Registered Nurse VS Psychiatric RN


I have been working at an acute men's inpatient facility for about 8 months. I started and ended nursing school wanting to go into psych nursing. I like the idea of helping people in a different way, talking them through things, helping them cope. I grew up wanting to do something like counseling, mental health counseling, but there isn't much money in it unless you own your own business, so I went into nursing.

I must say, there' s a MAJOR different in a nurse working in a psychiatric unit of a hospital and a psychiatric nurse. And to a psychiatric nurse, it's very aggravating.

Most people just think nurses come in and pass meds. They all say we aren't "real" nurses b/c we do not do normal nursing skills. Well we are suppose to use a different set of skills. Communication skills, therapeutic skills, patience, understanding, and empathy. Unfortunately, you can tell the difference between the nureses. You can tell the nurses here b/c they need a job or b/c of the extra money, and you can tell the psychiatric nurses, the nurses who love every aspect of their job, who love being in that environment. It shows, it shows in their time spent out with the patient, the quality time, the communication, the tone, the body language, in the attitude portrayed to the patients.

Nurses are suppose to treat the diagnosis. Oncology nurses, they have to be strong, be willing to deal with a high percentage of their patients pass away, neuro nurses have to be used to not understanding a lot of their patients b/c of their deficits from a stroke or something, psych nurses have to be willing to spend one on one time with patients, be willing to listen and help that depressed patient, that patient who may be a little needy and just want to talk b/c he has no one else in the world and lives in the streets. That's what makes us special, that's what we do. They don't need their IV checked, they don't need their chest tube checked, or a neuro test, they need to talk.

Let me tell you, those nurses who come in, give 0800 meds, then sit in the nurses station, do their nursing notes, do their charting, and give PRN's after the patients have asked 100 times and the nurse has talked about the patient being needy or drug seeking, who have no empathy for a patient who lives on the streets, or a patient who tried committing suicide after his wife passed away or is tired of living on the streets with no food. What skills are they using? These patients are here b/c they are sad, depressed, they did something to hurt themselves... There's a reason for that.. Why don't you try and help them through that, be compassionate. Instead they sit in the nurses station and act like the patients are bothering them when they ask for something. Or the nurse thinks their only job is meds and nursing notes. Anything else the tech can do.

Please, if you don't enjoy the essence of psych, dont be a psych nurse, don't be a psych tech, a psych anything. Go to a nursing home, go do home care somewhere. Go to the floor. Just don't do psych. There patients need compassionate and empathetic nurses, nurses who don't blow them off. Who don't make them feel worthless or unimportant.

Our patients are special, and it takes a special person to work with them. Please think of that before being a psych nurse.

*** This does not necessarily work with all patients, psychotic, delusional, paranoid patients, violent patients, they will not respond to any nurse until they are on their meds.. I am talking about he sad, depressed, suicidal patients which is a good majority of psych patients.


A psychiatric RN


177 Posts

Has 2 years experience.

I love this post!!

I've always been interested in psych & mental disorders. I just graduated nursing school in May & got into a psych facility and just recently started my floor orientation on a long-term inpatient unit. Learning the paperwork & charting is overwhelming, so I haven't had much time to spend with the patients. But when I do get a chance, I'm out there with them. Some won't talk to me since I'm new & they don't know me, but I always say hello & ask how they're doing, trying to build rapport. I can't wait for the day I finally have a handle on my charting & paperwork so I can spend more time out there with them on the unit!

There were a few people in my orientation class that just graduated & took the job because it was the only offer they've gotten. You can tell when you talk to them that they look down on the patients or they feel like they're "not a real nurse" and are just in it to get their time in til they can get that hospital job they want. It's so sad. Out of any place a Nurse can work, psych is the one that needs to have the nurses who want to be there! These patients need a caring person, someone who will take the time to talk to them or just listen to them!

Specializes in NICU. Has 10 years experience.

Amen, I wish there were more nurses like you and I like out there. Our patients really need it. I hear so many compliments from patients I never even had about how nice I am and how I took time to talk to them, even when their nurse wouldn't. A lot of times, I know more about what the patient is actually going through then their own nurse. It's sad, cause a lot of the people wouldn't be "frequent flyers" if we took time to know our patients and fix the problem or help them cope with their life outside of the hospital. Instead we just feed them meds and let the therapist talk to them for 15 minutes a day, they see the psychiatrist to tweak their meds, and then they attend groups that are not individualized so I don't believe it helps as much as people think... Got to run to work. Good luck to you and hang in there, the paperwork will be nothing once you get the hang of it :)

TerpGal02, ASN

540 Posts

Specializes in Psych. Has 11 years experience.

