Recollections from 25 years of psychiatric nursing

allnurses Guide · Jul 11, 2012

...And it's fascinating.

Most of my instructors and classmates looked at me like I had two heads when I said I wanted to work in psych... and geriatrics, at that.

I could never work a medical floor.

I like Psych!

Kat_everdeen · Jul 11, 2012

Wow, I would LOVE to be a psych nurse. I can't believe it's something that new nurses would not want to do. My long term goal would be to be a psych NP. To each their own I guess.

Simply Complicated · Jul 11, 2012

I made the switch to psych almost two years ago, after five years of medical nursing. I'd always been interested in psych, but wasn't sure I was ready to make the jump. So glad I did, I love it!I agree, it's a very misunderstood specialty at times. Many of our staff have worked there for 20+ years as well.

Cali_Nurse_209 · Jul 11, 2012

I start nursing school next month and I had a few ideas on what kind of nurse I wanted to be. I'm a CNA and I've been working in a psych facility for over a year now and working there and seeing what the psych nurses do has really sparked my interest in psych nursing. I've started thinking about maybe working as a nurse in a psych facility or prison, but my fiancé and family don't like the idea of a prison. I figure once I start nursing school next month and explore the specialties I'll figure out what I actually want to go into.

mathis1965 · Jul 11, 2012

I recently changed paths and have become a psych nurse. I find that it is very sad because so many of the patients are there against their will. It saddens me that patients are treated like criminals. On the other side of the coin, I have been a nurse since 1986 and this is the main department that I have felt threatened. I have also been hit and cussed for every name in the book.

These patients are set up to fail and I want to help but do not know how. Any suggestions?

mathis1965 · Jul 11, 2012

I want to wish you luck in your studies and career.

Brekka, ADN, RN · Jul 11, 2012

...And it's fascinating.Most of my instructors and classmates looked at me like I had two heads when I said I wanted to work in psych... and geriatrics, at that.I could never work a medical floor.I like Psych!

You sound a lot like me. I was the ONLY one out of 80+ that wanted to work in geriatrics/psych. One changed her mind toward the fourth semester. I hated floor nursing, and could never imagine myself enjoying working there.

Long Term Care Columnist / Guide · Jul 11, 2012

As of this month I'll have been a nurse for 25 years, almost all of which have been on the same psychiatric unit. It's not just me, most of my co workers have been there almost as long, and many longer. We are fortunate to be a close group that works well together.
We were discussing this today. Psychiatry is not considered "cutting edge" and not a field new nurses want to get into. I don't think many truly understand what it's like. I know my family and friends still don't quite "get" what I do or even why.
That sheltered, naive 21 year old girl has seen and experienced the worst of people. So much pain, sadness, anger, violence, suffering, poverty, addictions,... I have also seen the best of people. Enduring strength, hope, love, resilience, patience, gratitude, faith...
I have been challenged and blessed in more ways than I can count throughout these years. Have even experienced, at various times, what many patients do. Major depression, anxiety, chronic insomnia, even assault, PTSD and chronic pain. Certainly brought about growth in empathy and humility, which helped me to be a better nurse.
There are many who have crossed my path that I will never forget. I remember most with fondness, even a few with fear; but they have all played their part in my growth.
I am so grateful to have a job I love, with terrific co workers, at a hospital I'm proud to be a part of!

Bless you for your caring and concern. :heartbeat Psych patients need and deserve good nurses just as much as everyone else, and maybe even more because of the pain and distress their illnesses have caused them.

Back when I was going through nursing school, I got to sit in on a drumming group session during my psych rotation. I will NEVER forget how powerful those primal rhythms were and what great music we made, even though it was totally impromptu and the only rule was not to swat your neighbor in the head with your sticks. When I left the facility that afternoon, I knew I'd never felt more relaxed in my adult life......and all it was, was ten or twelve patients with a variety of diagnoses, sitting on the floor with eyes half-shut and making music together as one.

I didn't choose psych nursing for many reasons, although I've certainly seen my share of mentally ill and demented patients in long-term care. However, I have great admiration for those who do this work, and believe me, if I ever need to go inpatient I hope I get a nurse like you. :hug:

ctmed · Jul 11, 2012

Psych is not all that bad. At least you have all the proper tools to deal with things on a good psych unit as opposed to a hospital floor or worse, a nursing home. If I were going RN instead of OTA, I would choose this. You can limit family, you can be firmer (not abusive- there is a difference!) with patients for thier own safety and good, and if you are on adult psych you have much less poop. Also, these horror tales of folks getting beat up or raped by patients is an extreme rarity, not the norm and mostly only happens in state lockdowns.

My only deal is that sadly, they cut mental health. I have watched over as a CNA 1:1s in an emergency room where someone was stuck in ER for weeks waiting on an open bed! The ER nurses had to keep this guy doped up that whole week. It must be something to have thoughts and voices about wanting to kill ones self. But my, stuck in the ER for a week where all they are doing is holding you before you can get help?

arelle68 · Jul 11, 2012

I recently changed paths and have become a psych nurse. I find that it is very sad because so many of the patients are there against their will. It saddens me that patients are treated like criminals. On the other side of the coin, I have been a nurse since 1986 and this is the main department that I have felt threatened. I have also been hit and cussed for every name in the book.
These patients are set up to fail and I want to help but do not know how. Any suggestions?

This is not the way it is supposed to be! If it is as you say, patients treated like criminals, you feeling threatened, and actually being hit, then things are not being done the right way. Where I work, there is enough staff support to keep other staff and patients safe. Patients are not to be treated like criminals! That is outrageous! If my environment were like yours, I would want to change it too.

How to change it: Staff education:Respectful Workplace, Non-violent Crisis Intervention, De-escalation Techniques. It will take a while to get attitudes readjusted. Just know in the meantime that you are the one who is right about how patients should be treated. You be the first to make the changes by treating everyone with respect.

You feel threatened because patients are out of control. They are no doubt upset about being treated like criminals. A lot of the irritable edge will resolve when that changes. There are still dangers involved in working with patients who are actively psychotic, or just antisocial. That is why you need staff who are trained in non violent crisis intervention who also know how to take a patient down if they have to without anyone getting hurt. You also have to have plenty of staff available and/or law enforcement standing by. Sometimes when you have to enforce a Treatment Override, you just have to wait until the next shift comes on, and then use the extra staff to get it done.

I am sorry that your foray into psych nursing is going like this for you, but there is a better way to do things, and you are right to be concerned about what is going on around you now.

Imarisk2 · Jul 11, 2012

I have more than 19 years to go to catch up with you. I've loved the nearly 6 years in psych nursing so far. I knew I "belonged" when I started on a floor with super-experienced psych RN's and techs, and they took me under their collective wing. They taught me what I needed to know to love my patients, my work, and be a successful team player. Maybe one of them was you! In any case, thank you for paving the way, and braving the many changes that psych nursing has seen. Thank you for sharing your knowledge and experiences with those of us who join your team. As you know, we can't keep our patients safe if we don't work together to create the safety first. Thank you for leading the way.....