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We split pills because our pharmacy is too cheap to get meds in the right dose - ergo, we touch the pill. I have taken to using gloves because the hand sanitizer has irritated my skin to a point of eczema rash at the base of a few fingers & my hands now begin to crack & peel on day 3 of using the hand sanitizer.

The work arena does not get better, however, you will get better at what you do & that will make you more able to handle your workload. Overwhelmed is an understatement for how any new psych nurse feels. I was in mortal shock & dismay for at least 1 year but had an intense desire to understand. After that it was more about learning & doing more pt. care with increased ratios (now at 11:1 at my facility). I believe in what I do, I believe we help people even though they won't maintain it, we help them. If you are hating your life, dreading going to work, you might look into a different avenue of nursing. The amount of "warm & fuzzy" feelings are very few & far in-between. Best days for me? Seeing the psychotic patient make a turn & start making sense or the hopeless person D/C with real connections & F/U care. Otherwise, it can be just another day in the neighborhood.

4 nurses 2 techs for 21 patients would be a dream. We have 2-3 nurse, 1-2 techs (someone called in?) 5+ Discharge 5+admits. Welcome to Psych.

I have been working the acute psych floor for 4 years now & still keep my mouth shut & eyes wide open when another nurse is being what I may consider overly snappy, loud, yelling or mean. I stop & watch the effect it has on the patient & what happens next. I learn, I decide what I will do & won't do. I have been overly whatever at times when I am overwhelmed, tired, having a bad day - No one is perfect. I also try to do better the next time. I find myself much less "nice" & more firm & matter of fact when patients are attempting to crowd at the nurse station. Learn first, judge less & then decide how you want to proceed.

I remember my clinicals - I was assigned to 1 nurse who glared at me every time I offered to help make a bed, empty something. I spent 10 hrs with my mouth shut & watched, taking all the notes I could because I'd be writing care plans on those patients for my grade. Sometimes it is the luck of the draw who you are assigned to. Some are incredible teachers, some are not & some just don't want to teach you for whatever reason. I would had thought it would had been a perfect opportunity to have the last semester student doing teach back under supervision of RN & you learning.... But hey,,, maybe she was just having one of those crappy days & didn't have the decorum. You should have reported immediately to your Clinical Supervisor & ask for reassignment.

Em31200 ---- Everyone has something. Doesn't matter who you are, how much money you have, don't have, where you work or are jobless, homeless. Rich or poor, boss or worker bee --- Everyone has something. And those that tell you they don't --- are lying to themselves because right now they can't deal with what it is they have..... So - you have an eating disorder.... If you feel Psych is for you, I see no reason why having a problem should stop you. Psych opens eyes, I have found it has given me respect for my own problems as well as everyone else's. Good luck to you.

That's an outright brawl you're describing!!! I am one who doesn't talk back to Dr. orders, but I'd be screaming at my Dr. for an IM B-52 or Geodon --- SOMETHING to slow that one down!!! If nothing else, someone - ANYONE - should be dressing that Dr. down for letting patient get that far out of hand --- Obviously not thinking of Staff & Pt. safety.

A lot of my patients are looking at jail time or are from jail, after they abused those children, women, others - & then made suicide attempt (real or half hearted). The ones you all have worked so hard for, pulled back from the brink of death, back to life & sent to my unit for eval. And sometimes it is hard to be that patient advocate - when you have patients act like the world owes them - there should be a mint on their pillow, they are inconvenienced because there are actual rules on a Psych unit..(who woulda thunk?). We don't wake them up to take their Valium to calm down...(seriously I have been chewed out for this by several pts.!). And after too many extra shifts, being yelled at, cursed at, being called the B or C word all weekend --- when one that is blatantly avoiding jail - there is NOTHING wrong with her other than not wanting to go to jail, draws back a fist at me for telling her she cannot have cover over her head & then threatens to kill me "because I've been to jail before, I'll beat you up" ???? Oh lord, I almost dropped her right there. I walked away. I took the next day off --- and I realized there are some times my patience can be worn too thin & that my license is not worth risking over jerks like that & I don't look good in Jailhouse orange. Never a dull moment on a Psych Unit........

I've learned that being able to assist someone with their emesis, clean them up & go back to nurse station starving is an actual "asset" on the Psych Unit. So is being able to perform wound care on nasty & scary wounds, clean out bedside commode,& still be hungry --- always get the "in awe" look when I wash up then head for my snack!!! I've learned that I really am a Psych Nurse (dang it!)

