Psych floor in hospital vs Free-standing Facility

elkpark · Sep 30, 2009

I've worked in both settings, and haven't seen much difference. I think a more important consideration than the physical plant is the basic philosophy and competence of the employer and your administration (for-profit vs. public or not-for-profit, how experienced and competent are the management people running the unit or facility, that kind of stuff).

Guest321574 · Sep 30, 2009

Thanks :) Have you ever felt that hospitals preferred hospital-psych experience as opposed to a free-standing psych facility?

Jules A, MSN · Sep 30, 2009

I have also done both and have not noticed a preference for which type of experience they want. Usually they are just happy to have someone with an interest in psych. At the private hosp. we got paid more than the hospital but it was not as organized, imo. Pros and cons to both and as Elkpark said weigh the particulars of each place you are considering. Good luck.

Guest321574 · Oct 1, 2009

Thank you both :redpinkhe

elkpark · Oct 1, 2009

Thanks :) Have you ever felt that hospitals preferred hospital-psych experience as opposed to a free-standing psych facility?

Acute inpatient psychiatric experience is acute inpatient psychiatric experience, whether the unit is located in a general hospital or a free-standing psychiatric facility. Or, when you say "free-standing psych," are you referring to something other than acute inpatient psych? An outpatient mental health center? Because, yes, that's v. different.

Guest321574 · Oct 1, 2009

Yes, by free-standing facility I meant inpatient psych-only hospital.

Thanks again, I figure that the experience should be the same, but 6 months of being rejected by hospitals for "no-experience" has left me feeling vulnerable. So now that I've found a job, I'd really like for it to count towards something when I eventually try to move to a hospital. I've literally heard a recruiter tell another candidate that they don't consider LTC as experience, so I kind of had it in my head that perhaps anything outside an acute care hospital would be rejected as legitimate.

Ultimately I'd like to be on a medical-psych unit so I can get the best of both worlds.

elkpark · Oct 1, 2009

No, the issue is that LTC really is v. different from acute inpatient care, not that the programs are located in smaller, separate buildings. Good luck with your new job!

rn/writer, RN · Oct 1, 2009

I used to work in a free-standing private psych hospital. The psych part doesn't vary much by location or type of facility, but the physical aspect certainly does.

I'm aware of psych units that will admit patients with concurrent medical problems. Our free-standing unit, for the most part, did not.

Because we had no ER or ICU on the premises (not to mention enough staff to deal with medical issues) we had to put limits on the types of co-morbidities we could handle. Severe detoxers had to be cleared by the nearby medical hospital before we could take them. This was also true for patients who had substance-related suicide attempts. Anorexic tube-feeders were okay, as were folks on basic IVs, but antibiotics and tele patients and other medical needs were more than we could manage.

Once patients were medically stable, we were happy to admit them.

As far as the mental health-related issues, though, psych is psych.

elkpark · Oct 1, 2009

I used to work in a free-standing private psych hospital. The psych part doesn't vary much by location or type of facility, but the physical aspect certainly does.
I'm aware of psych units that will admit patients with concurrent medical problems. Our free-standing unit, for the most part, did not.
Because we had no ER or ICU on the premises (not to mention enough staff to deal with medical issues) we had to put limits on the types of co-morbidities we could handle. Severe detoxers had to be cleared by the nearby medical hospital before we could take them. This was also true for patients who had substance-related suicide attempts. Anorexic tube-feeders were okay, as were folks on basic IVs, but antibiotics and tele patients and other medical needs were more than we could manage.
Once patients were medically stable, we were happy to admit them.
As far as the mental health-related issues, though, psych is psych.

That varies greatly among facilities. I work prn in a free-standing psych facility now, and my facility will pretty much take anyone who is breathing and not actually coding at the time of admission ... I'm not saying we do a good job of taking care of people with significant comorbidities (and I'm not saying I think it's a good idea), but we sure do take 'em.

rn/writer, RN · Oct 1, 2009

That varies greatly among facilities. I work prn in a free-standing psych facility now, and my facility will pretty much take anyone who is breathing and not actually coding at the time of admission ... I'm not saying we do a good job of taking care of people with significant comorbidities (and I'm not saying I think it's a good idea), but we sure do take 'em.

Maybe things have changed since I left the free-standing place. It wouldn't surprise me to find out they're doing the same. All I know is we had our hands full without adding med/surg to the mix.

My hat is off to you for doing a difficult job.

Guest321574 · Oct 1, 2009

Thank you, you all have given me some good perspective!