Scared at new job in psychiatric hospital

chevyv, BSN, RN · Jan 17, 2012

doggal, Can you tell us what NIOSH is?

Merlyn · Jan 17, 2012

I have worked at state psychiatric facilities in the late 1970's and late 1980's but not since. I have,however,worked as a consultant (RN,Psychologist,dually licensed) on TBI units, where violence can escalate quickly. With that said, generally the patients are more physically ill so the picture is different. I interviewed for a position recently at a state psych hospital that boasted of a no restraint policy, etc etc, -yet there have been many injuries. Certainly none of us want undue restraints, but there need to be consequences.
Until that happens, we as workers need to be in the face of NIOSH and others responsible for our safety. Do not do this alone-do it with your co-workers. But as a new nurse, go to your interview, I would say- and be brief re the safety concerns and clearly note to them that this is a state psychiatric inpt facility.

No restraint policy. Isn't that special. I think it's time for the administration to have that old check up from the neck up. The problem is that the people that run the place don't have their office chairs attack them. They have no concept what it is like working on the floors. They live in Never-Never Land. Where every day Tinker Bell spreads her pixie dust over them and they can fly. But back on the floors the workers are trying to survive the shift.

They only time Peter Pan and Wendy,and Capt. Hook come back to this world is when someone gets hurt and the workers says the magical words,"Lawyer, Commissioner of Health, and politician. That's how the hospital where I worked dropped their 'No restraint policy'. A relative of a federal congressman got hurt. He came down one, bright day. He inquired as to the mental state of the administrator. I think he said" What are you nuts? I want that policy dropped now." and it was gone, along with Tinker Bell.

GypseyGirl · Jan 17, 2012

They teach us to use verbal de-escalation when patients start getting riled up, but I agree that that doesn't always work. Luckily, the facility I'm at does use restraints when necessary. They also do the B52 injections in the butt, and usually at least a few staff is there to hold down the patient. At times, I've seen this agitate the patient even more. It's a difficult situation.

vikkirn · Jan 18, 2012

I so feel you. I went back to s state psych job that I quit over 10 years ago. Times ruff I had been out of nursing so no one want'ed to hire me. Well it's kinda like a time warp but more dangerous. The new model is talk talk talk till you turn blue. On the other hand I really love my job I work with the kids yes they are mega sick but they are awesome in thier own right. Never a dull moment but it's the STAFF i work with that sucks. Reason I quit first time prob the reason I quit again. They just bring people off the street it seems to have a body quota. They not nice people even sups suck and not to be judgemental they are all huge and sit around all day eating and talking and texting on their phones both be no no's. When you question them or reprimand they go psycho. They are wayy more problems I think then the actual patients. It's to bad cause I really love my job. Anyway thanks for listening and yes I need a new job too.

chevyv, BSN, RN · Jan 18, 2012

vikkirn, you are so right in your description!

I too love my job but I almost wanted to respond right away to not worry so much about the pts, but worry about the staff, lol! My supervisor had a melt down yelling and screaming the other night because I had the audacity to report a staff member telling me that another staff member had abused a pt. There are so many of my coworkers texting, doing cross word puzzles, etc instead of caring for the pts. When I can't find anyone, I know to check the kitchen because I will find at least one person eating while talking on their phone...and no it's not their lunch break. I come in, do my job, and clock out. My main objective is that I'm safe, pts remain safe, and the coworkers too. It's hard work, but I'd rather have my unit than be running ragged on a med surg unit! Most of the time :)

GypseyGirl · Jan 19, 2012

Hmm, maybe the staff starts to turn like the patients after awhile? Just kidding! :) I started on the swing shift now and it is a lot more quiet, which is better. Some patients still act out, but I haven't seen anything too crazy over the last couple of days. I have a new preceptor, who is very nice and nurturing so it has definitely been better since they paired me up with her because I don't feel stupid to ask questions. But when I told her today how much I made, she was disgusted and told me I really should look for another job. Lol

stella2blue · Jan 30, 2012

Thanks for sharing your insight, I agree the patients are very dangerous and safety is an issue because staffing is horrible. I've been in orientation at state psych hospital for 5 weeks now. I am apprehensive and have been contemplating the pros and cons daily. I appreciate your thoughts. I am trying to make a decision, any thoughts/advice is greatly appreciated!

