Scared at new job in psychiatric hospital

chevyv, BSN, RN · Jan 14, 2012

I work with 22pts, 1 lpn, and normally 3 cna's. Most of the time I would love to have more staff. It is dangerous and I don't think I would stay with 18pts and only 2 psych techs. We don't have security on our unit so we have to call and cross our fingers there isn't a good game on the television and maybe they'll come quickly. I've come on after severe beatings have happened to staff and it's scary. I pass meds behind the desk, not that its much safer, but they have to get over the half door to get me and I'm hopeful I can dash out the other half door if I have too.

Never turn your back and always be aware of your surroundings. At first you'll notice those errors of 'whoa, pt is in the door and there is no way out' types of scenarios but you get the idea very quickly of making sure you don't put yourself in that type of danger. I've learned a lot over this past yr. We too have pts that prisons can't handle and it seems strange that they end up by me. I work on a LTC unit with pts in the age ranges of 20-70's. You get to know them, but most you can never really know so please be careful.

Five&Two Will Do · Jan 14, 2012

I worked as a mental health tech when I was a CNA. The unit was not as bad as what you describe, but we always had more staff than that. It sounds very unsafe and I would go ahead and look for another job citing staff/patient ratios as my reason for seeking other employment. Do youi have to go around and give meds or is there a window they come to? Either way I would certainly make good friends with the techs and talk to them about how you feel. They may help protect you. What does your NM say?

GypseyGirl · Jan 14, 2012

The patients come to the counter to get their medication. The nurse's station or med cart can be somewhat of a barrier, but we have to pass the main area where the patients wander around just to go to the bathroom. I heard the jail is a lot safer because there are correctional officers always with the patients and they also have weapons. The mental health techs are even worse off than the nurses because they are supposed to be the first line of defense. Lots of risk for only $13 an hour. I am hoping to find something else. I want somewhere I can get good experience as a new grad, but it's just hard to get in somewhere. Not sure if I'm getting the best experience at the psych hospital- at least passing meds, it is. But I'm just concerned for safety.

Five&Two Will Do · Jan 14, 2012

It is terrible that the job market is so competitive right now. I would say that if you start in a specialty like psych or L&D taht you can become trapped in that field due to lack of experience in other places. That is why they always say start in general med surg nursing. Good luck and I am sorry that you are scared at work. That must feel terrible.

RN_2012, BSN, RN · Jan 14, 2012

Do they not have a week or longer training on holds and other self defense techniques that are safe for you and the patient? I worked in a pediatric boys home as a PRN aid and we had intensive training in that area.

GypseyGirl · Jan 14, 2012

We did a 3 or 4 hour CPART self defense training class and verbal de-escalation training. But I still don't feel like it is enough. Five & Two, I'm honestly not sure med surge nursing is for me either, and it's really hard to get into new grad programs. I know it's good to get the med surge training so you have experience, but I always felt totally overwhelmed in the hospital. I worked in home health as an LVN and loved that. I picture myself more in doctor's office or something a little slower paced where I can interact more with clients and not feel so rushed. I also was interested in hospice case management- I have heard it's very emotional sometimes, but that it's very fulfilling to be able to help the families. And also, in the hospital, I'm always scared of killing patients, but with hospice, it's more about making them comfortable. Thanks for the advice. I hope to find something else!

Multicollinearity, BSN, RN · Jan 14, 2012

GypseyGirl,

I'm so sorry you are going through this. The environment does not sound safe. I've read so many articles about the dangers of state psychiatric facilities - it sounds terrifying. And I work in a medium/maximum security prison, walking amongst convicted murderers. The difference is I have security, and there's no pretense about not offending the patients related to security matters. Security is first.

I wouldn't worry about getting med/surg experience if you don't want it. We are transitioning to a new era in nursing where more of the jobs new grads get are ambulatory/community health-based. The market is shifting away from all new nurses starting their careers in acute care because acute care employment is dwindling while opportunities are available outside of hospitals.

I have said before that I'd waitress at Denny's before I'd work in a state psychiatric facility. It's not because I don't have respect for the work; I do. It's that the patients are the most dangerous you'll find, and safety for staff seems lacking and staff assaults are frequent in so many state hospitals. Usually new grads are encouraged to stick things out. This is one instance where I'd encourage you to bail. State hospital psych patients are the most dangerous society has to offer - not something I'd want to encounter as a new grad and with the state cutting budgets and skimping on staff safety.

CapeCodMermaid, RN · Jan 14, 2012

You're an RN and you're paid $13/hr???? Horrible. The grocery store shelf stock people make more than that around here.

Multicollinearity, BSN, RN · Jan 14, 2012

I think she said the psych techs are paid $13 per hour.

GypseyGirl · Jan 14, 2012

Thanks Multi for understanding. I feel like I'm letting my family down to leave this job- they keep telling me the economy is bad and that there aren't jobs. I don't want to feel like a quitter, but I also want to feel safe. I do enjoy certain aspects of psych- more dealing with depression and more mild disorders. The things I see in the psych hospital are pretty extreme. One patient told me the other day that she was a hannibal and that she would find me and eat my face when she left the hospital. Maybe I should not take those type of comments too seriously, but it's still scary and there's just a hostility with a lot of the patients against staff because they don't want to be there. I will keep applying for other jobs, just trying to make a bit of money. But it is stressing me out- I've gained 8 lbs since I started there a month ago and haven't been sleeping well.

Yes, the psych techs make $13 an hour and RN's make $21 an hour. Doesn't seem like enough money to put your life in danger! I'm not sure about working at Denny's, but I'd rather be a nanny or work in an office answering phones than to deal with all this. Thanks for the support. I'm trying to decide what to do. Sucks to be a new grad, but I will try to keep my spirits up!

Multicollinearity, BSN, RN · Jan 14, 2012

Thanks Multi for understanding. I feel like I'm letting my family down to leave this job- they keep telling me the economy is bad and that there aren't jobs. I don't want to feel like a quitter, but I also want to feel safe. I do enjoy certain aspects of psych- more dealing with depression and more mild disorders. The things I see in the psych hospital are pretty extreme. One patient told me the other day that she was a hannibal and that she would find me and eat my face when she left the hospital. Maybe I should not take those type of comments too seriously, but it's still scary and there's just a hostility with a lot of the patients against staff because they don't want to be there. I will keep applying for other jobs, just trying to make a bit of money. But it is stressing me out- I've gained 8 lbs since I started there a month ago and haven't been sleeping well.
Yes, the psych techs make $13 an hour and RN's make $21 an hour. Doesn't seem like enough money to put your life in danger! I'm not sure about working at Denny's, but I'd rather be a nanny or work in an office answering phones than to deal with all this. Thanks for the support. I'm trying to decide what to do. Sucks to be a new grad, but I will try to keep my spirits up!

The things you see in a state psych hospital are among the most extreme a nurse will see. You have a right to feel safe and be basically safe. Most people have no idea how unsafe state psychiatric hospitals can be (many of them). You bet I understand.

I work with very dangerous inmates. Murderers. Multi-murderers, etc. Some are the highest custody level there is. You know who scares me the most? The ones who have just come from the state psychiatric hospital. Some of them scare me even when I have an officer standing right next to me. And when they are psychotic and violent - it's too much if you don't have proper security in place. Even then there are risks.

I wonder if it might help with your family to search google for news articles about safety risks and staff assaults in state psych hospitals?