Ways to Tell if a Psych Hospital Will Be Good To Workers

[Willofthewisp]

When researching psych hospitals as potential places to work, do I do the same things/ask the same questions that I would at other hospitals to see if it will be a good fit for me, or are there special considerations? 

[Davey Do]

Safety is probably the biggest factor you may want to consider, Willowisp, which includes staffing and behavioral crisis intervention.

 

[PsychNurse24, BSN, RN]

Ask who coordinates and has authority during a crisis, including restraints.  When Therapists had authority, in my experiences, there were more restraints.  Nurses generally have a better relationship with the patients.  

[Davey Do]

8 hours ago, PsychNurse24 said:

 When Therapists had authority, in my experiences, there were more restraints.  

This quoted portion of your post has me recount an experience that reinforces it:

A female patient was on a 1:1 status due to self-harming behaviors. The patient was calmly sitting outside of the NS in the hallway with the tech sitting next to her. A therapist sitting in the NS leaned back in her chair and said through the open door, "You know, you could do so much better if you..." and went on to critique the patient's past behaviors.

Within five minutes, a code was called due to the patient getting riled up and attempting to do self harm as a result by what the therapist said.

An example of someone attempting to fix something that wasn't broke.

[Willofthewisp]

Thank you, everyone who has replied so far. I loved psych clinical but still don't feel I have a good grasp on the actual employment aspect of it.

[SmilingBluEyes]

My friend worked psych and they were continually  understaffed and in danger. She was grabbed by the neck and pushed against a wall, ending her career in psych. Our psych hospital locally is infamous for gross understaffing of both nurses and security. SO I guess my point is, you need to know about safe staffing and security.

[PsychNurse24, BSN, RN]

1 hour ago, Willofthewisp said:

Thank you, everyone who has replied so far. I loved psych clinical but still don't feel I have a good grasp on the actual employment aspect of it.

I have been in psych for 11 of my 12 years of nursing. I have loved it. I have found  psychiatrists to be the nicest doctors to work with. I have never had a rude word, ever, from a psychiatrist. And generally the Therapists and Techs have been good too.  I work in a small acute treatment unit now. I don’t get paid as much as when I worked in a hospital, but the teamwork is better.  I don’t think there are many changes in employment that you have to consider.

[McNabK9, BSN, RN, APN]

What makes psych nursing dangerous?  Here is a list:  understaffing ie how many licenses on the floor=RN or PT or LVN, poor training in policy=medication compliance, restraint physical and chemical chain of command, poor continued annual training, poor communication about acuity of the unit, poor charting habits to protect the staff and the patient, lack of a level of custody or custody practices=room searches, medication cheeking, wheeling and dealing cheeked meds to other patients for 'favors', working with inexperienced people that don't understand the nuances of psych nursing=how to recognize a patient decompensating, how to decompress a patient's agitation, staff that enjoys triggering patients and then walking out the door to go to lunch while the rest of the staff is wrestling with an out of control patient.

[TriciaJ, RN]

Oh, gosh.  All of the above.  It might be a good idea to ask to shadow for a shift to see if it would be a "good fit".  

That would be the best way to determine if the place was appropriately staffed for starters, if minor behavioural issues were promptly dealt with, if policies made sense and were adhered to, if the unit has any grandstanders, or the more-compassionate-than-thou, if techs are given positions of authority "because we're all equal".  To name a few issues.

Good luck.

[TriciaJ, RN]

On 3/24/2021 at 6:53 AM, Davey Do said:

This quoted portion of your post has me recount an experience that reinforces it:

A female patient was on a 1:1 status due to self-harming behaviors. The patient was calmly sitting outside of the NS in the hallway with the tech sitting next to her. A therapist sitting in the NS leaned back in her chair and said through the open door, "You know, you could do so much better if you..." and went on to critique the patient's past behaviors.

Within five minutes, a code was called due to the patient getting riled up and attempting to do self harm as a result by what the therapist said.

An example of someone attempting to fix something that wasn't broke.

This reminds me of a psych hospital I worked in briefly.  A psychologist for the adolescent unit liked to stroll in after hours and take one kid aside for a 1:1.  Next thing the kid was rampaging and the psychologist would casually stroll off.

Staff would finally get the kid settled, then in would stroll Dr. Bonehead.  And take another kid for a chat.  Then that kid would be up in arms and Dr. B would bugger off again.  Rinse, repeat.

At the time I was working as a per diem aide (ahem, Mental Health Specialist) while my US nursing license was in the works.  I was shocked at how the staff let him get away with nonsense.  

[Davey Do]

16 hours ago, TriciaJ said:

Next thing the kid was rampaging and the psychologist would casually stroll off.

"Calling Nurse Firefighter! Dr. Arsonist is on the unit!"