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Such a bad rap

Posted

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych. Has 5 years experience.

I got a transfer to psych, I start in 2 weeks. Everyone seems to have an opinion. I can't count how many times I've been told to be careful, or asked if I am crazy.. don't I know I can get seriously hurt? It's like people think I'm going to get beat up every day or something. I'm not naive enough to think that it can't be dangerous. But I did a lot of research before making this decision. From what I can tell, as long as the place has protocols in place, that are followed, and you use your training when interacting with the patients, the risk is pretty low.

I've been bit, scratched, kicked, slapped across the face, all on M/S floors. At least in a behavioral health facility they plan for this kind of behavior. Did everyone else get this type reaction when people heard this was the field they chose to work in? I'm very excited about this new opportunity, I really don't want to hear people try and freak me out. I usually just tell them, thanks for the warning, I will be trained and I will be careful.

laurenicoleRN

Specializes in Cadiothoracic, psychiatric.

ME TOO! I took a job at a state psych hospital and all the ppl at my last job in a medical hospital reacted the same way. I love my job and have never been in harm's way. (Knock on wood!)

Davey Do

Specializes in around 25 years psych, 10 years medical. Has 42 years experience.

Simply Complicated:

I mentioned in another post that Nurses are second only to Police Officers in receiving physical trauma. And, it sounds like you've already recieved your share of physical trauma from the Medical Patients you've dealt with.

I've been involved in Psychiatric Nursing off and on for over 27 years now. I've been injured twice: I was stabbed with a pair of scissors by a Client dx with Undifferentiated Schizophrenia. However, that was in a Community setting outside of his apartment. And, he "did it only because the director told (him) to do it."

The other time, I was waylaid by a 74 year old Patient dx with Alzheimer's. It was a sucker punch that made me see stars.

Please don't allow the Naysayers to quell your enthusiasm. There are safeguards in place. Staff is trained. This can be a great learning experience on how to deal with people.

I believe that if you can talk down a Psychotic Individual, you can talk to anybody.

Good luck to you in your new position, Simply Complicated

Dave

totally_nuts

Specializes in mental health, aged care/disability care.

Good on you! Ignore them - they don't know what they are missing ... lol ... or maybe they do!!

I start my psych ward job on 4th Dec and have also been asked if I'm the one whose nuts. I love mental health nursing!

Good luck :yeah:

Simply Complicated

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych. Has 5 years experience.

Thank you. While it's not necessarily good to hear that this is common, it does help to know it is a common reaction. I might as well get used to it, because I'm sure it will be something I hear for a long time to come, whenever I say I am a psychiatric nurse.

with proper education and strict adherence to best practices, (never letting your guard down and paying attention to changes in pt's mood and behavior), injuries are rare, and minor if they do occur.

Simply Complicated

Specializes in Med/Surg, Neuro, ICU, travel RN, Psych. Has 5 years experience.

I've been working almost a month and haven't seen anything too crazy. Couple patients who get worked up and one female attacked a male worker. Worst she managed was to scratch him. We have pretty good safety protocols and manage to prevent things pretty well.

sarmedic70

Specializes in med-surg, post-partum, ER, psychiatric.

Best of luck to you.:yeah: Everybody posted some really great advice and so very true. Depending upon your facility, as long as proper traning is given to you all and good policy and procedures in place, yes, psych is a very violent career area; however, since you already know that when you go in to it (or hopefully realize that there is that risk), be smart when around patients (expect the unexpected; never EVER let your guard down, know you WILL be manipulated (especially when starting out.........and especially if dealing with Borderlines, but not limited to Borderlines); never EVER have your back turned on any patient, don't get yourself into a situation of which you cannot get out of/escape (patient's rooms, etc), remember that when a patient has a violent outburst/physical aggression, it is nothing to do with YOU personally but something transpired that possibly brought up past memories/trauma, et al; remember that with most patients that it will be a fight or flight and generally it will be a fight (especially in dealing with pediatric/adolescent population of which are trauma survivors with PTSD and RAD (oops Reactive Attachment Disorder)..........the list is endless, so I think you get the point:lol2:) From my own personal observations, staff who get hurt generally got themselves into that position/corner for many reasons........it is rare that is NOT the case.

