Psych Nursing - Boring?

Hi all,

So I'm a nursing student and we are halfway through our mental health clinical rotation. I am finding it completely boring, and so are many of my classmates. It seems as though the nurses only chart, pass meds, and call the physician, with extraordinarily little patient time. I'm SUPER disappointed by this! Psych has been the thing I've most looked forward to my entire time since deciding I wanted to be a nurse, and it was what I most pictured myself doing when I graduate. I've even accepted a position as a tech at a psychiatric hospital. But psych nursing at the hospital I'm doing clinical at seems insanely boring and I think I'd be bored to tears. So far I've been on both the adult and adult ICU units.

So, I'd like to ask those of you who have experience in the field: what do psych nurses do at your facility? Is it typically "boring"? How much patient interaction do you have on a typical day?

I'm not trying to offend anyone, and I know that psych nursing is not easy work. I'm not trying to make it out to be a lesser profession; as previously stated, I've spent several years wanting to do it when I graduate. But now I'm questioning those plans and would like to get a sense of what people's experiences are so I can refine my sense of what I'd like to do once I graduate.

Thanks!

I work on an adult inpatient psych unit currently (1 year), worked at an child/adolescent psych hospital (1 year) and worked adult med-surg (3 years)

Psych nursing can be so boring!! You don't spend much time with the patients. The milieu therapists who are out in the unit with them spend their entire shift with them. It's true that we give meds and chart mostly. Yes, you assess but it is not what is drilled into our heads in school and what is experienced on med-surg.

I tell all new grads to work med-surg first then go and do whatever. I didn't like med-surg that much in clinicals and didn't really like it while I was doing it as a job as it is so brutal- 95% harder than my psych job. I knew that it would look good on my resume and I really wanted to use the skills I learned! Med-surg is what nursing programs focus on and where all of our skill labs skills are used constantly- NG's, Foleys, IVs,trachs, feeding tubes, chest tubes etc.

There are now nursing programs that don't even have psych clinicals, the content is taught and SNs are tested but I guess that clinical time goes to something having to do with med-surg.

Good luck!!

It depends on the day and it also depends on where you work.

I work on an inpatient psych unit, and I am able to spend a good amount of time with my patients. My day consists of almost constant communication with my patients, assessing their mood, providing them with encouragement, and offering advice. I find it to be an art form, because if you are not able to communicate effectively with your patients, they could escalate.

I would recommend PM shift for you, it is a slower pace so you would have more time for therapeutic communication with your patients.

However, there is a difference between a nurse who intentionally spends time with their patients, vs. a nurse who chooses to sit at the computer all shift.

Psych ED ... so so not boring in the least (as I sit in my car, getting ready to face the day). Lots of patient interaction and therapeutic communication, lots of interaction with other medical/etc professionals (nurse to nurse from other facilities, SW, schools ...). Unfortunately due to some behaviors, lots of physical restraints lately.

God bless per diem.

And I agree with the pp, big difference between the nurse who chooses to spend time with her patients vs that who spends time hiding behind the computer.

I must admit, I am relatively surprised by some of the posts here!

First of all, I need to get something off my chest. I have a hard time imagining a nurse being "bored" at any capacity of work they are doing. So much of nursing is what you make of it. Yes, I know there can be a monumental amount of charting anywhere you go as a nurse, but certain aspects of nursing require being independently curious, continuously educating yourself, being creative, and thinking of ways to improve the unit/agency/field you work in. But I digress.

Don't let the fact that psych nursing "appears" to be boring fool you. I've been on the same inpatient psych unit for 3 years and I see my fair-share of nurses sitting on their butts in the back nursing office only coming out when a patient needs a medication. That is NOT what psych nursing is and that is NOT what it means to be a psych nurse, let a lone nurse in general. Our job as nurses is to be present and available in the milieu--especially in psych nursing. So try not to be mistaken by what you have seen or heard of -- psych nursing is what you make of it.

On a typical shift (I do 7p-7a now), it starts out with getting a routine report on the unit. Usually theres 3-4 nurses and we have a 24 patient capacity which means I have anywhere from 5-8 patients. Where I work, there are 2 other adult units, 1 adolescent unit, and 1 geriatric unit, so it's a somewhat big psychiatric hospital and there can be a lot going on at any given time in terms of mental health acuity.

Patient interaction largely depends on the nurse and can vary. I notice some nurses who seem to purposely avoid having a lot of patient interaction and get easily bothered by talking with patients and on the other hand there are nurses who take a lot of time talking with patients. For me, I meet with each and every one of my patients to do a check in. I would like to think that's pretty basic in many areas in nursing and is just common courtesy and the patient's right to know who is taking care of them. There are times though when you need to use your own judgement in meeting new patients and time it right. Some patients may be more willing to communicate than others. Some patients with schizophrenia may have a hard time communicating their thoughts (thought-blocking) and patients in a manic state may talk nonstop. But the beauty of psych nursing is, that's all part of the job and part of the assessment.

In psych nursing, you learn to assess patients by observations and behavior. There are no monitors hooked up to a psych patient telling you they are paranoid, angry, psychotic, or ready to escalate. So it is crucial to not only interact with patients one-on-one but to also interact by observing and being present in the milieu.

Out of all the areas of nursing I been exposed to, psych nursing has the most opportunities to interact with your patients, BY FAR. The assessment process includes interviewing them and talking with them. Communication in psych nursing is so important. Not only to assess for side effects of medication, but to also assess for their symptoms of their mental illness. So I think it is absolutely necessary for a psych nurse to spend as much time with their patients as possible, when appropriate and when it is necessary.

Never boring. Sometimes we have new patients. Sometimes we have patients that we have seen before. I love my "job" so much it doesn't even feel like a job sometimes.

The only time I've been bored is when the unit is full and all patients sleep through the night. This rarely happens. We usually get admissions throughout the night, and we almost always have more than one patient struggling with insomnia.

I worked for an inpatient locked facility with mainly forensics patients (meaning they were there bc they committed crimes). Super interesting. Granted, you don't use as much traditional skills but you'll be tested in other ways.

I'm also in psych ED. My job is never boring. I'm on my feet the whole shift and I work a lot with patients. I spend a good amount of time out in the milieu working with people. We see the whole age spectrum, so I have adults, but also kiddos with their families. Lots of education on what is going to happen next after we asses them and doctor meets with them. When we do get some down time, we all just enjoy taking a breath, because we know we can get slammed again soon! Never a dull moment!

It depends on the day and it also depends on where you work.

I work on an inpatient psych unit, and I am able to spend a good amount of time with my patients. My day consists of almost constant communication with my patients, assessing their mood, providing them with encouragement, and offering advice. I find it to be an art form, because if you are not able to communicate effectively with your patients, they could escalate.

I would recommend PM shift for you, it is a slower pace so you would have more time for therapeutic communication with your patients.

However, there is a difference between a nurse who intentionally spends time with their patients, vs. a nurse who chooses to sit at the computer all shift.

PM shifts are definitely more patient time centered. It's also for me when less groups tend to be going on and patients have more "down time".

I will echo what everyone says about the psych ED. I love it and I am never bored. Some days, when the census is low, the days can be kind of slow. But for the most part, no two days are alike. Granted I have only been there for six months. But so far so good.