Psych Nurses!!!

sweetieann · Feb 22, 2008

I graduated in May 2007 and started working in psych right out of school. I absolutely love my unit! I work with eating disorder patients, which is a good blend of psych/medical issues. I say if you want to do psych, go for it, don't worry about doing one year on a mroe medical floor. As I always say, there will always be people wth mental illnesses, so if you want to stay in psych for a good bit, you can always move around even within the specialty. I hate the really "technical" aspect of nurse (IV drips, vents, etc), but I love people and how the mind works, so psych is a great fit for me. I'm applying now to enter a MSN program for psych/mental health clinical nurse specialist (our floor's nurse specialist rounds with the attending psychiatrist daily and also has her own practice). You could also advance to a psych CRNP and meet with patients. Many options! Most of the psych nurses I know have been in psych many many years and haven't looked back! Any more questions, please let me know!

Lachrymologist · Feb 22, 2008

I feel I should add that I'm in an LPN program right now but plan on going for my RN ASAP.

Thanks for your response. I agree with you on the technical aspects of nursing. I don't see myself warming up to it too well. But I've always loved psychology. I was once a psychology major a few years ago...

Little Panda RN, ASN, RN · Feb 22, 2008

I am an LPN and just started as a psych nurse. So far I like what I see and what I am learning. Sorry I really can't answer your question since I have not been at it long enough to know the pros and cons.

Best of luck to you!

Lachrymologist · Feb 22, 2008

Anyone else????

PMHNP10 · Feb 22, 2008

Give the pros and cons of this field. I want to be a psych nurse but I don't feel I know enough about what it actually IS to make that decision just yet. Thanks to all who reply. Its much appreciated.

my pros/cons are very personal (esp. the pros) so some might not help you at all

So in no particular order--

PROS:

1) On average, a day on a psych floor is less hectic than on other units (e.g., ICU, ER, or m/s unit, etc).

2) On average, the physical health is not as acutely poor as a pt. on another unit (but believe me you get plenty of chronically ill folks as well as a portion of acutely ill patients)

3) Due to No. 1 above I had the opportunity to sit down with my patients, have a discussion, address concerns, and provide a therapeutic ear to people who often desparately want someone to listen to them--IMHO this is critical in your care of Axis II patients (specifically, the personality d/o's)

4) Even though there are a limited number of mental health Dx's, no 2 bipolars or schizophrenics, etc. are the same

5) I have a broad sense of humor and simple mind and find that my patients, although totally unintentional on their part, can keep me entertained and fascinated for extended periods of time--always expect the unexpected

6) Psych/mental health is incredibly fascinating to me

CONS:

1) Inappropriate admissions to an adult inpatient unit--e.g., IMHO, little old ladies who have alzheimers should never be admitted to a unit where manics, psychotics are being treated...it is a horrible horrible thing some docs/hospital admin do

2) Although many conditions are treatable, none are curable (i.e., in the way that giving an abx eliminates an infection, for example)

4) Many treatments for certain disorders are like 30% effective and the side effects of many medications are quite serious (e.g., IDDM from atypical antipsychotics, tardive dyskenesia from typical antipsychotics, coma from lithium/dietary sodium intake noncompliance, etc.)

4) There's a huge issue of noncompliance amongst this population, so it's not uncommon to see a newly Dx'd manic or schizophrenic go through multiple admissions in a short period of time

5) On a whole, mental health services/resources are minimal, and this population is often overlooked in the early stages of their disease or misdiagnosed when early treatment could result in an improved prognosis

5) There is a stigma for the psych patient as well as the nurse

6) Due to the overperception of No. 2 (if that makes sense) of the "PROS" as well as the presence of No. 5 of the "CONS", staffing levels are way way subpar. It's not uncommon for some hospitals to have 13:1+ ratios. And although as I said, "On average" they aren't as acutely, physically ill, make no mistake about it...you do get patients who are on EtOH or benzo or other drug detox. (as well as a number of other acute medical illnesses) which can be fatal, therefore they require intense monitoring

So in summary (and I'm certain I could add more if I thought a little longer), psych/mental health is only for individuals who truly love the field and are good communicators and listeners. IMHO, you have to want to work with this population. If your only reason for wanting to become a psych nurse is to work in an easy field of nursing because you are burnt out of ICU or ER, etc. or to share your mental health issues with your colleagues, I highly recommend you spare yourself, your patients, and your fellow colleagues the stress and look elsewhere--and I'm not meaning this directed at you, but anyone in general.

If your "PROS" match mine, I have no doubt you will be very satisfied with your career choice if you can overlook the "CONS"--and that really can be quite difficult to do at times; but in one way or another, I don't think the cons I've listed in psych are any different from any other field of floor nursing.

Good luck to you.

