Michael_Espelin

If you "really want" to work inpatient, than work inpatient! From my NP colleagues that work inpatient, they say it definitely is more fast-paced and allowed them to have the steepest learning curve with the greatest amount of support around them. Personally, I want to do outpatient. I am in a similar situation as you; I'm a newly graduated PMHNP. But I have a goal of starting my own practice and clinic so my focus is on outpatient at the moment. The beauty of this field, and especially as NPs, is that we can go anywhere we want and change it if we desire! Best of luck to you. -Michael

What hours were you working that shift? And how was the order written for the furosemide?

I must admit, I am relatively surprised by some of the posts here! First of all, I need to get something off my chest. I have a hard time imagining a nurse being "bored" at any capacity of work they are doing. So much of nursing is what you make of it. Yes, I know there can be a monumental amount of charting anywhere you go as a nurse, but certain aspects of nursing require being independently curious, continuously educating yourself, being creative, and thinking of ways to improve the unit/agency/field you work in. But I digress. Don't let the fact that psych nursing "appears" to be boring fool you. I've been on the same inpatient psych unit for 3 years and I see my fair-share of nurses sitting on their butts in the back nursing office only coming out when a patient needs a medication. That is NOT what psych nursing is and that is NOT what it means to be a psych nurse, let a lone nurse in general. Our job as nurses is to be present and available in the milieu--especially in psych nursing. So try not to be mistaken by what you have seen or heard of -- psych nursing is what you make of it. On a typical shift (I do 7p-7a now), it starts out with getting a routine report on the unit. Usually theres 3-4 nurses and we have a 24 patient capacity which means I have anywhere from 5-8 patients. Where I work, there are 2 other adult units, 1 adolescent unit, and 1 geriatric unit, so it's a somewhat big psychiatric hospital and there can be a lot going on at any given time in terms of mental health acuity. Patient interaction largely depends on the nurse and can vary. I notice some nurses who seem to purposely avoid having a lot of patient interaction and get easily bothered by talking with patients and on the other hand there are nurses who take a lot of time talking with patients. For me, I meet with each and every one of my patients to do a check in. I would like to think that's pretty basic in many areas in nursing and is just common courtesy and the patient's right to know who is taking care of them. There are times though when you need to use your own judgement in meeting new patients and time it right. Some patients may be more willing to communicate than others. Some patients with schizophrenia may have a hard time communicating their thoughts (thought-blocking) and patients in a manic state may talk nonstop. But the beauty of psych nursing is, that's all part of the job and part of the assessment. In psych nursing, you learn to assess patients by observations and behavior. There are no monitors hooked up to a psych patient telling you they are paranoid, angry, psychotic, or ready to escalate. So it is crucial to not only interact with patients one-on-one but to also interact by observing and being present in the milieu. Out of all the areas of nursing I been exposed to, psych nursing has the most opportunities to interact with your patients, BY FAR. The assessment process includes interviewing them and talking with them. Communication in psych nursing is so important. Not only to assess for side effects of medication, but to also assess for their symptoms of their mental illness. So I think it is absolutely necessary for a psych nurse to spend as much time with their patients as possible, when appropriate and when it is necessary.

As many else have shared, I had a similar wave of absolute dread and the thought of "Why did I choose this field?" loomed in my head every time I went to work. I endured that for nearly 2 years as a LPN on long-term care unit. At the time I was bitter about being a LPN, so with encouragement I went for my BSN. Honestly, there were many times during the BSN when I wanted to throw in the towel--especially during clinical in the hospital settings on med-surg units. That all changed when I discovered psychiatric nursing. That's the beauty of nursing; there are so many areas! I would highly encourage you not to give up and to consider changing units, or changing your entire specialty as a whole. I know I am glad I did. Now I am set to finish my MSN in under a year and become a PMHNP with a goal to have my own practice and explore business opportunities. There really are no boundaries to the field of nursing, if you're willing to put in the time and effort. Hang in there and best of luck!

Definitely worth it! But it did take me a while to realize the awesomeness of being a nurse. I started out as a LPN working in a SNF in long term care and, to be quite honest, I was miserable. Many times I felt like throwing in the towel. Luckily, I had some good support and motivation from other fellow nurses to not give up and keep going forward. So I decided to stick with the nursing home gig while going for my BSN. After I got my BSN I immediately landed a new job as a RN in the new field of psychiatry. That change is what did it for me. It opened up a whole new world of nursing and possibilities. Don't give up and keep pushing forward. Something is bound to open up for you. I am now almost finished with my MSN to become a PMHNP and plan to open up my own practice while exploring other business opportunities. Best of luck to you!

