I work in a 23 bed psych unit at a hospital. This is my first job as an RN, however, I've worked in the psych field for about 5 years doing other things. I am still on orientation until the beginning of October. Due to staff issues, I have already worked without a preceptor many times. My patient load increases daily it seems and my pt's seem to have higher levels of acuity. For some reason right now, most of these pt's are all axis II and are very demanding, needy, cutters, constant suicidal thoughts, swallowing things for attention, etc. I am constantly sending down pt's to have things fished out of their stomachs. We have more pt's than we can handle and they still seem to find a way to squeeze even more in. We have been getting pt's that are admitted to us who are elderly and depressed because they have been diagnosed with terminal cancer....duh! I'd be depressed too. Some of these pt's medical conditions far outweigh their mental illness. We have tons of pt's on coumadin, tons of IV's, people on oxygen, etc. We have had 3 deaths on our unit in the last couple of months because they send three elderly pt's there to basically die since they were depressed. I wanted to be a psych nurse and now I am a med surg nurse anyway. I have been going home and crying in the last few weeks after work. I am so stressed out. There is so much to learn. There is so much paperwork. I don't know if I'll ever learn how to do it all and manage it all. I am going home depressed. I really love the counseling end of psych nursing, which we do as well, but rarely because we are always calling doctors and giving meds and running around crazy. I love the quality time with the pt's and I have no more quality time than any other nurse. I thought this was what I wanted. I just feel like a bad nurse because I feel that I can't possibly do my best under the stress I'm in. I don't know what to do. I didn't sign my contract yet. It was supposed to be for 3 years. I really hate being a staff nurse. I would love to do outpatient behavioral health counseling or even home health at this point. I just don't know how long I can keep this up. I am not happy and I'm starting to feel like not even getting out of bed. Does anyone feel like this? Can I work in home health or something without working as an RN for a long time? Ugh!