Tell me more about psychiatric nursing...

TerpGal02, ASN · May 26, 2012

I am a new grad RN and I work on an Assertive Community Treatment team. We work in the community with the sickest of the sick. We take services to the clients. As nurses, we obviously asses, manage meds, do physical assessments on clients and advocate for them with any somatic health needs, but we also do case management with the clients. In that light, we help clients obtain housing, SSDI, budgeting, etc. This is not exactly a new grad position but I love it. I absolutely feel psych is ok for a new grad. The only thing with this is as a new grad, you won't have the instincts to tell if a client is decompensating like a seasoned nurse would. You also don't use the smae clinical skills as you do in med/surg. We do give a lot of IMs though. If you are worried about losing you med/surg skills, I might suggest getting somemed/surg experience. I personally have zero desire to do med/surg. I always knew I wanted to be a psych nurse.

Stephalump · May 26, 2012

TerpGal, this is something that worries me. My educational background is in psychology, and psych nursing has always been my goal, but I'm wondering if I'll be "stuck" if I go into it right away with zero bedside experience. I'm thinking maybe I should also try to work PRN in med/surg or something like that...

illcleff · May 26, 2012

I always say psych nursing is different. You have to love it to do it. I currently work in the ER as a psych nurse. Some of the responsibilities include, maintaining the milieu on the unit. You deal with lots of psychotic, manic and substance abuse pts on a daily basis. I agree w/ TerpGal02 that there is lots of IM's medications involved. I started my nursing career as a Med Surg nurse then switched to Psych since that's what I wanted to do.

Med surg is a good starting point.

illcleff · May 26, 2012

Get some Med surg experience and then switch to Psych. However some nurses have only been psych nurses and do great. Psych is not for everyone. I am glad you love it. Its a different kind of nursing but very rewarding. You will find what works for you.

Mandychelle79, ASN, RN · May 27, 2012

Get some Med surg experience and then switch to Psych. However some nurses have only been psych nurses and do great. Psych is not for everyone. I am glad you love it. Its a different kind of nursing but very rewarding. You will find what works for you.

The way the job market is right now this may not be possible. That was my plan but ended up getting hired straight into psych.

Davey Do · May 27, 2012

I have *always* been fascinated by psychology and how people "tick."
I would love to hear about the typical job responsibilities of an RN in the psych. field (hospital, office, or otherwise). Can you tell me about your experience with it? Also, how likely is it for a new grad get into this field? Would you recommend a new grad for this field?

I'm there with you, emptyboxcars. And after 37 years of working with Mentally Handicapped People, with 33 of that being in the Medical Field, I continue to be fascinated by Peoples' Behaviors.

There is a broad range of areas of Psych Nursing: From Inpatient to Community and Strictly Psych to Medical/Chemical Dependency/Psych. I've done them all, and each has its Pros and Cons, but each can also be exciting, rewarding and fulfilling.

Currently, I feel as though I'm in the Autumn of My Career. I work predominately in Gero Psych where there's both Medical and Behaviors. I believe I am utilizing a vast amount of knowledge and experience gained. However, I also work with relatively new Grads who find this area challenging. I would heartily recommend this area of Nursing. You have your share of IV's, catheters, feeding tubes, oral, IM and subq medictions along with Direct Care and Grunt Work.

Good Luck and the very best to you, emptyboxcars.

Dave

chevyv, BSN, RN · May 27, 2012

I work in a county long term psych unit. Ages range from 20's - 70's. My pts are the one of the most difficult because most cannot function out in the community. I too have always loved psych and can't recall a time when I wasn't walking around with a "come tell my your problems sign" on my back. Now that I've been through nursing school and am working in the field, I am finally learning to take that sign down outside of work.

I do give a lot of IM's and call Security almost every shift I work. It is never the same day twice and boy what I would give for a boring night!

