tricia1

I read your post this am and have been thinking about it. I have been working in psych about 13 years. To answer some of your questions. Some of what your role is is to be the resposible person on the unit. You set the tone for how compassionate and caring your staff we be. Some settings your staff will only be required to have a GED to work as a floor staff so how you direct the care is very important. Yes you do a lot of documntation again part of that is so you can demonstrate that the care you give and the care given under your direction is competent and safe. As the RN I have a dierect responsibility for my patients I can direct the level of observation for my shift for example. I am the care-giver for the staff in that they get burned and need support. To feel a little better maybe you can remember that in psych you have to appreciate the small, small changes.Psych is never, never boring. To suggest how to make documentaation easier maybe have a clipboard handy where you have a template, example of all the areas you want to cover when documentating. It is quicker for me to make a quicl reference to my hospital portocols than to rely on my memory. I make a little lisit of when I need to do my documentaions anything to make it so I don't have to keep thinking about the tasks and use my brain for other things. good luck. I hope you get some more posts to your issue

I can SO relate to the burnout. I agree it is feeling more and more unsafe in psych. I am thinking to change area of practice. I am thinking Hospice as it would be lower medical type nursing and heavily still using my psych skills. My biggest issue is I do not like home health. I don't like to drive around, I don't like the lack of contact with peers etc. Would welcome any feed back.

I work as a RN in a State Psychiatric Hospital that went smoke free about two years ago.The hospital consists of forensic as well as adult and geri patients.There was exstensive groundwork to prepare for the change ie. smoke cessation groups, patches etc. and lots of hard candy. Surprisingly the change happened with remarkably few physical acting outs. But what did happen was alot of contraband on the units. Patients with the priveleges woud go off grounds and get smokes and matches/lighters and sell to other patients. There were several rrather serious fires on several different units. We have since gone back to allowing the smoking in off ward pavillions with built in cigarette lighters after about a year and a half.

My Husband was in the Hospital for 3 weeks in September. I started out very low key/low profile and discovered that I should have been far more assertive and alot sooner. Medical care was OK but the Nursiing care was terrible. I spent everyday day at the Hospital from 630am (to be there when the doctors made rounds) and left at 930pm usually. My husband eventually came home with a draining fistula in his neck that required a wet to dry dressing/packing and all meds/nutrition etc through a j-tube. He started on a unit that was usuallly for short term observation like a 24 hour or 48 after surgeries. He eventually stayed on 4 different units one of which was the ICU after haviing a laryngaspasm after an external biopsy of the esophagus.So I got to sample some variety of wards.In this time I would say only 3 nurses were kind, caring and professional. One example of many of my griviences is asking the evening before discarge (as noone as yet offerred me any pt teaching towards my husbands home care this whole time except the first unit evening nurse demonstrated the NG tube feedings when originally he was to have just had the NG tube. Other than that nothing) I requested to have a copy of the discharge instructions (the Doctor had told me he was goiing to write them that morning ) and I was told that no he would not go over them with me or give me a copy as "They'd probably change by the morning anyway" which did not happen. but anyway that is just ONE of my many issues. I'd be interested to hear from otherws and I can share more and might. I think I am still dealing a little with the trauma of it all.

The husband that DOSE'NT listen to you 'cause he is more use to ignoring you :)

My Husband was recently in the Hospital for 3 weeks with what started as a biopsy with a 24 h observation but turned into the afore mentioned 3 weeks which included 3 days in ICU.and in that entire time I can only give you 2 names of nursing stafff and yes it was the only 2 nurses that were worth 2 cents. I should probably start another thread about being the RN family member....

I am so sorry for your lose.I too had very close relationships with both my grandmothers. I belive you can use this to give the kind of care you would want to have seen your MawMaw receive.

The only thing I would add to all the great replies is if you do only Psych. Nursing first I have seen several RNs that personally felt limited when they wanted to make a change out of psych nursing. I had the experience of needing to assure an interviewer one time that I did do/could do "regular" medical type nursiing which I was easily able to do as yes in Psych you are the person resonsible for your patient's health. They are really almost more complicted to "nurse" medically because they are often non-compliant and not accurate reporters/historians and you have to be that much more vigilant.

I also am a Psych. RN interested in changing over to Hospice.I specifacaly want free- standing unit as I have done home health for psych before and do not like the driving/ the isolation from colleeges. I did training for Hospice volunteer in Virginia when we lived there w/ the idea to check into it as employment opportunity but Husband came done w/ short notice orders to Wa. State. Have worked now 10 years in State Hospital. Ready for a change. Got re-interested in Hospice after being w/ husb. 3 weeks in hospital for esophogeal cancer.Missing some of the gratification of more medicaly oriented nursing.Let me know what happens with you.