PSYCH NURSES-please help

Whispera, MSN, RN · Apr 17, 2010

yes you can take state boards with a psych hospitalization in your past

aura_of_laura · Apr 19, 2010

Personal psychiatric history is not part of your school record, and not disclosable.

However, please evaluate your motives and abilities to provide psychiatric care. The mental health field is stuffed full of people who have their own ongoing psychiatric issues - it rarely makes for better nurses.

Psychiatric nursing requires an objective eye, and the ability to separate yourself from the problems of your patients. Too many people become enmeshed, and you can end up hurting your patient and yourself, as well as risking your license.

Until your symptoms are well under control, and you've mastered the coping skills you are going to be teaching your patients... just be careful. (and I wouldn't broadcast your medical history around school or the workplace - not only because of stigma, but because it is unprofessional and can come back to bite you.)

Good luck in your treatment and in your decision-making! Nursing school is a long process, so perhaps you will find yourself in a better state to pursue psych nursing by the end!

Freud and Jung are way old-school The field is totally different these days! Psych is fascinating, isn't it?

Smitty08 · Apr 23, 2010

I agree with the other two posters and would add: your experience may even be an asset as you will empathise with others and understand some things from first hand experience. Good luck!

LethaChristina · May 10, 2010

Believe me, the field is full of "wounded warriers" (most can not deal with the amount of abuse happening to them as nurses in this field when they don't "understand")... spread yourself out in your reading (as suggested); not only have Freud and (not so much Jung) the "old school" (as already stated) become antiquated--the theories largely shown wrongful (Freud's contribution was the understanding that we are complex: "there's more than meets the eye". He also found that behavior is grounded in past life experiences--the most recent research in "neuroplasicity" has shown that it is entirely possible to transcend all past life experiences, brain injury, "brain chemical imbalance"--a flawed theory, as well as genetic inheritence)... yet it is also important to know the history of the field in order to integrate the new research, and to be an effective nurse (because each is unique, and does not "fit the pattern" of the prevailing theories and research). Without having a very broad background: usually not going first into psychiatric nursing... one can be stymied in one's assessments and interventions.

A word of caution: don't let anyone limit you! Not by "incurable" dx, or words of derision, or any "stigma"... keep reading--and don't limit yourself there, either... it's a big world and you will meet some very intelligent and knowledgeable people who are "psych" patients who will challenge you every step of the way... it is important to have a very broad background!

horus2001 · Jun 2, 2010

i hate to seem cynical but most of psych nursing is pushing pills. Before i get jumped on, i work as a psych nurse at a state mental hospital so i do have some background. modern psych is give them pills, get them stable and get them out. most insurance companies are cracking down and need a strong reason for inpatient care. as a psych nurse, you can offer some interventions but it is out of our scope of practice to offer therapy. i have caught both psych techs and other nurses trying to counsel patients and had to write them up. as a group, we psych nurses are not trained to run therapy groups, do psychology groups or analyze our patients.

most of my day is spent passing out drugs (SSRI's, Atypicals, mood stabilizers and a scattering of ADHD meds), chatting with the patients-checking for AVH, SI/HI and their moods. I also may ask if they have developed any skills for coping with their issues, improved relations with their families and get a general feeling of how they are feeling. Our nurses will run groups that are educational: drugs, ETOH, medication education, STD's and the like.

The other thing to remember is that the patient to nurse ratio is really out of whack in psych with anywhere between 1 nurse to 8 or as many as 16 patients. you don't have tons of time as we are putting orders in for the doctors, responding to emergencies, documenting behavior, trying to keep the borderlines away from the desk.

i wouldn't worry too much about not being med/surg nurse first. if you like psych go for it. most psych hospitals want the patients medically stable before being admitted. that said, you do have to be able deal with issues like patients who have a hx of ETOH abuse and how to deal with the risk of DTs.

psych care is changing though, it seems to be more and more about the pills. i am not comfortable with just pumping them with drugs and discharging them but the simple fact is that the insurance companies call the shots. on our indigent patients, it is on the state dime so they can stay longer but they have high rates of recidivism due to socio-economic as well as mental health issues so you can become a little burned out on the "3 hots and a cot" types that know just what to say to be admitted for evaluation.

another discouraging thing in Texas, you can file a mental health warrant on anyone so we do have adolescent patients who get filed on because they are running away, doing drugs or in a gang. the parents expect us to fix their kids. sorry but it ain't gonna happen and you should have set boundaries when they were five not fifteen and using fry and sleeping around. bad behavior is not a mental illness.

my favorite are the parents who drop of their kids and then tell us they don't want them anymore because they don't behave.

Whispera, MSN, RN · Jun 2, 2010

I think psych nursing, within the confines of available time, can be what you want it to be. Sometimes over the course of my career, I've seen nurses that never leave the nursing station. That has seemed to be the traditional way they have worked. New nurses pick that up and assume it's how it is and don't do otherwise. Then the patient contact is left to others except for the pill-pushing and assessment related to the pill-pushing. I think many nurses would go out and be with their patients if it didn't seem as if that was not the thing to do. Or they've become lazy. Or they've just gotten into the habit of it. Or they're burnt out.