Oh wow, 3 classes huh? Think I am sticking to 2 a semester, but we will see. Excited to start school again???

I just registered for 500 and 519. Cool to see another person at USJ on here!

Hello all, Just wondering if anyone is currently in or soon to be starting the PMHNP program at Saint Joseph University in West Hartford, CT. I just recently submitted all my documents and could potentially be starting as soon as January 2016. It would be cool to know if anyone else on here will be there as well.

Not sure if this pramipexole prescription is working out for me doc...

The only way to know for sure is to try it. I know that's very fundamental advice, but oh so true. You seem confident in succeeding in psych, which is a huge part of trying a particular area in nursing. Also, you seem to have a genuine interest in psych, a necessary prerequisite for any psych nurse. I know many people (including myself at one point) have thought or have told others that being a med-surg nurse is what you have to do at first to "sharpen your skills". But I now believe that if your interest is psych, you should go right into it as early as possible. Contrary to what a lot of people think, you still use your skills, and gain plenty of new skills unique to psych. A better example than myself (I am a new grad) would be my Mother...a Psychiatric Nurse Practitioner with many years of experience. I always ask her about the violence aspect of her experience in psych and it is very similar to what I have seen so far on this forum. It really depends on where you are working. Her experiences span from prison systems, psych hospitals, nursing homes, to the community, and she can stands by the fact that violence, albeit a concern, is not an issue as long as you are smart about how you go about your day. Always watch your six, always have a partner when you feel uncomfortable, never put yourself in a dangerous situation, and similar to watching your back, never turn your back on a patient casually. The mental health workers are there for you, never be afraid to ask for their help. Yes, violence does happen, but violence happens everywhere...at least in the psych setting there are people there to help you and the staff is equipped to handle a dangerous situation.

I didn't get any questions specifically asking about meds either. The key questions I was asked were: Tell me about yourself Why nursing? Why Psych? Why NOT social work? Talk about any previous experience in psych What would you do to prevent a problem from happening or escalating in psych? Those were the biggies. Be ready to talk specifically about you and why you are interested in psych, and sound exciting and enthusiastic. To me, that's the most important part--to convince them you're really excited about the job.

1. I have a college degree and LPN license. I really want to get my RN but honestly fearful on if I should attempt this endeavor after being out of school for some time. Go for it! Trying to choose which track (ADN, BSN & accelerated programs) Also aware of having to take core courses in nutrition, A&P, pharm. etc.You will obviously have to decide on your own ultimately, but you have several options. The ADN route gets you the RN license the fastest. So if you want to get your RN fast, you could start with that route. Definitely use your LPN license if you can while you go for your ADN. The downside is a lot of hospitals are now looking for nurses that have a bachelor's degree, BSN. So if you go with the ADN, I'd recommend getting into a RN/BSN accelerated program as quickly as possible. 2. What advice and preparation would you suggest for an LPN new to working in a small psychiatric hospital (no prior experience in this Do you have any LPN experience at all? There are a lot of other threads in the specialty section under Psychiatric Nursing that address some key points for new nurses in psych; that would be your best place to start. But definitely pursue to position if you are interested in psych.

Especially since psych nursing is all about anticipating what is going to happen or how the patient is going behave. You have to be able to pick up subtle cues and recognize what they mean and how to prevent something bad happening. Yeah the med passes and patient load may be less at times, but you need to be fully focused on the patients--as in never turn your back on them. Couldn't agree more.

Got my LPN when I was 25-26, should have my RN/BSN next year when I'm 29. Only recently got into psych in nursing, but always appreciated psychology as a subject. Hope to go all the way and enter a PMHNP program after a little RN experience in a Psych setting.

Yes, very long time indeed. But to me, now would be the best time to start thinking about it--before it becomes a reality. Generating a good research and theoretical background is always a good idea well in advance. Especially with fields like aerospace nursing, aerospace medicine, even advanced wound care with hyperbaric medicine and oxygen therapy. These all use modern technologies that I believe are the beginnings of a new frontier in not only nursing but in medicine. It is cool to see others have an interest in these kinds of things. Space is cool. I highly doubt anyone dislikes space.