Pros and cons of psych nursing?

GeminiNurse29 · Sep 25, 2016

I just finished my first month of psych nursing orientation at one of the state run facilities. We get mostly forensics patients with one civil unit. The higher security units tend to house the more aggressive and violent patients. As a new hire, all nurses float at first. So we get a range from those almost ready to enter the community to those who will be in for life.

Is it rewarding? Before this, I did home health and worked on a dementia unit. I can't say how rewarding it is yet but it definitely is interesting.

Draining? Yes. Some of the patients (many to be honest) have committed horrible and violent crimes. For whatever reason, they've been found not guilty by reason of insanity. Some have orders to treat until they're competent, others are for life. It can be hard to pull yourself back and be professional when dealing with someone after you learn why he ended up there in the first place.

zayrhia · Sep 28, 2016

I just finished my first month of psych nursing orientation at one of the state run facilities. We get mostly forensics patients with one civil unit. The higher security units tend to house the more aggressive and violent patients. As a new hire, all nurses float at first. So we get a range from those almost ready to enter the community to those who will be in for life.
Is it rewarding? Before this, I did home health and worked on a dementia unit. I can't say how rewarding it is yet but it definitely is interesting.
Draining? Yes. Some of the patients (many to be honest) have committed horrible and violent crimes. For whatever reason, they've been found not guilty by reason of insanity. Some have orders to treat until they're competent, others are for life. It can be hard to pull yourself back and be professional when dealing with someone after you learn why he ended up there in the first place.

Bless you. I don't think I have it in me to care for folks like that.

melaniecRNBSN · Nov 3, 2016

I'm a new grad who went right into psych (despite all the warnings...because psych is interesting, and med surg isn't for me) and for the most part I'm really enjoying it. I work in a private facility that has 5 different units for different age ranges/acuity levels and I'm on the Adult Acute unit - night shift (:

How often does one work with a violent/aggressive patient? (daily, weekly, monthly?)

In my facility, patients get physically violent maybe weekly, and verbally aggressively pretty much daily. Most of the situations are de-escalated with a combination of our awesome techs at the front lines and then nurse intervention to either calm, redirect, or medicate the patient depending on their needs. We don't use mechanical restraints at all in our facility - the patients have a "quiet room" where they can go to calm down or an isolation room if they are extremely agitated. I have only seen one physical hold used since I've been on the unit (6 months) and they are generally a last resort for everyone's safety.

Is being a psychiatric nurse rewarding and satisfying? Is it an interesting career?

Interesting, absolutely! The best advice I can give to work in psych is to have a sense of humor. You will see a lot of patients with tragic stories, and ones who will try to make you feel awful with the things they say to you, but at the end of the night the patients who stay in my mind are the ones who made me laugh. I have an absolutely amazing team of techs and nurses on my shifts, and sticking together to help the patients and have each other's backs makes all the difference. Cultivating a great team changes the atmosphere not only for you, but the patients feel it too. When one staff member has had a bad night someone will make a Starbucks run or we'll order pizza and it makes a big difference for morale. As for being a satisfying career, I feel up and down about this - I have only worked psych for 6 months and some nights I feel wonderful about the work we do and other nights I ask myself, is anyone really getting better? I'm not the best person to speak to this with my limited time on the unit.

How emotionally draining can the work be?

It is draining, but isn't all nursing? Taking care of yourself physically and emotionally is essential for being a good nurse. Having time to debrief with trusted staff members is helpful. And having a life that is healthy outside of work is really important.

I am enjoying psych nursing very much and love seeing the change that mental healthcare is taking..there used to be a stigma against not only the patients but also the staff, but I feel privileged to work in a facility of (mostly) compassionate, smart, hard-working nurses and techs. I love my job!

rjones416 · Nov 4, 2016

How often does one work with a violent/aggressive patient? (daily, weekly, monthly?)

I'm working on a forensic psych unit and haven't had any incidents so far. I have heard stories of nurses being attacked a few months ago though.

Is being a psychiatric nurse rewarding and satisfying? Is it an interesting career?

For me personally I love it. I find it rewarding to help a patient achieve their goals and be discharged from the hospital. A lot of them have been in the hospital for years so it's nice to see them moving on with their life.

How emotionally draining can the work be?

I think it depends on the nurse. For me I don't let any of the negative things get to me so I'm fine. I'm able to stay calm even if an angry patient is swearing at me. I understand that I'll have patients who committed very disgusting crimes but I don't judge anyone. I treat everyone with respect no matter what they did in the past.

SwampCat, BSN · Nov 16, 2016

How often does one work with a violent/aggressive patient? (daily, weekly, monthly?)

Verbally aggressive is a all day thing where I am. Physically aggressive is usually at least once a week. Aggressive to the point of full blown restraints, a couple times a month (all depends on the crew of kids I have).

Is being a psychiatric nurse rewarding and satisfying? Is it an interesting career?

Currently the floor I am on is not rewarding whatsoever. We all feel as if it has become a detention center for boys with aggression issues. When we do get an actual psychiatric patient (yes behavioral is psychiatric, but you know what I mean) then I feel as if it is rewarding.

How emotionally draining can the work be?

I excel at not bringing work home with me, unless it is a funny story. While I'm at work I am constantly drained. I take none of it personal, but it is incredibly draining to have insults and swears hurled at you when all you did was ask a simple question. If it is one kid, then it's usually easy to keep it from dragging me down, but when I have this kid over here throwing chairs, and that kid over there cussing staff out, and this other kid running around without regard to staff's directions it gets old very fast. It's also exponentially draining if your teammates are useless (or worse: escalate the kid because they feel like they need to have the last word).

I know other areas of nursing are draining, too (I was a tech on a med surg floor), but in different ways

shanon0403 · Nov 18, 2016

I love love love my job almost every day.

Pros:

Being there for people who are often disregarded

Seeing progress

Making a difference

Free therapy when you go to groups lol

Teaching someone skills they will use the rest of their life

Getting really close with patients

Saving their lives

Funny stories that make you very popular at parties

It is never boring

Cons:

Underfunded

Getting injured (I have been punched/slapped/kicked/bit/spit on and I'm usually the nice one)

Often other nursing professions give you a hard time

You do lose some nursing skills (I haven't started an IV in years) though they have health problems too so you still take care of that as well

High turnover

Sad stories

Patients who are terrible sometimes

NurseNinja1990 · Jun 7, 2017

In terms of acuity/aggressive patients, I've found it really varies from one facility to another. I worked Per diem at two hospitals across the street from each other and the difference was night and day. While one was private and the patients were very low-key for the most part the other was run by the state and I have codes nearly every day. I ended up taking full time at the more acute one and find it a lot more stimulating.

I like psych because I spend more time talking to patients and doing teaching than I'd ever have time for in medical. I have a million great stories too.