few admissions here and there. Kids usually sleep at night. I didn't like 12 hour shifts as much as 8's because it seemed like the census turned over too quickly and I wouldn't know the children as well when I came back from my days off. Good luck and have fun. There is nothing more energizing (or heartbreaking) than working on a pediatric psych unit!

Thanks for the advice. I'm also starting my first travel job next month. I'm looking forward to it but it's a little scary. I love to travel and I figure I've tolerated my last "real" job for 13 years, 13 weeks should be a cake walk! Anything else I should consider?

I agree with much of the what has been written previously. I would avoid benzos at all costs not only because they are addictive but because they can "impair" you. And no one needs to worry about being impaired when they're trying to deal with anxiety and stress from their job. Frequently our doctors use low dose Seroquel or Neurontin for anxiety. Additionally, there is also Xanax XR which has been released and requires only once a day dosing. Allegedly it doesn't give the "buzz" like the benzos(regular Xanax) and it lasts 24 hours. Both Celexa and Lexapro are very effective in reducing anxiety. I've never seen BuSpar do anything for anyone! Find a good psychiatrist ( I believe they are the experts) and let them help you decide what's best for you. Good luck!

Wow! I've been out of school for 18 years and write care plans every time I complete an admission and then have to evaluate them to see if the patient is progressing. It's been this way as long as I've been a nurse. Wish I didn't have to write them but I don't know of any hospitals that don't use some form of care planning or care maps. Care plans in school are time consuming and frequently a pain to write but they do help a student get a more global view of the client's needs rather than just their medical diagnosis. Care plans get easier the more you do and there are plenty of care planning manuals on the internet and in college bookstores. Good luck with school...it does get easier.

Another thing...you said it was a clinical...isn't there a staff nurse on the floor also assigned to care for the same patients? That's how we did it when I was in school and that's how we do it now. The students have to report off to the staff nurse responsible for the patient. I imagine the staff nurse would have been available if you needed help. And I don't know any nurses who haven't worked doubles or come to work after sleeping only a few hours. I wish they'd send me home!! To repeat what others have said, it's very important to be as calm and non-judgmental as possible. As soon as the program director feels "threatened" or defensive, you've lost the battle. Best of luck. At least you were conscientious enough to show up for clinical! Sounds like my kind of nurse.

If you had asked me this 20 years ago when I finished nursing school I would have said PSYCH! I hated every minute of my clinicals and it seemed like no one ever got better--of course I was only there a few hours/day for a couple of weeks and we changed units every week. When I finished school, the only job I could find was in psych, so I took it thinking, "I can do anything for 6 months, then I'll transfer to something else". That was 18 years ago and I can't imagine doing anything else. I love working with the patients and their families and most get better and go home. I couldn't work in NICU or peds because the first time a child/baby died, I'm not sure I would be able to come back to work. And I doubt I would be very therapeutic if the death was a result from abuse or neglect. It's too hard for me to see little ones sick.

The involuntary measures the mentally ill homeless have had to endure come more from the de-institutionalization mandated by the federal government that occurred in the 1960's and 1970's. These mentally ill persons were released from long-term psych hospitals without any reasonable follow-up because none existed. The individual communities had no where to house them, had no jobs for them and no programs were available to monitor their need for medications or to provide job training/supervision. In addition, these people faced the stigma of having been diagnosed with a mental illness and the communities didn't necessarily welcome them with open arms. People still have to cope with that stigma now...some 30-40 years later. These people could not afford then or now psychoanalytic psychotherapy. For that matter, most people can't afford psychoanalytic psychotherapy as it's rarely covered by insurance and it's extremely time consuming. What these people need are programs set up to provide support, supervision, crisis intervention and access to the health care system. Sadly, this just isn't a priority in most states because it's expensive and it's not a popular cause.

Sometimes alternatives aren't used. At the hospital where I work, after a particularly difficult and aggressive "psych" (and I use the term loosely here) patient was admitted to a M/S unit, the next psych patient (one with a long psych hx and a martial arts background) admitted there was kept in restraints and with 24 hour security guard monitoring until a bed was available on the psych floor. He never threatened anyone or behaved in an aggressive manner after he was in the hospital. I guess the rationale was: he could be aggressive, so he had to stay in restraints. Now the policy is: if a psych patient is in the hospital ER and the psych unit is full, the most stable patient is transferred off the psych unit to a M/S unit (with a psych staff providing 1:1 care the entire time they are on the M/S unit) and the patient in the ER is brought to the psych unit. No one has addressed the fact that the psych unit is now short staffed (because a staff has to go with the transferring patient) and a more acute patient is now on the unit! Most psych patients are not violent or aggressive and seclusion/restraint is only used as a safety measure when all other efforts have failed. Only in very few instances have I heard any of the secluded/restrained patients c/o further emotional trauma from the seclusion/restraint event.

I've been a psych nurse for a long time and that's been one of my biggest gripes. I don't have any trouble with treating people well but a little discomfort (not torture or anything quite that dramatic ) goes a long way to getting them out the door and back to reality. I've told patients that I'm not a short order cook, a bellhop or a cruise director. Some are offended and others just laugh. I think how a unit "feels" in regards to providing a therapeutic milieu (I really hate that term!) or a hotel depends on the facility philosophy and how the staff function as a team. It was amazing when we would set limits and expectations how those that were the most comfortable started heading for the door.

I was stunned to see something like that on ER. I agree there have been some "over the top" episodes but this took the cake. I've been a nurse for a fair amount of time and have experience working with agitated, psychotic, aggressive patients and I have yet to see someone fling themselves on top of the patient and stab them in the neck with a 10cc (or bigger) syringe! We tend to use a show of force and restrain the patient, then give meds IM. Certainly the portrayal of this nurse in this instance made her look like a "take charge" person, but she put herself and her coworkers at risk. Additionally, later in the same episode, she placates the woman who's been in the ER for 12 hours but does no nursing assessment of her. Isn't that what triage is for? I imagine the general public doesn't notice these things in the detail health care workers do and I know there are nurses who work on the production of ER but what were they thinking during last week's episode? I usually enjoy the show but the nurse stabbing a patient in the neck was really too much.