PMHNP10 · Feb 22, 2008

Side note to my post above: I highly recommend that if you are a new nurse graduate, please for the sake of your patients, get some medical experience. You really don't know what you don't know straight outta school and you aren't going to necessarily learn it on your psych floor unless you happen to work on a med/psych unit with experienced nurses who can mentor you. Indeed you can be a wonderful psych nurse without any other experience, but I guarantee you will be an even better psych nurse (and colleague) if you do devote the first few months of your new career to caring for medical patients.

jenn27 · Feb 23, 2008

I work with MRDD. Most have underlying psych disorders. From brain injury, autism, cri du chat, and gen psychosis nos. My advice is everyone is different. just because 2 people have same diagnosis doesn't mean there alike. Expect verbal and physical aggression to be an everyday occurance. But it is so interesting, and rewarding. Do some volunteer work. Good luck

cloudstrife1ph · Feb 23, 2008

i'm a BSN graduate and waiting for my eligibility. i'm currently working on one of telecare corporation's program here in california as a mental health worker.

during my college years, i, together with my classmates talked about our "specialty" where we are very knowldegeable at. they always make a joke out of me that i'm psychotic because my strength is psychiatric nursing. i even realized it in myself maybe because i can handle the stress better than them when dealing with patients with mental illness and i'm very observable and can read people's personalities and attitudes just by looking at them. i'm not judgemental but what is see is always true...

because psych is my "forte", i tried to find jobs related to mental illness. i worked in an alzheimer's facilty as a CNA and an on-call mental health worker at cordilleras. i didn't liked working in the alzheimer's facility because they're too predictable and bored me (a feeling that i'm not happy and contented)so i quit and chose to stay with cordilleras.

pros that i can in pursuing pyschiatric nursing are:

1. many people hate or afraid working or even hearing taking care of mentally illed patients and YOU really have guts and courage if you work on one.

2. you can really learn about "people". you can understand the differences (personalities, behavior, factors, answers on why did they became like that and why they do they think like that and etc.) of people around you from one another.

3. not as toxic as other nursing jobs/field.

cons:

1. you don't know what they are thinking. they maybe nice at one moment then suddenly becomes assaultive.

2. very dangerous workplace to work especially on critically mentally illed patients. we had our pro act today and we've heard stories such as a physician is alone in a room with the patient for physical exam and the doctor was stabbed in the neck with an object in which the patient got from the bag and the patient banged her head continiously until she died. or a patient kicked the knee of a staff sitting on a corridor and it was so hard that the leg went inside the pelvis.

3. you can't fight back because of the policy and law and you can only do is escape or evade if they attack you. RUN FOR YOUR LIFE!!!!

i think that's the major highlights from my experience working in the psychiatric field....

Lachrymologist · Feb 26, 2008

2. very dangerous workplace to work especially on critically mentally illed patients. we had our pro act today and we've heard stories such as a physician is alone in a room with the patient for physical exam and the doctor was stabbed in the neck with an object in which the patient got from the bag and the patient banged her head continiously until she died. or a patient kicked the knee of a staff sitting on a corridor and it was so hard that the leg went inside the pelvis.
3. you can't fight back because of the policy and law and you can only do is escape or evade if they attack you. RUN FOR YOUR LIFE!!!!

Oh. My. God. How common are occurrences such as these???

cloudstrife1ph · Feb 26, 2008

it's not that common i think. maybe it also depends on the person if he/she let his/her guard down.

because the patient was always nice and approachable, she became too confident and didn't expected that the patient will have a sudden change. we all know that we should never ever stay alone with a patient as much as possible. we should always have a buddy or another person with us......

about the no. 3. that depends on the protocol and i think it's the law. the patient is admitted there because he/she is "SICK" then you're gonna hit them back because they hit you too? i know it's unfair but they can ask you this question: "you know before you started working here that this job is very dangerous right? then it's your fault because you accepted the risk".

elkpark · Feb 26, 2008

Although incidents do happen, the vast majority of clients seen in psych settings (even inpatient units) are not dangerous (or, more dangerous to themselves than anyone else). Obviously, risk level depends somewhat on the setting (e.g., clients in a specialty forensic unit at the state hospital are likely to be more dangerous than clients in a community hospital mental health unit ...)

I've been in psych nursing since Hector was a pup (>20 years), and I've very rarely seen a situation where a client became aggressive/assaultive with staff (or another client) without broadcasting/telegraphing in advance that that's what s/he was building up to -- in my experience, when staff say, "He suddenly just slugged me without any warning," what really happened was that the staff member failed to pay attention to clues/hints that the client was heading in that direction, or failed to take typical, reasonable safety precautions (or, in some cases, the staff member was, intentionally or unintentionally, being challenging and provocative with the client and the client was provoked to act out when s/he otherwise wouldn't have ...). However, let me also add that anything is possible (esp. in psych!! :)) and I'm not saying that it couldn't ever happen that a client would suddenly assault someone out of the blue, without warning ...

Every mental health employer/facility will provide new employees with training in intervention techniques approved by the state and the facility that are designed to protect yourself if attacked and physically restrain the client while also protecting the client from injury. In most settings, you're not allowed on the units to provide direct client care until you've completed this training. You do not have an absolute, unrestricted right to defend yourself in any way you choose, but you do have means of defending yourself and taking control of the situation to keep everyone safe.