Tips for the new girl?

Orca, ADN, ASN, RN · May 5, 2017

You will hear some very odd things. It is important to remember that these things are real to the people who are telling them to you. Patiently listen and offer support. Reorientation to reality is important, but almost equally important is how you do it. If a patient is visually hallucinating, for example, rather than saying "There aren't any dragons here", less judgmentally say "I don't see any dragons." That way you aren't trivializing or demeaning what the patient is experiencing, but you are saying that it is only real to him/her.

Sometimes patients just want you to hear them out, and it may not even be important to them that you believe them.

Be careful about self disclosure of similar experiences. Some patients may find it comforting that their nurse has been through some of the same things and understands, while others may be disconcerted that the nurse is apparently no better off than they are.

Don't share personal details with patients or become personally involved in their lives. That leads to nothing good. If a patient knows where you live or even the places that you frequent, that patient may track you down. Odds are that he/she will not have been completely compliant with treatment since release. Also be mindful that conversations with coworkers may be overheard by patients in the area. Even if you didn't tell a patient something directly, he/she may learn a great deal about your personal life just by listening.

Happy.Nurselet, LPN · May 5, 2017

Thanks for the tips! Lots of things I would not have thought of! I try not to self disclose with patients because I know I'm am odd and confusing creature, at least that's one leg up.

Orca, ADN, ASN, RN · May 5, 2017

I have worked with staff who did far too much of that. One nurse in particular used to talk at length with the alcoholics about "my time in AA", which several said made them feel uncomfortable. This nurse was eventually fired after sprinkling salt on the windowsill of a paranoid schizophrenic patient's room to keep the evil spirits out. Fortunately I wasn't on duty the night that this happened, because I would have immediately sent her home and just worked short. You aren't supposed to feed the delusion.

It was not long after this that I developed the saying "Not all of the nut cases are on the other side of the desk." You will work with people with significant mental health issues. The good ones will find the right balance in incorporating their experiences into their practice. The not-so-good ones will use it as an opportunity to make it all about themselves - not what I want if I'm a paying patient there for treatment. People with significant psychiatric issues of their own often gravitate toward mental health.

katyq82 · May 9, 2017

I hope you don't mind hearing from a current student, I only want to offer a resource that might be helpful to you, as I'm not sure if all nursing programs offer a psych nursing course. I am just finishing up mine and we used a book by Mary Townsend called "Essentials of Psychiatric Mental Health Nursing". Its an easy read but I think would be really helpful if you are just getting your feet wet. You can buy an older edition fairly cheap online.

Orca, ADN, ASN, RN · May 12, 2017

I hope you don't mind hearing from a current student, I only want to offer a resource that might be helpful to you, as I'm not sure if all nursing programs offer a psych nursing course. I am just finishing up mine and we used a book by Mary Townsend called "Essentials of Psychiatric Mental Health Nursing". Its an easy read but I think would be really helpful if you are just getting your feet wet. You can buy an older edition fairly cheap online.

I seem to recall that book from nursing school. Or it may have been on a stone tablet. :) Good resource. Thanks for sharing.

GeminiNurse29 · May 13, 2017

Hopefully they give you a good orientation. At my facility, it's 3 months long, give or take. LPNs do a lot of the med passes. Some people aren't compliant. And don't ever take what patients say personally. I also agree with the poster who said don't divulge personal details Bc patients can and will look you up.

Happy.Nurselet, LPN · May 13, 2017

So far. Orientation has been mostly focused on med/surg areas, but this hospital system is one of the top 5 largest employers in my state so its not surprising. I guess I'll start orientation on my floor in a week, because its another week of computer training modules first. Thank you for the resource, I will look into that.

Juryizout · May 23, 2017

Hi,

I've been the LPN at a psych facility for 4 years. The pp is correct about compliance. The more they get to know you, the more they will attempt to trust. I say attempt because sometimes they try trusting and decide it's too difficult. Don't take it personally. I get "fired" everyday I work from some patient. In trying to get to know them I start regionally and ask where they are from. I comment on how nice they look that day, ask them if they are ready for (whichever meal is next), and do they need anything. And now you will get most of your pharmacology class: by looking up their meds. I look a new one up at least twice a week that I've never heard of.

The last thing I'll say is don't let them rush you while you prepare their medication. They will push, don't let them get to you. :up:

Orca, ADN, ASN, RN · May 25, 2017

The more they get to know you, the more they will attempt to trust. I say attempt because sometimes they try trusting and decide it's too difficult. Don't take it personally. I get "fired" everyday I work from some patient.

You will be insulted, cursed and everything in between. In these instances, you have to be able to separate the behavior from the individual. The person wouldn't be on the unit if there weren't a psychiatric issue, and usually it's not personal - like the time when a patient who I had barely spoken to said "You're just a f---ing drug pusher. Get away from me."

Silver_Rik, ASN, RN · May 28, 2017

It was not long after this that I developed the saying "Not all of the nut cases are on the other side of the desk."

Recently I remarked, "half our staff are on the same medications as our patients. We're just on this side of the desk and have a badge that lets us leave."