As Dave posted, don't listen to the naysayers. You have come to the right forum to get some fantastic advice.......psych nursing is one of the most rewarding career fields you can be in on so many levels.:yeah::nurse: Those patients (and their families) truly do need us:heartbeat, especially when there still is that general perception/misunderstanding out there about mental/psychiatric illnesses because it does affect behavior:confused:. I have had the opportunity, by being in the career specialty, to educate people on so many levels. I also work in EMS and my supervisor has oft said (he does ER, fire, and air ambulance too) he does not understand how I can "do it"...........yes, it is NOT for everybody...........you are not going to cure your patients..............however, there is a service that you can provide to your patients like no other:nurse::yeah:..........on so many different levels. I am on one of the absolute most violent units in our entire state hosp facility............we average of late 10-20 holds/seclusions...........I have a fantastic staff:yeah:.................of whom truly do not get paid nearly enough for that they endure day in and day out..............they do it because they truly do care about our patients.........I knew early on in my career as a RN that I was going to do either one of two things once I got my Med-Surg experience done (felt it was wise to go that route for and very thankful for doing so even though I HATE Med-Surg)........and that was either ER/EMS or Psych.............I am both (full-time is psych):yeah:...............by being in this career specialty area has also assisted me in non-nursing situations every day......more understanding of people as a whole, et al................:redbeathe

At any rate, welcome to the "family"...................may it also be your passion! :redbeathe:clown:

Simply Complicated:

I mentioned in another post that Nurses are second only to Police Officers in receiving physical trauma.

now dave, you know better than that.

policemen and nurses don't even make the top 40 in terms of most physically dangerous professions.

deep sea fishermen, loggers, ironworkers, construction workers, road workers, and dozens of other professions have physical injury risks up to 100+X what policemen do. look for reference in the bureau of labour and statistics reports every year. hell, quicky mart clerks have a 10X higher incidence of injurious assault than policemen, and taxi drivers are not far behind them. get off your soap box and don't think for a minute that nursing is a dangerous profession. when was the last time you heard of a patient killing a nurse? it happens every day to quicky mart clerks over $42.53 and a pack of twinkies.

Jules A, MSN

Specializes in Family Nurse Practitioner.

get off your soap box and don't think for a minute that nursing is a dangerous profession.

You might want to tell that to the nurses I have worked with that include 3 broken noses, a broken leg, broken tailbone, bilateral knee damage and numerous bruises, scratches and bites. FWIW there have been two staff members in my area, both techs I think, that were killed by psychiatric patients. I'm not saying we are in more danger than other dangerous professions but imvho psych nursing does have its risks and that is something that we need to be aware of and at peace with before we sign on. If staff isn't willing or able to physically assist their coworkers that are getting assaulted I don't want them on my unit. The plus side is that we do know how to handle these situations and are able to head most of them off prior to anyone getting seriously hurt. Its the nature of the business.

P.S. wanted to add that despite the above I LOVE psych nursing and can't imagine doing anything else. :D

tell that to the ironworker i knew who fell 3 stories on a construction site DRT. tell that to the ironworker i knew who was hit square in the top of the head with a 6" long 1" diameter bolt that fell 8 stories DRT. tell that to the steelworker i knew who had a hand amputated after his sleeve got caught up in a power roller. tell that to the ironworker i knew who had half of his hand crushed in a chain while lifting a 3 ton beam with a crane assist. these are the deaths and some of the serious injuries i have personally seen while managing crews. myself? i can't count the stitches and broken bones. do i talk about it much? only when people raise the issue.

Jules A, MSN

Specializes in Family Nurse Practitioner.

tell that to the ironworker i knew who fell 3 stories on a construction site DRT. tell that to the ironworker i knew who was hit square in the top of the head with a 6" long 1" diameter bolt that fell 8 stories DRT. tell that to the steelworker i knew who had a hand amputated after his sleeve got caught up in a power roller. tell that to the ironworker i knew who had half of his hand crushed in a chain while lifting a 3 ton beam with a crane assist. these are the deaths and some of the serious injuries i have personally seen while managing crews. myself? i can't count the stitches and broken bones. do i talk about it much? only when people raise the issue.

