Psych nursing is easy

[studentnurse9806]

Does anyone else think so? I just started not too long ago so my perception can be wrong but it seems so much easier compared to other nursing specialties. I love that I get to talk to my patients , sit, and eat lunch and go to the bathroom lol. I know it depends on the floor ( I work on just plain adult psych so no substance a users) . Would love to see what others think, thanks.

[chevyv, BSN, RN]

Easy it is not! OP, you have it good! I rarely see a 30 minute lunch. Between putting out the small fires before they become blazing infernos, the charting, the admits, the more charting, the SI/SDV/AVH/HI, more charting, CIWA's q 2-4hrs, more admits, and more charting, I'm lucky to get out on time! I get the occasional day when I only have 6pts and get to spend quality time, but that is rare.

[Sun0408, ASN, RN]

I hope the OP's eyes were opened by what all of you wrote..I agree, if it's easy, you're not doing it right. Hopefully once the OP comes off of orientation, she/he will get a better idea of what it's all about.

My hats off to all you psych nurses.. Clinicals were enough for me !!

[PG2018]

A lot of people look down on psych nurses because they don't frequently use the same skills as, say, an ICU or med surg nurse.

LOL. And yet to me, that is a positive to psych!

[Meriwhen, ASN, BSN, MSN, RN]

I wouldn't say it's easier so much than it's different. It utilizes a different skill set that is less task-oriented and involves more patient communication and interaction. Psych isn't "drug 'em up and babysit them" but a hell of a lot more than that. And it's your brain that's working the real magic here, not your hands...unless you're securing restraints, but if you're really doing psych nursing right, you would be utilizing restraints as little as possible.

Anyone can insert a Foley with a little training. Dealing with a violent patient that is heavy on the Axis II while remaining professional--and uninjured--the entire time is somewhat more of a challenging skill to master (as well as being a description of one of my recent days at work).

If you are transitioning from a heavy task-oriented specialty, psych may seem easier, especially when you no longer have to act the role of glorified waitress and task master. However, check back with us after a year of working hard-core psych, and let us know what you think.

[PSYCHEE]

If it's easy, you're doing it wrong... seconded, thirded... ad infinitum...

Try figuring out what your patients medical issues are when they're speaking nothing but word salad and sign their name Abraham Lincoln. When they're a JSO dropoff and the Baker Act reads nothing more than "psychosis, walking in traffic". No gaurdian, no contact - his b/p is 190/90, after you got your tech to wrestle him still and get vitals... a lot of it requires an obscene amount of patience, creativity, and keen observation skills. If you're not watching closely and asking questions constantly, the deeply psychotic patient isn't going to know that they should report the muscular tension in their jaw that is the beginning sign of EPS. And sometimes when their thoughts are so disorganized they can't communicate effectively, agitation means they're missing something you should be providing -- another patient stole their dinner when no one was looking (and geodon makes most people ungodly hungry), they've got a headache from the meds.

And the verbal tango with explaining a BA to the patient who was told in the ER that "it's only 72 hours" when their second opinion transitions them into an involuntary hold...

I'm absolutely immune to insults. I've been called every colorful phrase in every language, tenfold. I've been choked out twice. I've had steaming hot coffee dumped over my head. I have learned not to ever wear my hair in a braid, lest I be dragged around by it like a leash. And all of this while remaining calm, collected, and friendly as can be with a smile on my face. I've known nurses in the two years I've worked psych who have lost it and thrown water in patients faces... or worse. :/

I may not be able to insert a foley, but I could learn if I tried once or twice. These are skills that take years to develop, if they ever do, if you have the resillence to develop them...

[LisalaRN99, BSN, RN]

Psych nursing is easy?? Please tell me where this unit is so we can all come work there! As a veteran psych nurse who has worked 11 of my 15 yrs in psych nursing, I'd say, never let down your guard! Just when you do that, something is bound to happen! Yes, you get to sit down. So what? Yes, you get to take a lunch most of the time. So what? You also need to de-escalate patients, put them in restraints and document that. You have to carefully watch for side effects and especially fall prevention due to the sedating nature of the meds! I could go on. Please don't add to the perception that psych nursing isn't like "real nursing" by saying how easy it is. You just haven't been in it long enough!

[macfar28]

Ask yourself this...what would you think if a psych nurse said to you, "wow, med-surg nursing is so easy. All you have to do is look at monitors and IV pumps. You just give meds and do tasks"???

Psych nurses have to be supremely aware of their patient's subtle changes in status. There are no machines that beep to alert us of such. Psych nurses must also be very in touch with themselves, as without that centered-ness, dangerous events can occur on a unit.

[Hygiene Queen]

Let's see, I've sent patients out for sepsis, brain bleed, MI, fractures, pneumonia... I could go on.

If I have an 80 year-old pt on Norvasc, metoprolol, lisinopril, Lasix, Novolog, Levemir, Nemenda, Risperdal, Ativan, Coumadin and Norco, you tell me some things I might have to worry about.

Then I have that person who won't take their meds. Then I have to think. Maybe if I can get them to take the Risperdal, maybe I can get them in a better place to take the rest... but no... Meanwhile, I'm on the phone getting a clonidine patch because I can't have a pt, who won't take their meds, running around with a BP 180/90. Oh, I can crush 'em, but they won't take anything by mouth... which leads to issues regarding that insulin... then I get their lab results... and now I have to go do that EKG... and now I'm coordinating a cardio consult... Meanwhile, somewhere in the dark recesses of the unit, there is a pt deciding now is a good time to strip naked, streak the unit and fall in the process...

Oh. You do not even...

Reminds me of a song:

"Come back, when you grow up, Giiiiirl

'Cause you're still livin' in a paper doll world

(Psych) ain't easy

(Psych's) twice as tough

So come back, Baby...

(ba-dum!)

When you grow up!"

[beemax079]

People who don't work in psych don't realize how mentally exhausting it is. Working in childrens/adolescent you are constantly scanning to see what could possibly be used as a weapon, are all the patients obeying the rules, who is where, what new med side effects am I looking out for, being absolutely consistent with everyone. You try to build rapport with your patients and demonstrate empathy but at the same time most of these kids have extremely manipulative tendencies. The paperwork is a whole other world because you never know who is guardian, and if they are a ward of the state there's another ball game, plus school paperwork is added on. This, on top of assessments and charting.

The violence and behavioral issues are our "hard skills" that we deal with. Our message is always "I'm here even when things get tough", which means we are closest when that chair gets thrown. I sometimes wonder what its like to have patients who willingly go along with the treatment plan. Or at least pretend to...

[Juryizout]

I have been in psych nursing for one year and can mirror the statements of many of the posters here. It may feel easy while you are on orientation, but that's kind of the "honeymoon" phase. Most of regular nurses don't want to "throw you to the wolves" and expect more of you right away until you are accumulated to the unit polices and the patients themselves. That was my experience, anyway.

The thing I can tell you about psych nursing is it is a definite calling. A psych nurse requires patience, diligence, and just talking yourself into coming into work everyday sometimes, because you know there are problematic patients who will give you a hard time. Stick with it and let us know how you like it, and if you think it's your calling.

[bell1962]

I give all you psych nurses a lot of credit! I get a little of it in school with our severely emotionally disturbed kids, our day treatment kids, and our kids with severe autism and there is no way I could work in psych full time. Not only do I not think psych nursing is easy, I think it is one of the hardest specialties there is.

[Yosemite, RN, ASN, EMT-I]

Sister (or brother, as the case may be), you've OBVIOUSLY have had limited experience if THAT is your experience. And, no, I'm not trying to be rude. I've been out of psych for 3+ years; it was the most rewarding type of nursing I've done, the most stressful nursing I've done. If you find, where ever you're working, that your experience is so "casual," KEEP THAT *******' JOB, hang on to it for ALL that you're worth. I've worked both a private for profit facility and a county facility; I've worked with nurses who've done state institutions and those for the criminally insane. MANY facilities are harrowing and hectic beyond belief... admissions, discharges with little to no warning. "Psychiatric emergencies" when you and your staff are least prepared to deal with it. Short staffing, meds not available, narcotic "counts" off, TB tests not done, orders changing daily as psychiatrists disagree as to medication regimes, contraband found, damage done by patients to the facility, Axis II behaviors executed to perfection to PIZZ you off when you have the least energy and time to deal with it, treatment team meetings, staff squabbles, administrators dictating st00pid polices and revisions with no forethought as to "real life" implementation, vomit, feces, multiple urinations in the hallways, trips to the emergency room or urgent care for injuries/bites/blood/semen exposure, lost/misplaced patient belongings/inventories, code blues, calling law enforcement when there's an escaped patient that is on a legal "hold," employee performance reviews. What did I forget? Oh, yeah... charting, routine medication administration when your med tech/LPN is injured or calls in sick, Q 15 minute (or what ever the policy is) patient checks for safety when short staffed, using a patient's bathroom (against policy) when you're about to wet yourself and don't have time to leave the unit, making snap judgment calls as to go to lunch (and leave the unit understaffed -but following policy) or to skip lunch (but clock out, again against policy) and continue working through the chaos.

Of course, when the day is done, and the tears of joy and desperation/exhaustion are threatening to start, your supervisor/boss lets you know that you need to work on "prioritizing" and "time management" while reminding you they are there to help you when you need it (except when out to extended lunches, meetings, unexplained absences, etc.) THEN it gets scary when you have to decide if prison time is worth the "education" said supervisor is in so desperate need of.