psych nurse position second chance!

[britmansf18]

Can anyone give me any advice on being a psych nurse? I want to know what it's like. I was diagnosed with severe anxiety after I graduated nursing school and began my internship at a major trauma center. From day one I was a mess and some days I just couldnt focus or seem to do anything. I ended up making a medication error to top it all off. I was put on a leave and not told anything for an entire month! I thought they were just prolonging the inevitable. However, instead,they offered me a position elsewhere in the network. I am working this week to secure it in psych. I guess the only thing I am fearful of is violence codes and doing take downs. Is there any way to get over this? Or is it just going to come with training/experience? Thanks all!

[taydian]

"Or is it just going to come with training/experience?"

Advice that 25 year psych nurse gave me: build a rapport with each patient from day one ...or within a few days of admission....and during each shift you work, meet with 2 or 3 patients a day and just shoot the poo poo with them. Have a friendly conversation with them with some therapeutic nursing stuff squeezed in here and there. That way if someone becomes agitated, you've become trusted enough that you just may be able to redirect them before any escalation occurs that could result in a take down or psych emergency. For me, having a peppy personality and using humor helped put the patients at ease with me.

Of course there are always going to be a few patients who are just not approachable due to severe psychosis.......I, personally, leave them alone for the most part until they are more stable. But even many stable patients can just be unapproachable.

But, very important: don't let patients intimidate you and don't show them you fear them no matter how effing scared out of your wits you are on the inside. Don't let them manipulate you. Be consistent.

Again, it all takes practice and experience.

One more thing: Always fist bump. Don't shake their hands. On an inpatient psych unit, you'll have an idea of where that hand has been. And you won't want to shake it.

[psychRN2005]

First I think you could be a great asset knowing what it feels like to suffer from severe anxiety. Second I hope you have received help for dealing with it before you consider a position on a psychiatric unit. It is a very rewarding area to work in and taydian gives good advice. It is stressful in a different way than trauma but still stressful. Maybe shadow prior to making a decision so you are able to ask questions of the staff that already work there. Good luck!

[2011RN]

"Or is it just going to come with training/experience?"

It is really wrong to lump all psych patients into the same don't shake their hand category....yes some psych patients do nasty things with their hands and don't wash them but so do other people of whom you would not hesitate to shake their hand. Hands are washable after all! This is just another way of stigmatizing and treating psych patients differently than you would other people or patients. :-(

[taydian]

It is really wrong to lump all psych patients into the same don't shake their hand category....yes some psych patients do nasty things with their hands and don't wash them but so do other people of whom you would not hesitate to shake their hand. Hands are washable after all! This is just another way of stigmatizing and treating psych patients differently than you would other people or patients. :-(

Fair enough. However, my patients don't know how I interact with people outside of the unit, so, as far as they know, I fist bump everyone. It does fit my personality and they're all very receptive towards it. But when I see one too many patients engaging in some self lovin' activities, especially when these guys have been on a locked unit for weeks or months, you're darn right I'm gonna lump them up and greet every single patient with a fist bump.

[2011RN]

Fair enough. However my patients don't know how I interact with people outside of the unit, so, as far as they know, I fist bump everyone. It does fit my personality and they're all very receptive towards it. But when I see one too many patients engaging in some self lovin' activities, especially when these guys have been on a locked unit for weeks or months, you're darn right I'm gonna lump them up and greet every single patient with a fist bump.[/quote']

Fact of the matter is just about everyone practices self lovin'. Unfortunately those on inpt units don't have the privacy to do so. I assure you there are more people out there in the general population that have practiced self lovin' and gone without washing than we would care to know. :-)

[TerpGal02, ASN]

Well in my facility patients/staff aren't allowed to touch eachother at all, so I have become a fan of the "air five" lol. The advice you've been given is great. Psych codes seem very scary but it's really no different from any other code. It's all very controlled. If you have good staff behind you and have built rapport, it usually won't come to a restraint, esp if you are working with adults. I work with kids too, and that's a whole nother ball of wax as the younger pts have no impulse control. If your unit is worth it's weight in salt you will be trained in how to handle an aggressive person to keep everyone safe, and 9 times out of 10 it's usually the staff that's in the restraint. The nurse is calling the doc getting orders, giving meds, and documenting.

With your own anxiety issues, leave em at the door. It is the very rare situation that it's therapeutic to the pt to share your own stuff, but for sure you will able to treat them with empathy. Welcome to the dark side, psych nursing is amazing and you will learn crucial skills you can take with you in any area of nursing.