Tell me about your psych job

[Scarlettz, BSN, RN]

I have been working as a psych nurse for about a year and a half and I am not so sure if I like working there anymore. I think maybe it has more to do with my job duties than working in this specialty/psychiatric patients. In our facility, we have a charge nurse and a medication nurse and 4 mental health assistants. I work as a medication nurse and the job has become so tedious anymore. I work nights, so I spend a lot of time pulling meds for the HS and AM med passes. Of course there is stuff to do in between- but even those tasks have become boring/annoying to me. I would rather have a smaller load of patients where I do their assessment, notes, med pass, etc.

My question is, what is your facility/psychiatric unit like? Is there a charge nurse and a medication nurse? Or, are you on a unit where you divide the patients up and each nurse takes their own group of patients? How many patients do you care for? Also, do you have a computerized charting system or paper system? Do the assessments include both a psychiatric and physical assessment?

I am just trying to get an idea of what other places are like. I debating as to whether I want to stick with psych elsewhere or explore another area of nursing that interests me.

[umbdude, MSN, APRN]

I have some experiences at 2 facilities. Neither one uses the "1 charge RN, 1 med RN" model.

Hospital #1: Charge RN takes 1-3 patients who are most acute, the rest of the RNs take a maximum of 7 patients. All RNs go to morning rounds with SW, MD, and patient; pass all meds; discharge patients (admissions are usually done in evenings); do brief mental status assessments on 2-3 patients with higher acuity and delegate the remaining patients to MHTs to conduct mental status assessments; do charting on paper (though it's being switched to computer). RNs don't usually take vitals; RNs don't do safety checks or 1:1 unless covering in emergencies. The unit wouldn't accept folks with acute/present medical needs. No physical assessments are done.

Hospital #2 (my current job): Adult psych unit (within a larger medical hospital) with various psych diagnoses plus detox. Charge RN takes 4-5 patients and do mostly the same stuff as regular RN except the charge will print out admission evals for other RNs and go to rounds (patients do not attend). Other RNs take 5-7 patients. RNs pass meds; take vitals; CIWA/COWs; discharge and admit patients (often in same shift); do at least 1 hour of safety checks; answer phones (no secretary); do 1:1; chart and write notes on computers. Physical assessments only done if there's an order. Whether the RN conducts a full psych assessment depends on the RN. Some RNs don't do it at all, and some do.