LPC2RN Your quote "am repeatedly shouting for help only to see one or maybe two of the techs open the door, watching the patient attempting to rip my face off, only to see them close the door" make my head spin!!!! My first thought - Oh helllll to the NOOOOO!! After I have gathered myself from all the red alert alarms going off in my head I can tell you this --- I would go to my Nurse Manager or Program Director immediately!!!! My unit is small, plenty of out of control, plenty of restraints - we are all well versed. When someone gets loud, a sharp noise you will see nurses & techs BOLT towards the danger! If it is delicate, we will hang back but close --- You are NEVER alone when the fur starts to fly! And to CLOSE THE DOOR???? OMG --- I am simply outraged! Psychotic can snap - all the more reason for co-workers to keep on alert while you are talking to him.... There is no excuse for not backing your team member up --- even those I would love to throw under a bus will have me next to them with violent pt. - I will not leave them alone. Incidents like that will get you killed - this is not an dramatic statement, I have a co-worker that has a wicked scar around her neck where pt. grabbed her & slit her throat - she is not dead because her team members intervened.....just sayin'! Good luck to you - I know I'd be having melt downs on my co-workers & quit if that happened to me!

ni_garrett - Get your BSN ---- Can't go into Administration without it & it will only broaden your possibilities!!! If you are feeling like this is what you need to do then you are being called --- no matter what age --- you will never go wrong following a calling. Good Luck!!!

Older New Nurses --- stand tall, put that chin out, square those shoulders & remember --- We have stuff that those young nurses don't have & that is Life Experience. We will stay our ground, keep our job. We don't call in unless we REALLY are sick or we REALLY have emergency. We don't pop around job to job just because we are fussy & "it isn't fun". We know work is work -- sometimes we get to love our job, sometimes not. We don't expect to love everyone, but we know how to get along with everyone because we don't sweat the small stuff. We don't go running to the boss whining about this & that - we work. We are stable, we are reliable, we are dependable & we work weekends!!!! Please do not let the Bull-Crap of "ageism" suck you in --- Stand Your Ground & Let your interviewers know you are valuable BECAUSE of your age!!! And one more plus --- at 53 you won't have to worry about me being on maternity leave! Wisdom balances out young impetuous workers every time.

usnretired1997,RN --- I am looking forward to getting BS so I can do Med Review / Utilization Review for Insurance companies. You can also look at health dept., other type of nursing --- Psych is interesting! Wound Care - Home Health. Agencies as PRN for right now??? Wow - there are tons of options, you are just looking at hospitals??? Use your class mates & your instructors..... You will find something soon - Trust me --- just keep confident & pray --- the right job for the right nurse at the right time.... Let the time be now!!!!

Work a psych unit - BSC - Bat S Crazy; Circle with a Dot = Borderline/attention seeking; Special = Diva; M.R.ish - high functioning or not! Active family = Calls screaming & demanding this & that for the pt. I am sometimes heard whispering "Lord have mercy, Christ have Mercy, Lord have Mercy" on particularly bad days usually followed with quietly asking the nurse next to me to please stab me in the eye (to take my mind off of how crazy it is today!) We also have a few hand signs --- the OK sign (always with a smile) = A. Hole. Crossing self = Psychotic like in the movies. We all shake it off during report - but it can get pretty intense at times!!!

I was 48 when I started Nursing School, 51 when I passed NCLEX & got my job on a psych unit (I always say age plays well there!) The only problem I have is the 23yr old nurse with 6 months more experience than me pissed off because everyone thinks I'm the charge nurse or the one with most authority because I am older:) I get the stink eye from her every time --- ask if I care

Our ratio varies as staffed -- a lot of call ins = short staff 1:11 with 1 tech --- we do our own discharges & admits, which makes our acute care unit a machine rather than a therapeutic venue when we discharge 6 & admit 8, move patients around like a chessboard to accommodate. It can be way too heavy of a load especially when you have several with active psychosis & or violent tendencies. Sometimes you just have to get through your day as best as possible.

When I have to do a turn on a 1:1 with pt. I am flat, matter of fact, quiet & do not interact much. If the pt. wants to know why I have to be there, chances are they already know, so I reiterate exactly why I am there. If there was no behavior before you were posted to be a sitter, I would had just said it was policy to keep her safe, I was there for her - in the most soothing tone I could. Borderline likes to get conversations going & elicit friendship & then favors (control issues) --- do not bite - keep it professional. Bathroom??? I am there, walking? I need exercise too -- I am there, sleeping? I keep you safe --- I am your shadow, until you have had XX amount of days without self harm behavior (or whatever treatment plan says). Last one was one that flooded our floor/hospital by triggering sprinkler system which earned her a sitter.

All patients can be potentially violent. Please remember this & let your actions reflect this. I work on a unit where it is very relaxed, very homey, but not for one moment do any of us take for granted a moments peace. The scary & obviously sick ones are no brainers - but I too have seen many a 1:1 sitter very comfy & not aware!!! Please remember this: We have "repeat customers" that can look as sweet & innocent as a church mouse & have been known to then stab a person with a fork while smiling so sweet. It happens, must be ready at any moment. I am a short, fat woman who can move lightening quick & have surprised many when there is a sharp sound or a scream!!!!

