confused psychiatic nurse - page 2

Hi, I am a new grad just finished my degree in 12/2006 and passing the boards on 3/14/2007. I am very interested in psychiatric nursing because I have a previous Bachelors Degree in psychology and... Read More

  1. by   TrudyRN
    I think you are ok having gone directly to Psych.

    Let me add, though: Your patients are mentally ill BUT they might still have other health issues. I see many Psych nurses view everything from the psych perspective and they seem to forget that the patients have cardiovascular systems, GI, GU, Derm, Pulmonary systems, and so on. To an alarming degree, they don't think about EENT, dental, neuro, endocrine, reproductive, orthopedic/musculoskeletal issues.

    I don't think you should necessarily do a year of M/S but I do think you should always bear in mind that the schizophrenic might also be diabetic or have seizures. The personality disorder client might also have a tooth abscess or sinusitis or allergies. The patient with depression might have renal impairment or addiction issues or scabies or psoriasis.

    Someone with a psychiatric diagnosis is still inside a body and can have many issues related to that body that, as the client's nurse, you need to keep aware of.

    Practice listening to lung sounds, for example, when your criminally insane patient says he needs his inhaler. Learn what wheezing sounds like and where he is having it. Inspiratory? Expiratory? Audible without stethoscope? All lobes anteriorly and posteriorly? And so on.

    Keep aware of the client's general ability to void, to defecate.

    Your facility likely has an internal med or family practice doctor to help with medical/surgical needs of Psychiatric patients. Don't be reluctant to refer clients. But you just should keep aware of every body system of your clients.
  2. by   mkohut_
    Trudy, your post was very helpful! Thanks
  3. by   frodo50
    Hi, I have been an RN for 18 years. I was an acute rehab nurse for 8 years, and a home health/hospcie nurse for 4 years. I have been a psych RN for 10 years now and do psych travel nursing. It's not necessary to do the med/surg nursing to be a great psych nurse though it does help because many of the psych patients have medical problems and it just helps to be able to recognize the signs and symtoms of medical problems if your pt. gets into trouble. This of course seems even more important when you are working a free standing psych hospital where the ICU and ER aren't available immediately. It sound though that you are very dedicated and will be a great asset to psych nursing. Good luck!
  4. by   deidrasue
    Hi kiddo,
    Follow your heart and it will be ok. There are too many opportunities in psych to put it off - and if you decide later you want to go into another field - hospitals and other sites will train you just as they would a new grad.
    I'm pretty disillusioned right now about psych nursing but it's the setting I'm in. I work for a state facility and if you aren't a psychologist or social worker - you have no power. Even the psychiatrists are at the mercy of the people who are licenced addiction counselors or LPCs. All they want us to do is pass meds.
    HOWEVER, that being said, we do not have an internist or any other doctor on staff who isn't a psychiatrist so they rely on the assessment skills of their RNs. THIS you should concentrate on - and stay current on. Believe me, when we say "ship 'em" - they ship 'em.
    You stick to your guns - we help more people that all the meds in the world - the meds only help the client to focus on adn remember what you're teaching.
    Best of careers and my wishes,

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