"real" role of pysch nurses

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Hello,

My name is Amy and I am new here. I graduated nursing school last year. Before graduating I wasn't sure what area of nursing to go into. I have a real passion for psych. I have an AD in criminal justice because I wanted to work with juveniles which never panned out for me. I also liked critical care. My psych instructor was real encouraging saying she thought I had the ability to be good at psych nursing. She also said if that is what I wanted to do then go straight for it, skip that year of med-surg. Well being that I wasn't sure, I ended up in med-surg. After almost a year, I feel like I am getting burned out. I really struggle with the fact that because of the patient ratios and general job duties I can't provide the care I want to give or would even want my family to recieve. It honestly makes me ill. I am thinking more and more of heading into psych. But I don't feel I am really aware of what all goes into psych nursing. For my psych rotation we concentrated on the "communication" aspect of everything. We didn't pass meds, etc. I am just concerned that I am blind to what it is really all about. I know my passion isn't med-surg. If anyone could give me a run down of their resposibilities and how their day goes it would be greatly appreciated.

Thanks

Amy

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Amy.....Hospital psych is alot of depression, mania, bi-polar and schizo's. You know how it goes, besides passing meds( if your the nurse passing them that day) its alot about having conversation, documenting behaviors and meetings. I know a few nurses who went into homecare nursing, then once they worked a while and got to learn all the paperwork, they learned the psych paperwork, and got a certification in it. You have alot of choices. I know what med surg can do to you. I also burned out in it, its a great place to learn though. You see just about everything. Good luck to you :)

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There are MANY areas & types of psych units, clinics, home care, etc. in psych that you could consider going into. If you don't feel up to jumping into locked unit right from the start & prefer a less volatile area then perhaps an open unit or clinic position would better suit. You will have more opportunity to run groups & do 1:1 communication in these areas. Home health nurses do community mental health, it is also another interesting area, as you have much autonomy in this situation. You could work Geri-psych, Child Psych, Adolescent Psych, Adult Psych, Forensic Psych, the list goes on. I guess you would have to apply some places & see what they have avaliable. The meds of course are different but you will become familiar with them as you go about working, you will be passing many of them all the time. The paperwork & assessments are different but again as you become familiar with the routine, meanings of the terminology & the differing questions & focus of the assessments you will find it comes rather easily. There is of course shortage of staff where ever one goes nowdays. The amount of paperwork & work load is steadily increasing. I don't much like that aspect as it takes time away from my actually working with my patients but what can one do? I have been in Psych for 15 years now & still enjoy it most days ;)

Whatever you decide, I wish you the best.

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It all depends on the psychiatric facility. I use to work at the state psych hospital many years ago. It seemed all I did was break up fights and give shots to psych patients who became agitated when they were treated like dirt by staff. When people asked me what I did for a living I always said "I'm a bouncer at the state psych hospital." :stone

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When people asked me what I did for a living I always said "I'm a bouncer at the state psych hospital." :stone

:rolleyes: LOL...these days with all the 'open visiting' I can relate. 'Visitors behaving badly'...with the nurse as bouncer and referee... :uhoh3:

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I thought I would toss in my 2 cents too. I just recently accepted a new position in child psych and won't start for a couple of weeks, but it is my dream and I'm looking forward to it. My new job is inpatient, but I'll only have 4-5 kids assigned to me each day and I think that ratio is pretty good. My current job that I'm leaving is also psych, but adult residential, where I oversee 30 residents medical and psychiatric care. It does not allow me the time I want to spend with each one, but it's a good job and I've liked it a lot and am only leaving to work with kids instead. I've been able to keep up a lot of the medical skills because many have medical problems and they are getting older too. A typical day does allow me to really sit down with someone in crisis and put other things on hold, my schedule is very flexible, and in fact I'm salaried so it gets done when I get it done. Anyway, find out about the options in your area, you never know what you will find. There are quite a few opportunities here and I don't consider the Midwest to be very intuitive to the mentally ill. Hope this helps, good luck!

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Hello Still searching,

I get mad when I hear yet another potential psych nurse has been told to do a years me/surg by university lecturers to get that 'vital' experience just incase you dont like psych, I always counter with "in that case why don't you advise all nurses planning to do med/surg to do a years psych" 'just in case'.. sheeesh. It is a thinly veiled predjudice against psych that prompts this rubbish, there are nursing shortages everywhere, if you'd done psych straight up I guarantee you'd have still got into med/surg should you have chosen that.