One of psych nurses' most important tools is "therapeutic use of self," or the plain old listening skills. This isn't counseling. It's just being a human who cares enough for another human to listen to what's going on. All nurses need to use this skill, not just psych nurses. It matters alot. If you can find the time to do it, do it. I've found it's where I've gotten the greatest satisfaction in being a psych nurse, and also what has made the biggest difference in my patients' lives.

stephva1008 · Jun 2, 2010

I disagree with the psych nurse image of "pushing pills." It honestly depends on where you work. I manage a 20 bed unit and the nurses are right there among the counselors running groups, doing 1:1 counseling, etc. It's what psych nursing should be. You rotate being charge (giving meds and taking off orders, staffing next shift, etc) and being in milieu. It really depends where you're working. So don't let that image discourage you.

Nursing is a great field. Continue to heal in your own treatment and seek therapy. We all have different baggage to bring to the table. It's the ability to be objective that is important; you can do that and still have a psych diagnosis yourself. Taking care of yourself is paramount.

marilynmom, LPN, NP · Jun 3, 2010

Yes you can have a psych patient/psych dx background and still take state RN board and still work as a psych RN. I will tell you though that a lot of the nurses I work with who are bipolar, etc have a lot of problems with setting boundaries and becoming way to enmeshed with the patients. That is not a good thing, but its very easy to get involved like that.

I love psych nursing. The patients are very interesting to say the least. I enjoy my patients. I'm planning to apply to a psych NP program. I enjoy the medication part of it, some of those drugs can really work wonders. Some "psych" is nothing more than out of control behavior (I work with adolescents ). Its a very interesting field I think. Go for it : )

starzzz · Jun 3, 2010

I work on an adolescent behavorial psych unit. We have 17 beds on our unit. When it is full, there is me the RN, an LPN who passes the meds and helps monitor the kids and 3 mental health workers for the day shift. On nights we have the same except 3 MHWs. We do a heck of a lot more with these kids than just push pills. We are not trained therapists per say but the majority of our kids need someone to care enough to listen and help them feel safe enough to share everything. We are an acute hospital unit and we see all kinds of kids. Some its probably far past the time of helping them find the coping skills to be a positive part of society but they still need people. Psych nursing has changed tremendously some are good and some not so good, some changes from society and some from the financial (insurance) arena. Just the other day we admitted a kid at 11pm even tho insurance said he didnt qualify, our DON didnt bat an eye said we will give him as many days as were feasible. He stayed 5 days. Those are probablly days our facility, a for profit facility, wont get paid for but sometimes even for profit facilities are generous and have morals and do whats right. Our facility also has a 10 bed pre ad unit and a 10 bed overflow unit and 60 bed RTC and for the most part we have stayed full long past where the normal slow down occurs... Hmmm wonder what that says about our society and our economy?

sorry if i rambled....just found my niche in nursing i guess.....lol....

iwanna · Jun 4, 2010

Yes you can have a psych patient/psych dx background and still take state RN board and still work as a psych RN. I will tell you though that a lot of the nurses I work with who are bipolar, etc have a lot of problems with setting boundaries and becoming way to enmeshed with the patients. That is not a good thing, but its very easy to get involved like that.
I love psych nursing. The patients are very interesting to say the least. I enjoy my patients. I'm planning to apply to a psych NP program. I enjoy the medication part of it, some of those drugs can really work wonders. Some "psych" is nothing more than out of control behavior (I work with adolescents ). Its a very interesting field I think. Go for it : )

IMO - Even out of control behavior is psych condition. Many of the out of control adolescents have borderline personality disorder. Some drs. view it as having a physical origin in the brain. And, a trauma can bring on the BPD symptoms, later on in life. BPD can be treated with medication and Dialectical Behavior Therapy. However, the recovery process is a long one. BPD patients have extreme emotions and are highly sensitive. Also, they appear to be just mis-behaved brats, but it is much deeper than that.

I used to believe that most of the adolescents are just behavior problems, and all they needed was behavior modification. However, the majority of the behaviors stem from some psychiatric disorder i.e. PTSD, Reactive attachment disorder, BPD, bi-polar. Most of these disorders require medication along with therapy.

babblingbrook · Jun 21, 2010

I had to laugh as you hit the nail on the head regarding the parents of many adolescent psych pt's. I work in adolescent psych and have many return customers and the parents complain b/c we didn't "fix them". Sad that many of the kids do things right before they will be released b/c they like being in the hospital rather than being at home w/their family. I'm learning now just how manipulative some kids can be. But with the group home kids, despite their manipulative ways, I feel sorry for them as they seem to try to continuously go to the psych hospital b/c they aren't getting the love they crave in the group homes. Makes me wonder what these kids will turn in to as grown ups. Scary!