STATE PSYCHIATRIC HOSPITAL..place for New Grad RN?

tyvin, BSN, RN · May 12, 2011

State psych hospitals can be ... rough depending. I worked in one and was shocked at the behaviour and attitude toward the patients. I changed many things and it got really ugly but I know that place is better for it.

It all depends on the staff and how seriously they take their job. You should do a walk through first and meet the staff and see the facility and ask lots of questions. Trust your sixth sense; it will tell you whether it's a good place or not. If you're really interested in mental health then it's a good start IMO.

Many people cringe at the thought of a in-patient psych unit. I think that they don't understand mental illness as many people don't. You couldn't drag some nurses to a psych unit and then they're are people like me who go a runnin because I love mental health.

Visit first.

Whispera, MSN, RN · May 12, 2011

Make your visit a longish one. Maybe even job shadow the part of the facility where they'd like you to work. Observe and listen to both staff and patients. Get a feel of what it's like there. I'd recommend a few days...

I think you could walk into some stuff in a state hospital. Do you have psych experience? Do you have enough psych experience? Any inpatient psych unit is a whole lot different in it's totality that you can possibly see in your psych clinicals for school.

Are you a person with large personality? By that I mean, do you show a sense of being in charge of yourself and situations? That is very necessary.

nursemichelle80, BSN, RN · May 12, 2011

I have been the charge nurse for an inpatient psychiatric unit in a men's prison. I have been a nurse for 5 years and was trained on a med-surg floor. I wanted a strong medical foundation to stand on. Psych is not my thing. This is merely a stepping stone while I'm in school. I would suggest getting some med-surg experience. You never know when you will get tired of mental health. It will be harder for you to find a job if you don't have any medical experience. In fact, it is a requirement here that you have at least one year of medical experience.

Just a thought :) Good luck!

Whispera, MSN, RN · May 12, 2011

not every place requires a year of medical experience...

Mrs. SnowStormRN, RN · May 12, 2011

Whispera and Tyvin gave great advice. There is so much stigma attached to mental health, and I agree its not for everyone. I mean I see so many nurses who want to work in L&D or Peds and I know those fields arent for me. I personally love Psych. Its why I have stayed in it so long. It can be interesting and challenging, but I think any nursing field can be challenging. In my 8 years Ive never been attacked by a patient(which is usually negative stigma associated with this field, I was actually hit on and spit on more when I worked in LTC - not to say it cant happen, but I was well trained on how to speak and handle this population of clients and you will too. State hospitals usually provide extensive training) and I work in research now where we take our psych patients through "washout" removing all meds from their system to study their behavior off of meds. I love mental health. I really enjoy this field. You've heard the saying, "Don't knock it, til you try it." Try to stay away from the negative views and thoughts related to mental health, that many people have and go in with a positive outlook, you may be surprised. GOOD LUCK TO YOU!!

Rob72, ASN, RN · May 12, 2011

"Be vewwy vewwy careful..." I love psych. I can deal well with psych patients.

I would not work in a State psyche hospital unless it is not part of the current "expressive" paradigm. Allowing unrestrained expression of violent behavior, ejaculating on the nurses station/less than aware nursing staff, or physical assaults on staff is neither theraputic nor safe. This is, however, part of a new "enlightened" model coming (IIRC) out of a large institution in Tennessee, and being adopted by facilities across the country.

Bottom line- this is the same philosophical group that tried to sell "rehabilitation" crap to Corrections in the 60s-70s, got more than a few Corrections Officers and inmates killed in the process, and took their PhD/MMH degrees into State mental health.

If you can talk to several nurses, without the recruiter/Admin around, it is probably a decent facility. If the recruiter/Admin is flustered or dismissive in response to a request to visit privately with floor staff, run.

One more edit- if they have co-ed housing, that tells you quite a bit. Not a safe model.

Heidi the nurse, BSN, RN · May 12, 2011

I always thought psych was the place for me and one of the first places I applied was the State Hospital - they were in the middle of a hiring freeze at the time, but I did end up working for them several years later. In the 3 psych places I worked, med surg would have been a waste of time. Depends on the unit you are on.

You are able to find just about everything at a State Hospital, diagnosis wise. It would be a great learning experience. I would agree with Rob's advice - never wise if the recruiter won't let you talk to the people who are doing the job you eventually will.

Laufey · Jun 30, 2018

I am a new grad (May 2018) and was lucky enough to have three days at a state psych hospital during clinical. I'm already finished with the application process to start through a contractor and start on July 9th! (I'll apply through the state soon, but the process takes a long time and I want to know what I'm doing at the facility and have a better idea which unit to push for before applying with the state) I will be making $42/hr base pay.

I think it's a great CAREER option, you have a pension, 401k, and great pay/benefits, there will always be state jobs open to you in the future if you decide to leave the psych hospital. I had a LOT of local nurses very scared about the hospital and warning me not to go and basically ganging up on me about how bad it was. However, when I actually went to the hospital for three days (on two different units) I found out all the employees I talked to loved it! You don't need med-surg experience and even if you get a year of it you'll forget it after a few years anyways. If you decide to go back to the regular hospital environment you can do a refresher course for $100-1,000 depending on the program.

verene, MSN · Jun 30, 2018

I think it depends very much on the State Hospital. Some are great places to learn if you have a strong desire to work in-patient psych and some are scary, scary places. Get a feel for this particular hospital - what is training like? How much support will you have? What is the staff/patient ratio? What is the acuity of the specific unit you would be working? Are you required to float to other units? What training on those units do you get before floating? etc.

There is a lot of stigma around mental illness (and health care workers can be some of the worst when it comes to perpetuating it), and a stereotype that people only work psych or addictions because they are either a) desperate or b) have their own mental health problems. While this may be true for some it certainly is not universal. It does however lead to a lot of nurses being VERY negative about working in psych or anything related. So I would really want to clarify with nurses who don't work a particular setting if they have specific fact-based concerns about the hospital or if it is a more general "eww why would you want to work psych you're better than that attitude" and they are letting bias sway their opinion.

Wether or not you want/need a med-surg background before working in psych depends on what kind of psych job you are applying for. Geri-psych or medical-psych unit it could be very helpful other units potentially less so. My first/current job is sub-acute/locked-residential psych and while I occasionally wish my medical assessment skills were a bit more solid, the reality is because of the practice setting I don't have the equipment or human resources to do more medical/surgical interventions even if I had the additional training and experience.

dream'n, BSN, RN · Jul 1, 2018

I've found my Med-Surg skills invaluable working in psych. Particularly due to Munchhausen and factitious disorder possibly encountered in this patient population. These particular patients can be extremely difficult to manage without having strong medical nursing skills to determine if the issue is medical or psychiatric. Many times the patients with these diagnosis' are intelligent and well versed in medical lingo.