As TitaniaSidhe and Honu0612 sadi there are many different areas of psych, not only that but the facilities themselves vary in practice and what they offer staff in the way of support etc. So make sure whatever you choose to do you do your research, ask to look at each of the facilities etc. speak to the staff on the ward, not necessarily the managers.

Of course I'm biased, but I find Mental Health the most challenging and fullfilling thing I have done in my life, through psychological and psychiatric intervention I can watch and contribute to a persons recovery to independent living. This is very rewarding, and often helps to overcome the other shortfalls in the job.

regards StuPer

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Working first in med/surg and cardiac units has helped tremendously in my work on the psych unit. How many times do anxious patients report chest pain, not to mention all the somatic complaints, and the medical emergencies? My medical background has been extremely helpful in assessing patients' medical conditions.

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Don't misunderstand me, I do feel medical skills are invaluable in the Psych realm as we can & do often times have medical emergencies where you WILL put those skills you have to use. Mind, if you don't have them you can always find ways to obtain them through education. I am seeking advanced life support training b/c of the need I am seeing at my facillity for more skills as our medical emergency situations increase. I draw blood & do many other funcions which many of the nurses I work with can't, are not trained to, or won't do. I really don't like to be pulled frequently out of my speciality to medical units but can & will go in order to maintain my medical skills. It gives me the chance to practice the medical tasks I might not normally get to do as often. Of course it goes witout saying if I come upon something unfamiliar I ask for help. Mind you this is just for me.

Any way you look at it, any experience be it medical or psych is valuable. We always have opportunity to better our knowledge base through education if we choose to do so...

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In my experience, some time working Med/Surg right after graduation was invaluable in fixing many of the things I learned in my memory. Things like lab values, common medical meds, common medical conditions, etc. There are certain categories of information common to all areas of nursing, and working Med/Surg requires dealing with them on a daily basis.

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Hello nursethis,

I have no arguement with the value of learning much of the things that you mention, maybe things are different in the US, but where I come from in the UK and where I live in Australia, much of what you say is taught as part of a nurses training, so many graduates are familiar with these things anyway. Secondly as part of any psych nurses on-going training and experience they will come across clients with co-morbid physical ailments, in-service training can help with this sometimes. But a lot of the time, its simply a question of learning on the coat-tails of much more experienced nurses.

Lastly I would again argue, if it is a requirement of psych nurses to be more aware of the physical needs of clients, then surely the reverse holds true, isnt it incumbent on nurses working in general wards to be more aware of the needs and effective treatment of people with a co-morbid psych diagnosis?.. How many generalist nurses do you know who hold an active interest in mental health awareness?. The fact is that mental illness/distress is the most likely co-morbid clinical feature of any presentation of physical illness/disease. Depression alone is expected to to be the second biggest health burden in the world after coronary heart disease by the year 2020 (WHO), never mind any other mental health presentation.

regards StuPer

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There are MANY areas & types of psych units, clinics, home care, etc. in psych that you could consider going into. If you don't feel up to jumping into locked unit right from the start & prefer a less volatile area then perhaps an open unit or clinic position would better suit. You will have more opportunity to run groups & do 1:1 communication in these areas. Home health nurses do community mental health, it is also another interesting area, as you have much autonomy in this situation. You could work Geri-psych, Child Psych, Adolescent Psych, Adult Psych, Forensic Psych, the list goes on. I guess you would have to apply some places & see what they have avaliable. The meds of course are different but you will become familiar with them as you go about working, you will be passing many of them all the time. The paperwork & assessments are different but again as you become familiar with the routine, meanings of the terminology & the differing questions & focus of the assessments you will find it comes rather easily. There is of course shortage of staff where ever one goes nowdays. The amount of paperwork & work load is steadily increasing. I don't much like that aspect as it takes time away from my actually working with my patients but what can one do? I have been in Psych for 15 years now & still enjoy it most days ;)

I appreciated reading your post and thought you may be able to offer some advice to a new nurse going into psych. I like the former post loved psych and have sought a position on a closed unit in a hospital setting. It is a 45 bed unit with 2 RN's on the 4-12 shift and 2 behavioral assistants. The 4-12 shift takes on all admissions & discharges. This means each RN has 2-4 admits and who knows how many discharges as well as meds & documentation for 22 patients. Am I kiddidng myself or is this what to expect these days. I guess what I'm asking is once I am oriented and given some training (new grad) can this patient load be performed with the appropriate attention given to all areas?

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