I was at first, disappointed to not be able to work med surg for that first year, but I've come to understand that I most likely would have been miserable. I'm looking forward to moving from ltc to acute or venture out into the community. There are many avenues you can walk down in behavioral health. I landed this position right after passing my boards. I had been a CNA for many years and a LPN for a year in regular LTC. I see many new grads with no experience being hired by me now. Let us know how it goes for you and wishing you the best of luck!!

algebra_demystified · May 28, 2012

If you can get a year of med/surg first, I would jump on that. Or tele, or ED, or anything medical. While I went straight to psych, I'm working on getting into a jail so I can get some post-fight cleanup work under my belt. I feel unprepared to deal with some aspects of psych because I have no medical nursing experience other than two months as an LTC nurse.

It's up to you, though. The job market is tight these days. If you can't get some medical first, just get a job. You can always pick up your EMT cert and work a little trauma until you get some wound care experience.

Merlyn · May 28, 2012

The only way that you will know if Psychic is right for you is to do it. counselling people is nice but there is so much more. When you work in Psychic the only tool, so to speak, is yourself. If you don't know what you are doing it can be dangerous. One of my former patients was just convicted of murdering two people because they wouldn't give her money. But hopefully you will have your instructor with you. Just a couple things. The patients will test you. They will try to find out personal information. don't give it to them. Don't tell them your birthday, your age, where you live. Do not promise them anything. such as "Can You help me get cigarettes?" They will try to get into your head. They will lie, cheat, and steal from you. If you have to go into the day room with them, always know where the exists are. Follow the other staff. Just because they have CNA or HST after their names doesn't make them stupid. If they say don't talk to that patient because he is upset today. Don't talk to him. If they tell you to get out of the day room, get out. If they tell you to run, run. If they tell you to fly, fly. Just watch yourself.

chevyv, BSN, RN · May 29, 2012

That is real advice you're getting from Merlyn! They will see you coming a mile away and will absolutely try to manipulate you. If they can't get you that way, some will try to get you out of there. It's a great experience though and you'll know within a short time if its for you.

Wait until the diabetics try to get you to get them chips/candy. That can get pretty nasty too :)

I still remember the 1st time I found myself in a corner with no where to go to get away. The pt knew it too so I had to fake the confidence and be much more assertive than I felt. Worked out well but it could have really gotten ugly quickly. I've never ever put myself in that situation again. I am always aware of my way out/around a pt, always. I swallow my fear because they can smell it on you. Seriously, I swear they can.

HappyApple · Aug 11, 2012

I agree with all the above posters. I was lucky enough to be a CNA in a hospital when I became an RN. Resultantly, I easily & luckily got a job there. It was a med-surg floor in a big hospital. We dealt with pts from 20->100 , predominantly geriatric. In this pt population I cared for plenty of pts with medical problems who also had anxiety attacks, depression, bipolar disorder, schizophrenia, PTSD, etc. While we concentrated mainly on the medical issues, we also had to deal with the psychiatric issues. It is challenging but I really enjoy it!

Good luck in your future endeavors & do whatever is right for you. While I do recommend a med-surg job initially, take a good psych job if you have the opportunity. The job market is pretty tight in a lot of places currently.

I recently moved to another state and "fell" into great job at a small geri-psych hospital. I have worked there only a very short time but I love it. The fact that I work with a great group of people & not back-biting gossipers makes a world of difference. I feel my previous experience in med-surg has given a solid foundation upon which to build in dealing with this pt population, & has also allowed me to hone & utilize my nursing skills. Learning to practice therapeutic communication with psychiatric pts is a special nursing skill all it's own. It is however a whole different world from med-surg. I have learned to become more relaxed & not let my anxiety or fear show as they transfer onto the pt. I have not had an opportunity to deal with the more manipulative type of pts in the geriatric population, but I certainly did in clinicals.

As previous posters stated, you always have to keep your guard up, be aware, be assertive, be confident, don't ever give personal info to pts. Tell them, " I am here to focus on you & to help you." Develop a thick skin. Always leave an escape route for yourself when dealing with a pt. I have given more IM injections here in a week than 4 years on a med-surg floor, excluding flu shots. It has been a real learning experience.

At this hospital I am responsible for staffing, giving meds, doing staffing with another nurse, communicating with drs, taking orders,assessing pts, dealing with behavioral problems, assessing pts, dealing with families & much more.