What do Psych nurses really do?

[tessa45]

My daughter plans to go into nursing and psychiatric nursing is the area she is most interested in. When people ask her what area of nursing she would like to go in and she replies psychiatric nursing the responses are very lukewarm. Although she does not know anyone who is a psych nurse she knows nurses in other fields. They tell her that all psych nurses do is give meds and have mounds of paperwork. I am quite sure there is much more to the job than just giving meds. So, you wonderful psych nurses, what do you really do?

[elkpark]

There is tons of info about psychiatric nursing in older threads on this board. I suggest you (and your daughter) start with the "sticky" thread, "The Psychiatric Nursing Profession...a thread to begin learning about it," which appears first under the Psychiatric Nursing forum heading. There are also many other threads in the forum that are worth reviewing.

One thing I'm curious about is how your daughter has decided that she is interested in psychiatric nursing if she doesn't know any psychiatric nurses and doesn't know anything about psychiatric nursing?

Best wishes to your daughter on deciding on a career -- :balloons:

[PsychRN-Kris]

Much more than just "meds and paperwork". Here's a list of some of the things I do:

Pre-admission screening and admission acceptance, continuing mental health assessment and medical assessment, treatment planning and consultation with the whole mental health team of doctors, nurses, clinicians, social workers, therapists and court staff, coordination and supervision of my staff on shift, adminstration and monitoring of meds, management and treatment of co-existing medical conditions, patient teaching and counseling and family teaching and counseling.

True most of the above involves paperwork and meds but on a much more complex level. I was also interested in pscyh nursing right out of school and was counseled away from it by many peers but I went right into it and am still loving it almost two years later. I've never regretted it. Have your daughter see if she can spend some time in school doing a psych rotation and if it's only a short rotation have her request some extra days to see if it's a good fit. :)

[Blackcat99]

It depends on where you work. I use to work in state psychiatric hospitals. I felt like I spent a lot of my time trying to prevent phyical fighting between patients.:trout: People would ask me: "What do you do for a living?" I would always say: "I'm a "bouncer" at M*********** State Hospital."

[Weeping Willow]

I think it would be good if she spends some time in various psych settings. These include inpatient private hospitals, inpatient state mental hospitals, various behavioral medicine (mental health, psychiatric) clinics, homeless shelters, domestic violence shelters, day care for adults facilities, nursing homes with locked wards for Alzheimer's patients, and forensic units in jails and prisons, for example. She can spend time with law enforcement personnel, court personnel, child welfare personnel, and others who are involved in various ways with the mentally ill. These include social workers, psychologists, psychiatrists, nurses, police officers, parole and probation officers, employment rehabilitation counselors, sheltered workshops, and maybe others, such as teachers in the juvenile and child facilities.

Mental illness creates a lot of disability, that is, people who can't work are often mentally ill. Also homeless, due to no income, can't hold a job. There is a lot of dual diagnosis, that is, both mentally ill and abusers of drugs/alcohol. Does your church group have a jail ministry? Maybe she can start attending their programs, just to get a feel for these facilities and the people served in them. Legal Aid in your area might be a helpful contact.

She can choose to work with children, adolescents, or adults, such as at the VA facilities. (Veterans' Administration). There is also geriatric psychiatry, (geropsych), such as senile patients with behavioral issues, e.g., Alzheimer's Disease.

Maybe your local parish has a homeless outreach or an outreach or shelter for victims of domestic abuse. Your local ER should have referrals for mental health services and workers your daughter can talk to.