I work for an acute care psych facility. The nurses & techs are becomming more hostile to each other by snapping at each other, making rude comments, refusing to help each other. All of this is in front of patients. There is complaining to management about each other,, "this one isn't nice to me, this one doesn't do this, this one is too nice to the patients, this one doesn't have a clue, I refuse to work with so & so". I have heard nurses making statements about management pitting & siding. It seems like this place is getting more hostile by the week. I feel that patient care suffers when it is like this. Has anyone else had this kind of experience where working as a team is slowly eroded away & everyone seems to be at the others throats?

I fell into Psych nurse as my first job -(after swearing I'd never work psych during clinicals) --- still doing it. I was raised in SF Bay area -- my floor felt like a bus stop - nothing I hadn't really met from 11yrs on up...... Kind of filled in the gaps about my family --- & when I was having some of my worst bouts with family members dying & grief, it was the one safe place for me to do something other than wallow in my pain. The people??? Working with all levels of Mental health - from mild to violent - often physically wounded, sick, -- with bare bones staff -- trying to take care of to the best of our abilities with next to nothing. I get frustrated & often say -- god help me if he has a heart attack, I got Nitro in my pyxis & a few spit wads to throw at him. What have I learned??? Everyone has something --- & for those with their noses in the air --- my guess is there is a whole lot of something they are in denial over. So are psych nurses a little crazy? Pretty sure the answer is yes,,,, but at the same time, everyone has something - whether they admit it or not.

Still use alot of the advise, wisdom & warnings of my teachers ---- "Every nurse must decide what they are ok with & we try to teach good ethics --- so ask yourself, Is it ethical? Is it Legal? Is it worth your License? -- you may come to a time you will have to stand & speak up for what is right --- or maybe walk away. You can always get another job - but once your license is revoked, you will never be a nurse again." I sure hope you hotline this --- sounds like you are working in a time bomb!

My psych unit is low budgeted - we have a hard time getting supplies. One of our best techs went to nursing school & ended up CNA on medsurge in her 2nd semester. She said the first time she went to their supply room she heard angels singing & saw a glow around the supplies --- said it was "like manna from heaven - they had everything I needed to get my job done!!" We have never seen her back on our unit again....... So I will say to you what I said to her when she first started nursing school: Don't get stuck with a thought that you "have to do psych" -- allow yourself the freedom to learn about all aspects of nursing --- Psych nurse uses ALL aspects of nursing; Medsurge Nurse uses ALL aspects of nursing,,,,,, and so on. Do not limit yourself & allow yourself time to explore the different kinds of nursing --- don't worry if you find out you are more excited about one avenue than the other.........When I was going thru psych clinicals I swore I would never work at a psych facility.......Wouldn't you know -- my first job was psych & I found out this was where I belonged! Just goes to show you, never say never --- & have faith that you will be led to where you should be. Right Nurse for the Right Patient at the Right Time......I believe in this & it has been proven to me time & time again. Good luck!

Junebug903 -- On my Acute Care Behavioral Health Unit, our restraints require 1:1 sitter with a 15min. check sheet - if the pt. becomes calm & not fighting nurse must get them out ASAP --- it is about 1-2 hrs worth of paperwork & charting after restraints are used --- We HATE using them, but there are times they are necessary. I don't know what kind of place you are at where you think using a restraint would be easier - it's not like you can tie them up & leave.....

Thanks everyone!!! Escpecially to Meriwhen who brought me back to what I know but was too close & too worked up to remember!!! Saturday we did a little better, I was able to keep distance, shortened conversations & did a lot of "I am not discussing this any further, please step away from the desk". Sunday he was a more experienced nurse's patient & I directed him back to her, reinforced everything she said - when she said no & he came to me I reminded him his nurse just told him no - the answer was no & turned around & walked away. He went to every staff that came on the floor, lab people, house supervisor, complaining how mean the last one was to him. He tried intimidation, manipulation, wear them down by bugging them technique, guilt, threats to sue. When he said he was going to report it all, I told him I wish he would so our supervisors would understand fully. He kind of skulked away on that one. Thank you all for reminding me how to handle this type of pt. I can remember when it is female borderline, but the males just seem so much more intense & I don't see it as often. Just know that each of your points were used this weekend & I was able to finally regain my sanity. I am grateful!

femaleRN --- believe me - you have the dream job --- I just posted for advice on an exhausting male borderline --- and dread the next time I have violent jerk that we have to restrain!!!! And I'm not in a warm place!!!!! Obviously we are lining up for your job --- you might want to keep it!!!! Good luck with that job hunt --- let us know when & where you find it --- 1/2 of us will apply where you went, the other 1/2 will be fighting for YOUR job!!! LOL!