Psychiatric Nursing?

ex1140 · Dec 18, 2008

Psychiatric nursing can be easy or difficult depending on the facility. Most nurses love working in this area, but the pay can be low as you can imagine because there is not as much to do (depending on the unit). Currently, I'm under contract with the VA to work on one of their psych floors and I don't give medication and I don't have to chart on anyone unless there is an occurrence.

Psych floors can be a pain though because the patients are not always confined. The patients that I'm working with are not confined they are free to walk about the unit and the facility. There is a side for patients suffering from post traumatic stress disorder and there's a substance abuse section. I think the confined patients are easier to work with and I'd rather give medication and not have to constantly be redirecting people to sign out and sign in and having to look for patients. Remember when patients are confined it's much easier on the nurse. Hope you find a floor that you can tolerate...most nurses love working in psych because like I stated it's not really difficult.

josinda421 · Dec 18, 2008

Psychiatric nursing can be easy or difficult depending on the facility. Most nurses love working in this area, but the pay can be low as you can imagine because there is not as much to do (depending on the unit). Currently, I'm under contract with the VA to work on one of their psych floors and I don't give medication and I don't have to chart on anyone unless there is an occurrence.
Psych floors can be a pain though because the patients are not always confined. The patients that I'm working with are not confined they are free to walk about the unit and the facility. There is a side for patients suffering from post traumatic stress disorder and there's a substance abuse section. I think the confined patients are easier to work with and I'd rather give medication and not have to constantly be redirecting people to sign out and sign in and having to look for patients. Remember when patients are confined it's much easier on the nurse. Hope you find a floor that you can tolerate...most nurses love working in psych because like I stated it's not really difficult.

Is there any special training required for psych nursing. Sice I'm an LPN, what would be my duties as a LPN or do I have to go and get my RN? The only reason why I'm drawn to this is because, when I was in college, I took some abnormal psych class and really enjoyed it. Even in LPN school I also enjoyed it. But I've never had hands on training for the job. I'm a new nurse so how much experience would be recommended and what places hire LPN for psych nursing?

Jules A, MSN · Dec 18, 2008

Psychiatric nursing can be easy or difficult depending on the facility. Most nurses love working in this area, but the pay can be low as you can imagine because there is not as much to do (depending on the unit). Currently, I'm under contract with the VA to work on one of their psych floors and I don't give medication and I don't have to chart on anyone unless there is an occurrence.
...most nurses love working in psych because like I stated it's not really difficult.

We will have to agree to disagree. Sadly psych nurses tend to be discounted not unlike LPNs are sometimes.

In the DC area psych nurses at private facilities tend to make more because not everyone is willing to do it. The demand is higher so the pay is higher. When I was a LPN I got paid what my fellow RN students started making in med-surge when we graduated. As a RN I started making $15 an hour more than them. Of course VA and state jobs are not known for their great wages just awesome benefits but they are still competitive in this area.

As for it not really being difficult I guess it depends on your definition of difficult. Why just this morning in addition to doing a nurses group, charting on 15 residents, passing medications regular and PRN, a dressing change, a restraint/seclusion and numerous re-directions I also got hit in the jaw. It was a wild swing and not actually intended for me but still didn't feel delightful. You are right though this wasn't a particularily busy shift as mine normally go.

Jules A, MSN · Dec 18, 2008

Is there any special training required for psych nursing. Sice I'm an LPN, what would be my duties as a LPN or do I have to go and get my RN? The only reason why I'm drawn to this is because, when I was in college, I took some abnormal psych class and really enjoyed it. Even in LPN school I also enjoyed it. But I've never had hands on training for the job. I'm a new nurse so how much experience would be recommended and what places hire LPN for psych nursing?

There are tons of places around Balto. that use LPNs in psych. Sheppard Pratt and Spring Grove are two that come to mind. Not sure what they are requiring now but a few years ago they would hire a new grad without a problem. At the state you will be passing a lot of medications. At Sheppard Pratt, I think, its more closely related to what the RNs do like groups etc. Imvho if you can do LTC and enjoy it you would probably love psych. For that matter if you are good at LTC and enjoy it I can't imagine there is much in nursing that you can't do. I really admire LTC nurses. FWIW many of my patients have similar psych presentations as yours but they are just younger and caused by different things. The work load will probably be a bit lighter than what you are used to. Good luck and please keep us posted.

ex1140 · Dec 19, 2008

Is there any special training required for psych nursing. Sice I'm an LPN, what would be my duties as a LPN or do I have to go and get my RN? The only reason why I'm drawn to this is because, when I was in college, I took some abnormal psych class and really enjoyed it. Even in LPN school I also enjoyed it. But I've never had hands on training for the job. I'm a new nurse so how much experience would be recommended and what places hire LPN for psych nursing?

The amount of experience would depend on the type of floor or facility. The floor I'm working on doesn't require a lot of experience because the patients are not confined. However, if you worked in a crisis unit like say at a state ward or prison then that's a totally different story. I worked in psych in the prison system which basically over qualified me to work at my present job.

