"Just a Psych Nurse"

[JustKeepDriving]

There are so many negative stereotypes of Psych Nurses. I remember when my first day after taking an OR job (after I had been working in psych... I just wanted to try out a different area of nursing) the nurse educator stated, "you're going to have a hard time at this because you were 'just a psych nurse' you don't really have any *real* nursing experience".

To say the least, I ended up leaving that job pretty quickly.

To my OR nurse educator... OR was the "best that nursing gets" followed shortly by ER, ICU and Med Surg. To her... psych nursing was paramount to 'babysitting' crazy people. I mean all you do is "talk" to people right?"

This was a person that had been a nurse for 25+ years and no matter how much I tried to explain to her the nature of Psychiatric nursing... she just couldn't get it.

So this is to you my sweet psychiatric nurses... don't ever let anyone make you feel like you're "just a psych nurse" or have "no real nursing skills".

• We build teams... weather you're Geropsych, Outpatient, Adolescent or Forensic... we need to create a team dynamic conducive to maintaining safety and creating a therapeutic milieu environment.
  
• We max out on critical thinking - we are in a constant game of chess between patient rights and unit safety. We not only have to think like a nurse but also like a patient - constantly inspect our unit for items that could be used for self and other harm.
  
• Adrenaline - isn't just for ER nurses! There is nothing quite like a 200+ lb psych patient charging at you with a shank. You have to think fast! How can you maximize safety and minimize staff and patient damages all while remaining therapeutic and not getting turned in for patient abuse? You've got
• Autonomy - isn't just for ICU nurses! You've got a 25 year old TBI patient showing precursors to assault. You work swing shift and there is no regular MD on at this time. This patient responds best to 100MG of Thorazine IM.... most MD's don't want to give this out. How are you going to SBAR this in such a way that you get the order you want?
  
• Nursing on the fly - You work in a psychiatric hospital that is terribly underfunded and you have to place a foley catheter and the *only* pair of sterile gloves just flaked apart because they were outdated. What do you do?
  
• Master of the manual blood pressure cuff... because you're so underfunded that the only electronic vital machine you have hasn't been calibrated since 1980 and all blood pressures come out as 200/100.
  
• Ninja of the med cart... because at some places the omnicell/pixis just is too expensive. So med cart it is.
  
• Novelist of nurse narratives and expert at CYA because every patient is ready to sue you because they're involuntary and looking for any reason to take your license.
  
• Guru of the weight room... because at many places you *are* the first line of defense... and that olanzapine makes people fat... and you are the only one standing in between your staff/another patient and certain permanent damage.
  
• Professional at the *straight face*... "So I would get drunk off of pinesol. You know.. if you just put a little bit of turd in it, you denature it and won't get sick and just drunk when you drink it!?" No laughing!
  
• Sometimes you think you might have PTSD worse than your patient's diagnosed *WITH* PTSD... (because sometimes the only choices we have available to us are two bad choices).
  
• We've been in situations where we've had to decide between our personal morals and our career... like siting on a 1:1 while the staff member next to you is getting the crud beat out of them. Do you risk your career and leave your 1:1? Or do you maintain it and watch the staff get the crud beat out of them?
  
• Heavyweight champion? Many of us have taken a hit (or more) and come back... without holding it against the patient (at least in public... the chart room is a whole different story).
  
• On the clock 24/7... There is no leaving psych. You're constantly looking at crowds, in the back of your car, or around your house for security threats after that *one* (sometimes more) patient(s) got out that threatened to find you an kill your family.
  
• The bad guy - most of your patients will never appreciate you. Don't expect patients to bring food to your unit or write your praises. You'll never get a daisy award for being the best nurses ever (because many of your patients don't *want* to get better).
  
• That one patient - that makes everything worth it. It happens... once every 400 years. You get that thank you... or see real progress, and really see how you changed someone's life for the better.... so worth it.
  
• In many places our doctors are the best. They know how to team. They appreciate us. And they teach us so much.
  
• We learn new things every day.
  
• Our sense of humor is seriously twisted and we probably won't ever be able to find a job outside of psych because at some point our inner gate just "broke" ... if we ever had one to begin with.
  
• Without us, many of our patients would have nobody.
  
• Finally... our team again. We have the BEST teamwork in nursing. We have to trust one another 200%. Even if you leave your job for a new job... you'll never truly escape your team.
  

Never let anyone feel like you're just a Psych nurse. You are *A* psych nurse. Even if you choose to leave psych and go elsewhere with your career... you will always utilize the "psych" part of your job. Nursing skills can be learned... what you learn in psych will always be invaluable to your development as a nurse.

[rnsheri]

From working as a floor nurse, I heard that about psych nursing... From all the people who said they would never go into psych nursing. Every kind of specialty has it's own good and bad qualities. Of course, I have heard the same about floor nurses from ICU, ICU from floor nurses, etc.

I loved my psych rotations, I loved the patients, but the nurses looked kind of like they hated it. Patients banged at the plexiglass at the nurses' station, demanding this med or that privilege. They sang, cursed, threw chairs, and were just mean at times. This was expected but wasn't something I wanted to do for a career. I hated the closed off station, the annoyed nurses, and the whole set-up. I wouldn't be able to be a hands on help to those people. Not behind a glass!

Facilities vary, and in my state mental health is very wanting. If you love psych, do psych! Just remember that nursing isn't all about skills. Skills are easy. I learned most of mine when I got a job and not in school. You can't teach patience, or kindness, or that rare ability to not cry after your patient calls you a c***. It's a skill! You will be fine!

[Qteapi]

There is no health without mental health....something I didn't understand until I became a nurse! psych nurses rock!

[AllieSparksRN]

Good post and I would say it doesn't apply to only psych nurses. No one is "just" a long term care nurse, for example, or "just" anything. My internship was in psych and I loved every single second of it. I cannot wait to get back there some day.

My experience with hospice taught me that a person can take 20+ mg of sublingual morphine and still be wide awake and conversational. Appropriately dosed narcotics, for example, do not freak me out. Now a laboring mom? Help! We all become masters of our craft. For some, this is psych, for others, it is something else. To each their own.

And regarding psych nurses...I've worked with some who are smarter and more experienced than seasoned nurses with other backgrounds. Never judge a book by the cover :).

[Anna S, RN]

Psych nursing is sooo hard. It freaks me out, and I can't do it.

I'll stick to dialysis. My hat is off to all the psych nurses.

[beccajean]

I wish I could triple like this!

[f1j1nurse]

As someone in corrections I hear this way to often myself. I did a brief stint in psych for awhile and loved it. I still do it per diem. There is a niche for everyone in nursing. Hats of to those of you who care for the mentally ill. My State needs more of you (us).

[smoup]

Wish I could like this more than once! Can't agree more about the teamwork and trust in coworkers.

[sjalv]

It baffles me how someone got a job as a unit educator with such an attitude. Why would anyone belittle any field of nursing? I am a CVICU nurse and many nurses would say they couldn't do what I do.. but y'know what? I couldn't do what L&D nurses do. I couldn't do what peds nurses do. I couldn't do what oncology nurses do. I couldn't do what LTC nurses do. And I sure as hell couldn't do what psych nurses do.

[RN_jess]

I was just having a conversation with a coworker tonight about geropsych nursing tonight. I agree with many of the previous posters--I could not do your job but am so thankful for people like you to take care of the mentally ill. What a great post to remind everyone that everybody has their own niches, and one is never superior than another.

[Juryizout]

Well said! Thank you!