ajt575s

How about Psychiatric Nursing Made Incredibly Easy? You can find it on amazon. I have found that series to be very helpful in nursing school.

I get to talk with the patients quite a bit. RNs aren't usually only doing med passes, though that can encompass much of your time. We usually have a nurse assigned to meds and a nurse assigned to charge, and we rotate these responsibilities. I was disappointed that I don't get to lead groups at my facility, but I've known nurses to do this at other facilities. Our patients have a whole plethora of problems/psychological issues. The majority of the adults I work with are psychotic, suicidal, or suffering from substance-abuse disorders. A good part of my job when I'm not passing meds is managing patients who are escalating, though I also deal with acute and chronic medical issues, since it is an acute care facility. Some of my patients have been victims of rape, but I've seen most of that on pediatric units (very sad). In my line of work, you also may work with people who have sexually victimized somebody else, so that's something to keep in mind with psychiatric nursing. If you want to focus on rape victims, you can become a SANE nurse. Also, as I already mentioned, working in peds will give you more opportunities to work trauma/rape victims. I find working with these patients very rewarding. I'm not a SANE nurse, but it's something I would consider doing later in my career. It's an additional certification that you can get after finishing your BSN degree and becoming an RN. I'm not sure how much experience you need to have to get the certification, but it should be at least 2 years I think. You may find some good information about that on the forensic forum on AN. Here is a thread on the topic: https://allnurses.com/forensic-nursing/sexual-assault-nurse-152900.html Most SANE nurses that I know are ER nurses who are certified. They rotate as on-call nurses and are called in if a rape victim presents in the ER. I know a nurse who works at a crisis center, so that could be another option. If you have a local crisis center, you can probably inquire about volunteering there to get some good experience and get a better idea if this is an area you want to pursue further.

I agree with you. Do not apply to a place where you have been a patient--it's a conflict of interest. We have had patients who wanted to apply as techs after spending some time in our facility, but they were not allowed to do so. Also, we've had patients who came in and had been roommates or coworkers of employees currently working there, and they were not allowed to be on the same unit due to conflict of interest. I don't see a problem with you going into psych, but it needs to be somewhere where you haven't been a patient.

What about the Red Cross or local hospitals? Also, you might look into local low-income clinics. Best wishes!

I'm a new grad who started in psych, so it can be done. I would strongly suggest that you shadow a counselor/therapist and a psych RN to better understand what their roles are, because they do very different things. Depending on your facility, of course, a lot of psych RN's don't even get to lead groups, for example. My idea of what psych nursing would be like has been very different from the reality. I have a friend who went to nursing school with me and had originally wanted to be a therapist. Once she started doing nursing school clinicals, it really hit her that the nurse's role was not what she wanted after all. (She did not enjoy the technical/hands-on stuff that nurses do). She ended up dropping out of nursing school and studying to be a therapist instead, and she has been very happy with the decision. However, she wasted two semesters of money and time on nursing school to figure this out. Hopefully, you'll find the best fit for you! Good luck with your decision!

Forgot to mention--I know for sure that Cox Health in Springfield, MO does have a "experienced nurse internship" program for critical care and several other areas. It's about 3 hours south of KC. Just call the HR department if you're interested.

I would recommend calling Truman, KU medical center, and the VA. The VA may be a surprising one for you, since most VA hospitals don't seem to offer fellowships, but the one in Kansas City offers critical care fellowships for new grads, so I wonder if they don't for experienced nurses, too? I would just call the HR department of these hospitals to see. From what I understand, Truman has an awesome program for new grads, so it might for experienced nurses, too. I've heard of these "experienced nurse internships" before in other cities, and the application process is often similar to or parallel to new grad programs. With your background, I think you stand a good chance of transitioning into one of these programs. Good luck!

This gave me a much-needed laugh today!

I think I should have been more specific. I mean mandatory overtime (which we call "being mandated") in that you are already there, getting ready to finish your shift and leave, then you get a call from the supervisor stating that you are "mandated" and are forced pretty much to stay another 4 hours, if you worked a 12. If you have to come in and work again that night/morning, it's too bad for you, because they don't seem to care. If they were calling me at home and I wasn't actually at work, I could just avoid the call. This is happening more and more frequently, and you can see why it destroys employee morale. It's very difficult for nurses with children especially, because they aren't given enough notice to make arrangements to pick up their kids or anything.

