What is the expectation for a psych nurse?

Long Term Care Columnist / Guide · Nov 22, 2017

Congratulations on your new job! I hope you will find it enjoyable.

Now, I can only say this from a patient's point of view, but YES, a good psych nurse can make a difference in one's life. During my stay in a psych ward three years ago, I had a couple of incredible nurses who helped me a great deal at what was one of the scariest times of my life. While I would never advocate self-disclosure on the part of a nurse, one of them sat down with me and told me she had suffered from depression during a particularly stressful time in her own life; she was very empathetic and it helped me to know I wasn't alone. Another nurse taught me breathing techniques to use whenever I became anxious or over-amped, and we had some great philosophical discussions in the later evenings when most of the other patients had gone to bed. He treated me like an intelligent adult human being, and believe me, when one is a patient in a locked psychiatric unit that means a lot!

Bear in mind that you may never know what sort of impact you may have on a patient. We're notoriously negative and often seem ungrateful, but you will have a positive influence on many even though they may not realize it at the time. I don't think hospitals send out surveys to psych patients very often, so I imagine you won't get a lot of recognition for your good work. But take heart: with your willingness to help people at one of the most vulnerable times of their lives, you *will* make a difference.

pixierose, BSN, RN · Nov 23, 2017

I've had patients and their families write notes to my NM and/or other members of their treatment team (physician, SW) stating that I helped in some way. It's really nice to hear (although not necessary, it's certainly heartwarming), so yes, we can make a difference. The hospital does send out surveys, but it's usually those who were pretty disappointed/angry who filled them out (which can be disheartening).

I'm more often than not in the milieu than behind a desk. And it depends on the patient, truly. But after checking in with my patients, I'm often out there sitting with patients, even if they're not my own. Playing cards, just plain ol engaging in conversation ...

But you definitely have your tasks you'll need to complete as well. Meds do get passed. Various nursing tasks (EKG's, bladder scans, running IV infusions at a certain scheduled time, changing wound dressings, etc) and the never ending flowsheets and documentation do need to be completed so you won't look as readily available (depending on the unit).

I think with any nursing specialty, there are days where you'll feel you made a difference and days where you feel you barely made a dent.

TriciaJ, RN · Nov 24, 2017

Since psychiatry is not generally as task-oriented as other areas of nursing, it's easier to spend time doing nothing. Sometimes it only looks like nothing to the casual observer; sometimes it's nothing. You will find some of your coworkers might have gotten lackadaisical; psych doesn't weed out these people as easily as other areas. So try not to get complacent yourself. Be a presence in the milieu; you can nip a lot of chaos in the bud that way.

You will develop good listening skills. As a newbie, you will be a target for manipulation. Beware anyone who tells you "I'd never tell this to anyone else." or "You're the only one who has ever listened to me". Any time a patient is comparing you favourably to others, there is probably a game afoot.

Resist the urge to solve someone's problems for him. A lot of people will dump their sad stories in your lap and you will want to help "fix things". But you really want to support their wellness, not their illness. Start thinking of your patients (if you don't already) as functional people who need a little help and encouragement to empower themselves. Not broken people who need fixing. This will be challenging. Some see themselves as broken and will see you as unhelpful if you're not willing to "fix" them.

It's a balancing act to provide people with nurturing yet encourage autonomy. Some people are coping with illnesses so severe that complete autonomy will always be a long shot. Find some seasoned coworkers to be role models; expect to feel out of your depth for a while, and never stop learning.

Congratulations on your new position.

GeminiNurse29 · Dec 1, 2017

Some days will be really difficult. I feel that mental health is one of the hardest fields because you aren't always able to "fix" someone.

The previous post covered it well. I just have to add, don't take things personally. And always remember, safety first!