Merlyn · Jan 30, 2012

Hmm, maybe the staff starts to turn like the patients after awhile? Just kidding! :) I started on the swing shift now and it is a lot more quiet, which is better. Some patients still act out, but I haven't seen anything too crazy over the last couple of days. I have a new preceptor, who is very nice and nurturing so it has definitely been better since they paired me up with her because I don't feel stupid to ask questions. But when I told her today how much I made, she was disgusted and told me I really should look for another job. Lol

The staff sometimes does act crazy, like the time there was a fight between the staff over a chair. It all started when one of the staff members put his chair right under a fire alarm. He refused to move the chair for me, the RN, the Building supervisor, The hospital supervisor, and even the Union Rep. At one point, it turned into a shouting match between the Supervisors and the Staff. At the height of this fight a patient came up to me and said, "How come they all have keys to get out of here and I don't?" I told her, "Politics". It ended with the staff member getting fired then getting rehired again. Talk about falling down a rabbit hole. Oy!

Anoetos, BSN, RN · Jan 31, 2012

Forgive me if this has been answered elsewhere. Forgive me also if I piggyback this excellent thread.

Question:

Is there a difference between those floors in hospitals where the patients are, primarily, voluntary admits and those facilities where the pts are often court ordered?

Meriwhen, ASN, BSN, MSN, RN · Jan 31, 2012

Forgive me if this has been answered elsewhere. Forgive me also if I piggyback this excellent thread.
Question:
Is there a difference between those floors in hospitals where the patients are, primarily, voluntary admits and those facilities where the pts are often court ordered?

Involuntary and TDO patients are stashed on locked units. Voluntary patients may also be kept on locked units d/t their acuity. In the last couple of facilities I worked in, there was no separate "involuntary/TDO" unit: the locked units were a mix of involuntary and voluntary.

However, I have never worked in a state hospital...that's a whole other ball of wax.

clousehaus · Jan 31, 2012

I started a job a month ago with a state mental hospital. I was happy to get a job as a new grad, and they said they would give me 6 weeks of training. However, being in the unit, I've been feeling extremely overwhelmed. Many nurses and psych techs have been attacked by patients from broken ribs to punctured lungs and concussions, stabbing with pens...scary stuff! I was training in the Patient Observation Unit (the Psych hospital ER) and that was not as scary (the patients are only there for a minimum of 3 days and they're more being observed). Recently, I started training on the inpatient unit. I'm very concerned here because due to budget cuts, they have cut back a lot on staffing (there are 18 patients to 1 RN and 2 psych techs. A lot of these patients have a history of violence, many coming from the prison system, angry to be there, and unpredictable.
I am concerned doing med pass on this many patient as a new grad and making med errors. I'm concerned with my safety (the patients have free reign on the unit and are wandering around, constantly at the nurses station making threats and yelling). They say don't turn your back on the patients, but I don't see it possible to do this because they are all around me! I'm really not sure this is the right position for me or if it's worth risking my safety. As a new grad, I know there are not many options right now and it would be good to get experience. But I'm just feeling very scared and uncomfortable there. Any recommendations?

I don't have much of a recommendation, but not all of us nut cases bite....

chevyv, BSN, RN · Jan 31, 2012

Forgive me if this has been answered elsewhere. Forgive me also if I piggyback this excellent thread.
Question:
Is there a difference between those floors in hospitals where the patients are, primarily, voluntary admits and those facilities where the pts are often court ordered?

I work in a county facility and we have both together on locked units.