Switched to Psych, HELP!

Specialties Psychiatric

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Specializes in Med/tele, Ortho/surgical, transplant.

Hello All,

I've recently made the decision to switch to psych nursing from med/tele/pcu. I am really excited to begin this new field, but I've only experienced psych during my mental health rotation in school 4 years ago. I'd like to know what the typical day of being a psych nurse is. Also, I'd like to study a bit for it before starting my job at the end of this month, so are there any recommendations on sites or books to read in order to prepare for the job? I'm really excited and really nervous at the same time. I know it'll be totally different than what I'm used to and thats what I'm most excited for!

Thanks in advance guys!

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I work as a psych RN in an inpatient crisis stabilization unit specializing in suicidal ideation and homocidal ideation where probably 80% of my patients have transferred from a hospital or ER post suicide attempt. My 12 hour shift starts with report from the night nurses where I learn about the patient's reasoning for being here, diagnosis, significant medical hx, allergies, how they rated their depression and anxiety from 0-10, prn medications administered, any medication side effects they've been experiencing, any hallucinations or self harm hx, and if they're still currently suicidal or homocidal. After report, I prepare my morning medications for my patients (usually 6-10 patients per nurse) and introduce myself to them and ask them again about their pain, depression, anxiety, how they slept, side effects from meds, if they are suicidal here, if they plan on attempting suicide while hospitalized with us, if they would be suicidal at home, if they have a plan to leave and commit suicide, if they want to hurt anyone on the unit, if they have self harmed or are having thoughts about self harming, and if they are experiencing any hallucinations. After that, I go to rounds with the treatment team that consists of the other nurses, the unit manager, the social workers, and our doctors. We present how the patient is doing and how we can help them successfully and safely transition back to their homes. After rounds, I will do some charting and depending on the type of day I will check on my patients, work on admits and discharges, and put out fires . Patients go to groups, meet with the doctors, new meds are presribed or doses upped, and lots of prn's for anxiety and pain are given. I try to keep a watchful eye on all of the patients on the unit in order to address potential "break downs" before they become overwhelming. Then somehow 12 hours has passed and I see night shift coming down the hall and I get ready to go home! I love psych. Wouldn't be anywhere else!

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Check out the American Psychiatric Nurses Association for continuing education. I am new to psych and am doing their online self paced Transition program. It's to help new nurses and nurses who are new to psych.

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Specializes in ICU.

I sort of just searched online or read old nursing material/books on psych. I did buy one psych book that was purely about medications.

Here are some medications that I give often and are worth reading up on: Seroquel, Zyprexa, Risperdal, Depakote, Cogentin, Zoloft, Lexapro, Prozac, Ambien, Ativan, Gabapentin, Haldol, Lithium, Cymbalta, Klonopin, Hydroxyzine (I never even seen this medication on med-surg but we give it a lot in osych), Lamictal, Trileptal, Abilify, Geodon, Celexa, Benadryl, Trazodone.

Some of the things we ask during our assessments: Are you suicidal? Homicidal? Hearing voices? Seeing things? Eating and sleeping well? Depression and rate it between 0-10, anxiety and rate it between 0-10, pain and rate it between 0-10. I usually ask if something in particular is making them anxious or depressed. If they are suicidal, we ask if they have a plan, if they will tell someone on staff if they plan to harm themselves, etc.

Brush up on some labs values: Lithium norm between 0.6 -1.2 (they drilled this into us in nursing school) Depakote 50 - 100/125. You'll want to keep an eye on a patient's WBC level if they are on Clozaril.

Read about therapeutic communication and de-escalation.

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I also began working an inpatient psych unit in the past few weeks as a new graduate nurse. I have found the work thus far to be deeply rewarding and well suited to my personality and style of nursing. I appreciate all the the advice offered above. Cheers to the more experienced offering your insight and resources.

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I work inpatient psych, and I have psych crisis experience. The best thing to do is study up on the drugs like Haldol, Depakote, Librium, Thorazine, Clozaril, etc. over time you'll be able to learn some of the nauances and what certain things look like. For instance the difference between flat and blunted or different presentations of illnesses like schizophrenia and schizoaffective. Ask plenty of questions and really be mindful of communication, the better you are at building report, the more the patient may feel comfortable opening up, which make doing treatment plans easier and can better see their concerns.

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Specializes in adult psych, LTC/SNF, child psych.

How's it going?

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Specializes in Med/tele, Ortho/surgical, transplant.

It is going well! I love it! I decided to start school to become a psych NP!

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Do you ever actually get to sit and talk with the patients as actual care with talk therapy, active listening, or is the push to just administer meds to keep them all doped up and quiet, then discharged

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