:confused:

AltaEnfermera

Specializes in Geri-psych, corrections, wound care, MDS. Has 4 years experience.

You might want to tell that to the nurses I have worked with that include 3 broken noses, a broken leg, broken tailbone, bilateral knee damage and numerous bruises, scratches and bites. FWIW there have been two staff members in my area, both techs I think, that were killed by psychiatric patients. I'm not saying we are in more danger than other dangerous professions but imvho psych nursing does have its risks and that is something that we need to be aware of and at peace with before we sign on. If staff isn't willing or able to physically assist their coworkers that are getting assaulted I don't want them on my unit. The plus side is that we do know how to handle these situations and are able to head most of them off prior to anyone getting seriously hurt. Its the nature of the business.

P.S. wanted to add that despite the above I LOVE psych nursing and can't imagine doing anything else. :D

Ditto. I worked for 2 years in a correctional center clinic, and despite the fact that ALL of my patients were convicted felons, I never once felt threatened, let alone assaulted by my patients. When I returned to psych, I made it 4 whole days before getting socked in the ribs during an attempt to separate 2 fighting residents. It is dangerous, but as you said, completely worth it :)

totally_nuts

Specializes in mental health, aged care/disability care.

tell that to the ironworker i knew who fell 3 stories on a construction site DRT. tell that to the ironworker i knew who was hit square in the top of the head with a 6" long 1" diameter bolt that fell 8 stories DRT. tell that to the steelworker i knew who had a hand amputated after his sleeve got caught up in a power roller. tell that to the ironworker i knew who had half of his hand crushed in a chain while lifting a 3 ton beam with a crane assist. these are the deaths and some of the serious injuries i have personally seen while managing crews. myself? i can't count the stitches and broken bones. do i talk about it much? only when people raise the issue.

Can we not have a ***** session about this? Yes those jobs are dangerous but they are usually freak accidents. Nurses and police officers get hurt more frequently from what I have seen.

Nurses and police officers get hurt more frequently from what I have seen.

try working in the real world for awhile.

AltaEnfermera

Specializes in Geri-psych, corrections, wound care, MDS. Has 4 years experience.

try working in the real world for awhile.

I agree that other jobs ARE intrinsically dangerous by their nature, maybe moreso than nursing. This isn't meant to be a p**sing contest between healthcare and other jobs.

But I think the point everyone is trying to make is that the risks/dangers involved in nursing don't come from accidental injury (Excepting workplace injuries like back strain, et al.) We face a whole different brand of risk, namely that imposed by dealing with potentially violent and volatile clientele in very vulnerable positions, with little security and/or legal means to defend ourselves besides getting the h*ll out of the way. That, plus the notion that because we're nurses/doctors/etc, patients have carte blanche to be abusive, gives nursing a unique set of occupational hazards.

So in summation, maybe a better statement would be "Nursing is one of the most dangerous professions in regard to assault/physical abuse, etc." :)

sarmedic70

Specializes in med-surg, post-partum, ER, psychiatric.

JulesA writer is so right. Yeup, tell that to my staff too who have also had countless injuries due to our patients (again, I have one of the most violent units in our state psych facility). There are times, staff just didn't approach the patient in the right way. As with a caged/cornered animal, patients at times have the same reactions............and as a result, that is when staff get hurt. Vice just waiting it out for a bit, geting the rest of the patients out of the milieu, having enough staff (or campus police) to assist, etc. No matter, though, being is psych is very dangerous overall; however one of THE most rewarding specialty areas IMHO. And nursing HAS become a more dangerous profession to the point that the ANA, APNA and ENA have been addressing this more aggressively than ever on all levels............between later-to-lateral violence to violence inflicted upon nurses by either patients or relatives, etc. The reason it is not on the "Top 10" listing of the most dangerous professions is that there had not been that awareness made until relatively recently. At any rate, psych nursing is fantastic and I, too, cannot imagine doing anything else (except ER since I am also in EMS).