HeatherPsychRN

I would love to hear what you find out, please update with an answer...

I work in a behavioral health hospital where they have RN's with no background in Psych, they even hire new grads. I personally had my BS in Psych before nursing school. I work adolescents, and other than knowing the meds and CPR, the rest of is pretty easy in my facility. We have mental health counselors that do most of the counseling, rn are expected to be supportive to the counselors and step in when needed. I worked med surg for 4 years prior, and there is very little that I can carry over... It is almost frustrating at times knowing I am not using some of the skill I acquired... We do also have RPN as mentioned above, and they are usually a charge nurse or supervisor.

I work in a behavioral health hospital, so we have pt on different floor for different accutities. I work on an adolescent unit on pms and we have generally 2 rns, and 4 counselors for 19-22 pts. Nights they have 2 rns and one counselor for 20 beds.

Thanks for all the feedback, I can't tell you how much it helps! I have seen most of this stuff going on with other staff, but it is so much easier when you are told what is going on and then see it too. The talking to a patient with suicidal ideations right away is good advice-sometimes I just feel overwhelmed and need to remember how to prioritize care... And the references to google is great! Thanks again! This feedback is good!

I would say to have a good relationship, you don't have to be 2 perfect people, but 2 people perfect for each other. You said you were going to be a nurse, so he gets that compassion from you, but what do you get from him? If you get as much as you give, I would go for it. I would take it slow, just to see how life goes and make sure you are right for each other...

Thank you! It is a big help! I would love to hear more when you have the time!

Hi! I am a new psych rn (2 months now) but I have been a nurse for 5+ years total. I am looking for some basic info on psych nursing. In my training, I was taught all about how to do the paperwork, meds, assessments and admissions/discharges, but very little on how to interact with the patients. I know the expectation is that I can sub in for a counselor if needed, but I am having a hard time figuring out how to be helpful to the patients in that role. I found some amazing info on treating a patient with borderline personality disorder, but that is a small percent of our unit population. I specifically work with adolescents, but I do float to all units in our behavioral health hospital. I am looking for some "guidelines" of what to start with for any/all patients, knowing that individuals will need more specifics at some point. For instance, for BPD, it was said to focus on the present and future and not the past problems. I hope this makes sense, I just am looking for a solid starting point. Thanks!

OMG! Thank you for this! I am a nurse very new to the psych field, and I have had a BPD pt that has focused in on me... I now understand why, where I am letting this pt down, and what I have done that has been helpful! More importantly, I know what to do to help and structure 1:1 time for the future with this patient. Thank you so much!

Hi! I have worked as a nurse for a while, but only the last 2 months in psych... From what I have seen, heard, and done so far here is my scoop... (forgive my blunt terminology) The butt is the best choice to give an IM if possible because the bigger the muscle the faster the absorption. When we have a code, we have the pt usually in physical hold before the restraints are attached to the bed, and that is when we ideally give the medication- there are many people holding so it is fairly "safe". I have given 2 cc and I do pull for blood first, since the patient is being physically held, but I do try to go fast... If a patient is willing to take an injection, I go with what they choose, and alot of times I choose the arm just to make it least traumatic- they usually don't have to move from sitting to laying and they don't have to remove any clothing usually. But that is when there is no code. In the end, if you give an IM, it will get into the patient no matter where you go, so I wouldn't worry too much. As far as knowing where to out the needle- the butt, draw an imaginary cross dividing the cheek into 4 equal part and go for the middle of the upper outer square- using your fingers to know where to put the needle on the arm... Our facility doesn't have a policy about where to inject, but my advice is to make it easy on yourself and find out ahead of time which drugs can be drawn in the same syringe and which ones can't- you are much better off giving one injection over 2... We often get orders for haldol, ativan, and benadryl all at one time and we can give 2 in one syringe so you only have to give 2 IMs Hope this helps!

Thanks for all the advise and support. I have been at my new job for 2 months now, and my husband did finally get on board (mostly). I am really glad I went for the job, because I feel like I have even more support now with my new friends and coworkers. As it turned out, my husband got laid off for the first time ever about 2 weeks into my job, so we really had no other options. Thanks again.

After starting my job, I found that on my shift (pm), most the nurses wear scrubs... So I am wearing scrubs, but at least I know the option is there (like if I don't wash my laundry on time...) Also, scrubs are just so much more comfortable... Plus, I like that the patients can see who is a nurse and who is a counselor so they know who can address each need...

I am fairly new to the Psych nursing, though I have my BA in Psych and have had my RN since 2006... I started at my facility about 2 months ago. So far, I have had very little exposure to anything violent- I did have one patient who started to push me a little, I had one patient who tried to elope, and I have been threatened a few times. I would say the biggest part of why I feel safe working there is the staff... In my facility I know every other staff has my back as I have theirs. We all have an idea of what is going on with every patient, so you know who to look out for. If you are going to be anywhere where you have a concern, someone will always come with or be withing shouting distance. I can't say that I have felt yet or foresee any time when I would be in a situation with a patient that I would have to worry about how far to go to defend myself. Also, make sure you have a good poker face. I have heard and can see sometimes that if a patient who is not all there can sense there is something fearful, they are much more likely to focus on you. I have heard stories of past staff in my facility that would be less than helpful to you in the begining as to "weed out" the weaker staff, so really know who you are working with. And speak up if you feel off about anything. Don't be afraid to run away or not looking "professional" if you feel unsafe. In the end, if you can't take care of yourself, and you get hurt or too scared to work, you won't be able to help anyone. Just my 2 cents, hope it helps. Oh, and from my understanding, it is likely that no matter what you do, you will be sued or something. From the way my facility put it, it's mostly because the patients are not quite seeing reality, and they do everything they can to make it as little inconvience as possible (I work adolescent inpt, so we are often pulled into legal stuff from what I have been told). In conclusion, make sure you REALLY know who you are working for and with!

Does anyone have and info or opinion on business casual vs. scrubs? I recently started in an adolescent psych unit, and it is left up to each RN to decide if we wear business casual or scrubs. I like the atmosphere the business casual creates but I really miss not having the pockets of scrubs (especially when I am nervous about accidentally leaving a pen or something sitting around). Is there any scrubs that look like business casual but with pockets? Or business casual tops that have pockets? Thanks, Heather

This is great news! You have been in my thoughts since I first saw your post. I am very glad you are taking the steps foward. Please do give us updates, it makes me feel better. Lots of prayer coming your way! Heather

I could really use some thoughts, prayers, comments, advice, and mostly some support. I have just started the orientation of my new Psych Job. This is where I believe God is leading me after listening to my prayers for months now. I am a bit nervous about the job, but mostly thrilled that I will be in a position to help people when they need it the most. I have history of depression and anxiety, which I will never call my self cured, but defiantly managed. Everything is pointing to God wanting me to be here to help these people that I can relate to. I feel blessed to have this opportunity. But my husband in not on board. He wants me to be a full time stay at home mom and house keeper. In general, money is getting tight, our relationship is not great and I believe this is answered by following Gods path. But my husband has pulled back and while he won't stop me, he also won't be a support to anything going on with my new job and training schedules. Now the stress at home is making me uncomfortable because my personal past has always shown me to just stop trying and give up. I am really torn about listening to God, making my husband happy (if possible), and worried that the environment I will be working will be triggering me due to elevated stress levels at home and lack of support system. I hope this makes sense to anyone willing to read. Please let me know what you think... This site is great to be able to present this insanity of my life to people who can really understand as nurses what that life is about... Thanks, Heather:confused: