Psych Nursing, oh yeah!!!

Meriwhen, ASN, BSN, MSN, RN · Oct 14, 2013

I'm in the middle of a final project for school so I can't type much.

Read many of the threads in this forum as you will find them very helpful.

The one thing that I would say right now--and the first thing I usually tell students even though you're not one--is to always remember that psych patients have the same rights as any medical patient. This means they can refuse treatment and medications, even if they are under holds or committed involuntarily.

The only times that refusal can be overridden is if the patient is an immediate danger to themselves and others (i.e., assaulting staff or self-injuring) or through a court order (which is a separate hearing from the hold/commitment process).

Welcome to the dark side :)

302queen · Oct 14, 2013

welcome to the dark side we have cookies :) no really welcome and good luck.

Carrie RN · Oct 14, 2013

I could not infer what level of psych nursing you would be doing. Be prepared for people walking around. Unlike your usual patient they tend to be out of a bed. If it is inpatient hospital you may need to know proper restraint protocol (how to apply restraints, when they can be used, what type of order is required). If you are in a community based setting be sure to ask about charting protocol as this is how reimbursement is applied. Mostly for RNs it will be for teaching a specific thing to a client and requires at least 15 minutes. Be prepared for psychotropic drug use far beyond the doses that you ever learned in school. Learn what a B52 is and how to administer it.

Meriwhen, ASN, BSN, MSN, RN · Oct 14, 2013

Learn what a B52 is and how to administer it.

We call it "the Three Amigos" :)

chevyv, BSN, RN · Oct 15, 2013

Congrats! Don't be afraid to listen to your gut as well as your staff. I love psych nursing! Treat your pts with respect. Many people do not do this and you will be surprised how often you'll get a positive response. Be aware of your surroundings, especially where the door is. You don't want a pt to be between you and the only way out of a room.

My place of employment is in the process of closing. It can be pretty violent. I recently interviewed at a facility that told me they rarely have to use restraints. I thought I must be dreaming! Hopefully, you get a good place like that. We use restraints often and it's pretty dangerous. Psych nursing means you never have the same day twice!

psychRNmom2 · Oct 15, 2013

I love psych nursing. It's where my heart is. Most of these people are in the hospital frequently. They are an underserved population who often have no support in the community. They deserve patience, compassion and understanding just like anyone else-moreso in my opinion because they will not get it else where. The world is cruel to them. Treat these people with the respect and dignity they deserve. They are not prisoners. They do not deserve punishment. Although often times our rules and restrictions seem punitive so I am careful to explain the rationale (pt safety etc). Choose your battles-it's a lot like parenting. I have learned great parenting techniques from psych nursing and vice versa. Stay on top of prns with manic/psychotic patients. The second you notice that they are starting to rev up, give them something. It's the best thing you can do for them and yourself. We avoid putting our patients in restraints by keeping on top of their meds. Zydis 10mg is your friend-in my experience it works the best at calming manic/psychotic patients down. Sometimes it takes 20mg though. Good luck. You will love it!

Carrie RN · Oct 15, 2013

The three amigos made me laugh out loud.

NCindasun21 · Oct 15, 2013

"Booty Juice"

white gloves · Oct 15, 2013

lol u guys

LisaNICUrn, BSN · Oct 16, 2013

My advise is remember where you are working. Remember your most important tool and job for the day. Unlike med-surg, it's not hooking up or hanging IV's, checking Foley's or PICC lines, it's listening to your patient. It's sitting out in the mileu and talking to your patients, make them feel normal, human, like they matter. I love football, it's a great conversation starter, and it gets patients talking and they don't feel so bored all of the time. It gets the patients interacting with staff and other patients, it works on their people skills, and if things even begin to get out of hang, you can see where their coping skills are at before you stop the conversation. Our patients are here b/c of their mind, so they need your time, not just your medication.

Don't be afraid. I work in a very acute facility. We luckily don't use restraints very often, maybe 2 or 3 times since I started in Feb. We call a lot of "codes" needing assistance. I am a women, work on the men's unit, and with our panic button, staff will come running. In all instances I have seen of a man trying to overpower a female staff member or intimidate her, even the patients step in to help. I feel 100% safer working on the men's unit than the females.

A patient can flip and attack you with no warning. A patient today attacked a co-worker with absolutely no warning, she was walking by and he just grabbed her hair and threw her down and bit her in the head, it was over within 3 seconds, but that's all it takes. Never think a patient is your friend or "know" they would never do anything to you.

Good luck.

wingding · Oct 17, 2013

I am learning it takes a special person to be a psych nurse. I think it is the best of all worlds - I still get to do wound care, patients on paper (intake paper before presenting to dr.), Rapid Response, seizure, heart problems, UTI & Ammonia related confusion, Alcoholics, Drug addicts, true psychosis of all flavors. My favorite warm fuzzy is seeing a person from psychosis with audio & visual hallucinations to almost normal after some time - it always amazes me what sleep, food & serious antipsychotic meds can do. Every once in a while I get to go home & feel that I really did good by my patients. Most of the time it is running the day of meds, meetings, groups, calming the upset pt., admissions & reports, praying that we don't have to use restraints since I'm not trained in them yet. I fell into this 1st job of mine & managed to get it right -- but I pray every day for me, the staff & the patients to keep safe, calm & therapeutic. I am learning about forgiveness; I learn from the patients & I learn from my fellow nurses. I've only been here 6 months, but I still like my job -- still have mountains to learn, but I am staying with it. This is the true "disparity" population - people who have no one else to turn to but us --- how sad that we are the only ones that treat these people with dignity & respect, but how gratifying when you know you have helped someone because they stop you to say so. Good luck!! And BE CAREFUL!!!