How many of your facilities use mandatory overtime as a staffing solution? My employer staffs us inadequately to begin with, then if there's a call in, we end up getting mandated. This has been happening at least once a week lately, plus people find out they're getting mandated at the last minute. It seems like it happens more and more frequently as I continue to work there. It's very hard on employee morale and unsafe for patients. I'm curious what other nurses' takes are on this topic.

I think you did the right thing really, and dudette10's suggestion was good, as well. I work in psych, so I have to deescalate people all the time who are often aggressive and rude like this guy. Usually, the trick is to remain very calm and not really react to what they are saying while validating their feelings. Maintain a non-threatening, relaxed type of posture (no crossing arms, tapping the foot, etc.). It can be a balancing act in this situation, since you don't want to criticize your colleagues, either. I like the approach of saying, in a calm tone of voice, "Mr. Smith, I hear what you're saying. I'm sorry that you feel this way--what can I do to help you right now?" Sometimes, it's helpful to give the angry patient a decision: "Mr. Smith, I'm sorry that you're feeling frustrated right now. Would you like me to help you with X or Y first?" They have to stop and think to make the decision, which can calm them down, too. You'll find that using a calming approach like this will often mean less trouble/episodes from the patient later, while giving the patient a sarcastic type of response will probably mean the patient is going to act out again and staff is going to continue having problems. I'm often surprised by how well this can work with patients who are very violently agitated (i.e., throwing things, cursing, yelling, etc.). It sounds like he's actually upset about something else to me--something I tell myself to be calm in these situations is: don't take this personally. This person's anger really has nothing to do with me. That helps you maintain the placid mannerisms/expression necessary to deescalate the person quickly. Hope that helps!

What are typical staffing levels in psych? We're always full and have a general mix of adult patients (many with chronic and acute medical problems, as well). We get geriatric patients, acute schizophrenics, borderlines, depressed patients, manic patients, psychotic patients, substance abuse, etc. Lots of different acuity levels and disease processes going on. Our facility is wanting to cut staffing overnight to one RN and two techs for 21-23 patients. To me, this seems very unsafe, since this population is very unpredictable medically and psychologically at times. What do you think?

Just to reassure you: I work in psych also. I don't think you'll necessarily get "stuck" in psych, though it may depend on your location. I have seen several psych nurses at my facility leave for medical jobs without prior medical experience, one or two in particular at 6 months after graduation. Psych does give you some skills that are marketable in other areas, especially communication/de-escalation skills. I do acute psych, so I do get to do blood draws, wound care, etc. You get really good at IM/SubQ injections and administering lots of different types of medications because you have to do big med passes. Psych pts have medical problems, too, so you will run into medical crises from time to time. Also, psych gives you the opportunity to charge earlier than medical jobs, so you have leadership experience that will transfer well to another position. I'm not sure that it would look bad to other employers if you were planning on staying in your psych job as a prn or something like that. You may not burn a bridge that way. Several nurses at my facility work prn somewhere else as well, often to keep up their medical skills. Instead of giving a reason for leaving on your application, you can put "presently employed." Hopefully, that helps!

I'm in psych right now, and I'm finding that my psych class was not helpful at all. We spent the whole time going over various types of disorders and therapeutic communication for each disease process. During our clinicals, we barely spent any time with the nurses at all. I don't think many of us even knew what psych nurses do. We just sat around talking to patients in a rehab setting. We didn't deal much with psycotic pts at all. De-escalation would have been VERY helpful, and should be a must for a nurse in any field, but especially psych. Also, the legalities of psych nursing, specifically, 96 hour/21D/90D holds/restraints/seclusion would have been helpful. Techniques on dealing with problem behaviors would have been good. Usually, acute psych pts have multiple diagnoses or no diagnosis yet and don't fit neatly into these various disorders we discussed in school. So, I haven't found a lot of that "therapeutic communication" geared towards specific diseases or "coping skills" that I'm supposed to teach people with certain diagnoses to be all that helpful. Also, what to actually DO in certain kinds of emergencies, like chest pain, SOB, etc. would have been great. I feel like we were very rarely told what we should actually do when this stuff happens. Like everyone else, I feel that skills would have been great. Luckily for me, I had an externship during school where I got to learn how to put in IV's, draw blood, etc., and I worked as an aide, which helped me learn how to balance multiple patients. But, I didn't learn those things in clinicals.

Have you tried the University of Missouri hospital in Columbia? They hire new grads.