If you are going to pursue working in psych then do yourself a favor and start on a floor like the one I'm on...because it's very easy and you feel overwhelmed, and if you couldn't cut it on this type of floor then the more difficult units would be out of the question. When I worked in the prison system I saw some very disturbing things...people cutting themselves and watching the blood spurt out like a fountain...doing wound care on patients that decided to slice up there legs or arms with all kinds of objects. I wouldn't mind being a psychologist...I think it would be an interesting and rewarding career.

Sorry, you asked about duties...observation on my floor is key. We don't chart unless something occurs...which is basically never, and the patients medicate themselves...I am basically a babysitter. I am currently under contract, but considering full-time. I hope you find the right floor or facility.

lpnflorida · Dec 19, 2008

I worked for 20 years on an Acute care locked psych unit of in a level 1 trauma hospital.

We were usually assigned no more than 3-4 patients, which included doing any medication or treatments on them, wound care if needed. It was expected to have 1:1 time with each assigned patient during your shift. Some of in addition also helped to co-facilitate groups. Maintaining a therapeutic mileu was part of everyone's job. It could become harry during some shifts, especially with the patient who was pscyhotic, out of control. Use of restraints, seclusion was not unusual at all. Also the assessing of patient's undergoing ECT treatment.

I enjoyed this type of nursing. Staff always have to stay on their toes to try and head off outbursts of any sort. People's safety depended on it. High population of depression with active suicide ideation.

I never found it to be an easy job. Perhaps as our population was acute most caused from noncompliance with medication.

I could tell some horror stories which would curl your hair. But then any psych nurse could.

sallydee101 · May 9, 2009

I work on an acute psy floor within the VA system and love my job. Our patients range for severe ptsd, dementria, depression, SI and HI drug detox and schiz. to name a few.

So we take in all kinds.

I work.....wish it was easy.

I do am meds, many prns, CIWA's for detox, chart on each pt nightly and dressings and total care.......and redirect and redirect...break up fights, cry over sad stories, and deal with frequent flyers by first name.

70% of my patients are homeless.

I have learned so much in this setting and love the human mind. Love giving to those, no one else wants to or family just can't do it anymore.

off to work....

pagandeva2000, LPN · May 9, 2009

Psychiatric nursing can be easy or difficult depending on the facility. Most nurses love working in this area, but the pay can be low as you can imagine because there is not as much to do (depending on the unit). Currently, I'm under contract with the VA to work on one of their psych floors and I don't give medication and I don't have to chart on anyone unless there is an occurrence.
Psych floors can be a pain though because the patients are not always confined. The patients that I'm working with are not confined they are free to walk about the unit and the facility. There is a side for patients suffering from post traumatic stress disorder and there's a substance abuse section. I think the confined patients are easier to work with and I'd rather give medication and not have to constantly be redirecting people to sign out and sign in and having to look for patients. Remember when patients are confined it's much easier on the nurse. Hope you find a floor that you can tolerate...most nurses love working in psych because like I stated it's not really difficult.

I'm curious, you are an LPN and are not medicating? In the hospitals I have worked at (as an aide), the LPN was the primary medication nurse. What else do you do since you aren't administering meds?

I worked in psych for many years as an aide; was a certified medication tech in one of them. This is not an area where you will be using many bedside nursing skills. Most of the time, it was quiet, but when one or more acted out, it was a sight to see because you have to remember that what makes them act out are not the normal things that agitate mentally sound individuals. It can be because of the color you are wearing, that you look like someone that harmed them years ago, voices in their heads, many issues.

Many of them had a sense of humor...we had a psychiatrist that really did have features similar to Jesus Christ and each time he came on the unit, one of them would bow down to him and ask that his sins be forgiven. I mean, of course, it is not wise to openly laugh, but I have turned my head to expel a chuckle. One elderly woman stated she had a suicidal plan and when I asked her what it was, she showed me over 30 packets of sugar she planned to ingest. I knew she could not kill herself with sugar, but I reported it anyhow, because maybe somewhere in her head, she planned to steal something that would, in fact, harm herself with. That earned another chuckle.

I rather enjoyed psych when I was there. I may consider applying again; I tried last year and was told that I needed more experience as a psych nurse...this facility did not wish to count my 15+ years of psych experience as an aide.

Jules A, MSN · May 10, 2009

Pagandeva2000, I do so hope you eventually land in psych although it sounds like you have it pretty sweet right now. I love my patients sense' of humor and the funny things they say also. Truth is thought that its more often that we are collectively laughing and making fun of the silly things I did!

pagandeva2000, LPN · May 10, 2009

I hope so, also. I am hearing that the place I was going to be sent to has now laid off most of their per diem nurses, so, I am sure agency is close behind. For some reason, in my own hospital, they don't want LPNs in our psych departments. I was told that the few LPNs they have already get a great deal of extra hours through agency and don't have a need for any additional LPNs.

You are correct, I have enough to do for now, but eventually, I would like to give it a shot. I remember some fun days working in psych. I admit, it was not as hard physically. Even as a tech who gave meds, I was able to take care of the entire floor within an hour. I still have the list of meds you shared ready to study from again should I get the chance.