Typical Day at Work?

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Specializes in Case Management.

I'm a newish nursing grad who recently made the switch to psych nursing because I loved my clinicals and I find psych itself super interesting....well already (and it's only been 2 months) im feeling overwhelmed and burned out! I already left my 3 month cardiac job because I just HAD to do psych and now I'm hugely regretting my decision.

I'm scheduled to work 7a-3:30p but rarely do I ever get out on time. I usually get out at 6. There are 37 patients and 3 nurses with one being charge. I have to write weekly notes, shift notes, progress notes, special observation notes, prns and refusals and group notes. Today for example: 1 weekly, 1 shift, 3 progress, and 2 special observation. Lots of medication refusal notes and prns. We didn't have group today but if we did that would be more notes. The other nurses chart too but I always seem to get the most. The LPN can only chart on certain things and the charge nurse making the schedule gives herself a lighter load. So much charting and it's all free hand. No check a box charting. It wouldn't be so bad if we didn't have pts becoming aggressive everyday! We have 5 on our unit that wreak havoc. Seclusions, holds, cocktails every single day. I'm in a state facility so we get the worst but I'm wondering how typical is this across the board? I'm really wishing I stayed where I was but now I feel like I have to stay where I am for a while so I wont be viewed as a job hopper.

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Specializes in Family Nurse Practitioner.

I'm sorry this isn't what you thought it would be. Although your patient load sounds a bit high its not out of line with most units. State hospitals do have chronic patients but in my experience most of them were long term residents so well known to staff which can actually make things a bit easier than an acute unit where the patients are unknown, with frequent admissions and discharges. My thought is unless you want to stay a year or longer you might be better off to just jump ship now. Unfortunately the stigma of psychiatry will likely work to your advantage because I would guess many interviewers will commiserate with your not loving psych and support your transitioning back to medicine. The good news is you won't ever be one of the medical floor nurses who thinks psych is easy. :)

Good luck.

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Specializes in Neurosciences, stepdown, acute rehab, LTC.

Did you get a good rapport with the cardiac floor ? Maybe they'll let you come back ?

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Specializes in Case Management.

I wish that were an option but my manager was pretty ticked I left!

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Specializes in Psych.

Sorry to hear this. Leaving at 6 …yikes! Seems to me that the facility is not staffed appropriately/workload is not distributed efficiently. I've never worked in a state hospital before, so I am unsure if this is typical or not.

I agree. Nothing wrong with jumping ship. Apply around to other psych nursing positions in the meantime. Are there any regular hospitals with psych units in your location? Any stand alone private psych hospitals? Any hospitals with psych/med-surg units? You may still like psych, just seems that this position is not giving you a fair introduction so that you can make a true assessment as to if this speciality is a good fit.

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Specializes in Case Management.

Yeah our unit is staffed ok but then nurses will get pulled to other units because they're short staffed. Today I was charge so I actually got to leave on time because I divided the work load fairly. It's just different because in a hospital when you're assigned 6-8ppl, you only have to chart on those. Here, if you're the med nurse, you have to chart on anything that comes up on your side which has like 18 ppl so it could end up being a lot.

There are two hospitals near me with psych units and they have 12hr shifts which I prefer as well as private facilities near me. I just didn't want to apply if what I'm experiencing is the norm-Constant seclusions/cocktails and behavioral issues almost everyday.

Ive been applying to other places but unfortunately I feel it will be harder to find something with my spotty record.

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Specializes in Family Nurse Practitioner.

There are two hospitals near me with psych units and they have 12hr shifts which I prefer as well as private facilities near me. I just didn't want to apply if what I'm experiencing is the norm-Constant seclusions/cocktails and behavioral issues almost everyday.

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In my experience 4 out of 5 acute units I have worked are like you describe with high acuity and behavioral issues nearly every shift. The 5th doesn't have as many seclusions and restraints but there is a large percentage of SUD which results in other challenges for care providers. If there are any units around that don't accept involuntary patients they are usually less acute but again I'm wondering if psych just isn't your cup of tea.

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So sorry to hear this. Have you thought about transferring to another unit, the one where patients are getting ready to be discharged? I can't remember which one it is, but they go to those classes every day (East or West?). It would be better for your own career to stay at the same employer for at least a year than switch so soon. I think you should identify if what you don't like will get better as you get more experience...your documentation should get faster with time. Can you ask other nurses for tips and advice? Also, are there things on the unit that could be done to prevent situations? I used to work with Alzheimer patients and a good bit of what we did was preventing behavioral problems, but those skills are not taught at my nursing school. How about switching to the 3-11 shift until you get more experience...should be less meds. Or as JulesA said, maybe psych isn't your cup of tea? Hoping you are able to find a better situation!

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Specializes in Case Management.

I think unfortunately it just isn't my cup of tea. I've worked other shifts and have floated to other units. I truly believe my unit is the best but it just isn't for me.

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Sorry to hear that:( I don't think you have anything to lose by calling your previous manager and apologizing/explaining. What's the worst that could happen...he/she says no and it's an uncomfortable phone call?

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I have worked acute psych for awhile but have only done crisis based psych not floor work. From talking to friends who work on the floors it seems like it is the same everywhere in most things. I wish you good luck.

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Specializes in Family Nurse Practitioner.
I think unfortunately it just isn't my cup of tea. I've worked other shifts and have floated to other units. I truly believe my unit is the best but it just isn't for me.

And you know what? That is perfectly fine and kudos to you for realizing it early and considering a change. I don't think it is difficult to be a psych nurse but I do think it is difficult to be a good one and having an affinity for it is crucial imo. Best wishes with whatever specialty you pursue.

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