I wish I had more 1:1 time with my patients. That's why I went into psych nursing. I was always more interested in the psychosocial/therapeutic communication aspect of nursing. I always knew I wanted to do psych and I do not regret it in the least going right into it. You have to be able to see these patients as human beings, which many nurses are unable to do. The skills you learn in psych are invaluable. You can brush up on your skills like inserting a Foley or giving an IV push med. The time management, the communication skills, are not as easy to come by. Anyone who says we aren't real nurses has no idea. We are often left managing medical issues we don't really have the capability to handle, ado itnd as a result have to come up with creative solutions with minimal resources. The nurses who just sit at the nurses station have no business in psych IMO. If Im not busy doing 50 thousand admits or discharges, Im on the units, getting to know the patients and helping out the techs when needed. I got to go on a walk just 1:1 with a patient who just needed some fresh air to soothe her anxiety. I love doing things like that, and there are nurses who wouldn't be willing to do it.

The next time someone tells you you aren't a real nurse, tell them that psych patients are everywhere.

AMEN!!! as a newer nurse, I see many of my seasoned co-workers think its okay to just give meds and chart.. Sit at the nursing station reading, or internet surfing... ahhh, gets on my nerves!! I love being on the floor with the techs who KNOW the patients...

Hi There,

I am really sorry that you are experiencing this, that is terrible. I am an R.N I work in psych as well, and yes I have heard that before, but I have also heard " I don't know how you guys do it, God bless you"

I work in Toronto Canada, and in Canada we don't designate psychiatry, ICU,ER,Medical,or anything as a specialty, we are all treated the same, and make the same pay across the board. There are 10 levels of pay rate, the top being 43$ per hour.

The nurses that are saying those terrible nasty things, maybe should give there ego a check. It sounds like they went into nursing not to help people, but for there self, and to have the title of RN beside there name. Just ignore them and keep up the great work you do for your patients! All the best!!!

chevyv, BSN, RN

1,679 Posts

Specializes in Acute Mental Health. Has 15 years experience.

I've been a psych nurse for just over three years and although it is challenging, I love love love it! I too have heard the "I don't know how you do it!" from other nurses and people. I could easily say the same thing to a med surge nurse because I just feel I am not that. My place is downsizing and eventually closing but I've been looking to remain in this field.

I would love to see more nurses get the hang of therapeutic communication. Oh and also to quiet the ones who believe everyone is 'faking it'.


25 Posts

Specializes in ER, CEN.

Well before I became a RN I I was a mental health tech on a acute psych and psych nurses they don't do anything but pass meds and give PRN they make techs do all the work all they do is tell the patients to get away from the nurses station I'm trying to chart.


177 Posts

Has 2 years experience.

Caleb_RN225, sounds like you worked with some crappy nurses who shouldn't be in psych IMO.

In their defense though, the amount of charting I do daily as a RN at my psych job is completely insane (no pun intended!) But I always find time to sit and talk with my patients, get to know them, and try to help my techs if I can. Even if all I can do is take over their 15 minute check rounds for awhile so they can go make a phone call or deal with a patient who responds well to them, I'm there for my techs. I think it's like any job, you're going to have those people who do the least amount of work possible & you'll have the ones who go over the top to help everyone out.

There are days I work much as a MHW,doing checks,doing 1-1 etc, I find it can be useful to see up close what is going on. Just sitting watching a patient can tell you much of who a patient is. I did a 1-1 on a patient a few months ago,other than telling her who I was we did not talk. Yet watching the way she moved,how she held her feet, told me much.


24 Posts

Specializes in PACU. Has 25 years experience.

Every area of nursing has wonderful, empathetic nurses, and unfortunately, every area has nurses who will do as little as possible. We are all "real nurses," no matter what areas we work in. I have been a PACU nurse for many years. I am interested in what other specialties do. That is why I am on this thread. Every human being has something emotional or "mental" that we have to cope with. Nurses in all areas should compassionately deal with these issues. People waking up from surgery can be frightened or depressed. What I am trying to say is, don't let anyone, ever, tell you that you are not "a real nurse." Dealing with someone who is sick, & dealing with them compassionately, is what nursing is all about.


1 Post

Wow... apparently you haven't worked in a nursing home to look down on it in such a way... just try and remember, what happens to your residents when they move beyond your level of care? They become my residents, and to a greater degree, needing more care... give up your God-like presence, you are not the best and only nurse out there pouring out their heart and soul for those who need more than just "pill passing"... widen your scope of awareness...