What we do in Psych: meds, paperwork, refer clients to the dentist, podiatrist, internist, ER for emergencies, medical and surgical specialists, the lab, radiology, GI lab, etc., process orders, liaison with Pharmacy and make sure we have the clients' meds and equipment, such as diabetic test supplies, trach care kits, saline and other wound care items, change dresssings, do soaks and other treatments, and so forth, keep the kitchen clean and supplied, same for linen, keep the ward clean via communication with Housekeepers and Maintenance, attend meetings of the therapy team, which icludes social workers, nurses, recreational and activity therapists, psychologists, the clients themselves, psychologists, psychiatrists, and probably others who are not coming to mind right now. Handle crises, such as suicide attempts, patients fighting with staff or each other, attend inservices, make assignments, assess c/o physical problems, such as rashes, toothaches, and problems of every other body system (so she will need a good general nursing education to be able to deal with the whole person). We have to keep up with general responsibilities, such as keep our CPR, other inservices, and TB testing up to date. We mush hold and lead meetings on our ward for our shift at least quarterly. In these meetings, we discuss topics given to us by our bosses, such as new rules, policies, and plans, plus we do something educational, such as teach the assistants about teamwork, communication, and reconizing when someone is having a seizure or reaction to medications. We make rounds on all the clients at least twice a day, more often on the off shifts. We try to converse therapeutically with all clients at least once per shift. This is much harder than you might think, depending on what all else is going on on the ward and with each client. We adhere to JCAHO standards and CMS standards so there is lots to do to keep up with all of their requirements. We assist with electroconvulsive therapy (shock treatments) by getting permits, supplies, and monitoring the patients during and after the shocks. There used to be insulin shock treatments, cold water baths, straight jackets, and other really awful procedures. We don't do those any more. The meds today are quite effective and we have to be knowledgeable about these and skilled at giving them in a hurry (shots). We protect confidentiality and privacy. We lead therapy groups, such as for the eating disordered client and we help them not to practice their disease. That means we keep them in the dayroom or in our view so they can't go to their rooms to vomit after they eat. We encourage them to keep a journal or socialize after meals.

We serve on Nursing Council or Nursing Practice Committee or do personnel-related duties, such as annual evaluations on our staff. If we are managers, we interview, hire, fire, counsel staff, make the work schedule and vacation schedule, make daily assignments, and we order equipment for our wards. We substitute for the House Manager on weekends and holidays. That means we are involved in any emergencies in the house, you do staffing, and you notify the Director of Nursing and Administrator on call of any matters they need to know about, such as elopements, client injuries, serious staff injuries, physical problems like heat or water go out, allegations of abuse or neglect.

You keep your license up (do any required CE) and maintain professional knowledge by studying all the time on psych topics and med-surg, too, since mental patients also have needs in these areas and we need to be able to recognize these problems when they come up. Patients might be pregnant, post-partum, menopausal, have prostate enlargement or other male issues, etc.

We teach patients and families about mental illness, psych meds, and other topics. We help families cope with the devastation that is having a sick loved one, a mentally disable loved one, who is often criminally insane and unable to leave a locked ward for the rest of his life.

We enforce lots of rules. We live with danger because the clients are allowed to do anything they like to us (not really) but we can never respond in anger. We can defend ourselves, we can overpower them in a non-hurtful way and we can restrain them with meds and physical restraints but there are very strict rules for how and when this can be done legally. She needs to feel comfortable being strict, firm, and fair, and not be afraid to be in charge of other people, either clients, visitors, or staff.

I hope this is helpful and that she finds her niche. God bless her for wanting to do this. She should seriously become proficient in martial arts and learn really good communication skills, learn how to get along with people so they won't attack her and will help her in a pinch.

[mysteri]

very nice, very comprehensive, very true!! I work in psychiatric utilization management and besides the above, I tell insurance companies all the above and why continued hospitalization is appropriate.

[tessa45]

You all are amazing with the responses. Thanks so much for all the great information! I am so impressed with everything you do as nurses.

And as for as what makes my daughter interested in psych nursing even though she doesn't know anyone who is a psych nurse... Just a love for psychology and the interest in nursing. She has taken AP psych classes, job shadowed in hospitals, even though they did not have a psych unit, but also knows those who work in counseling, special education, rehab programs etc. Putting it altogether gave her an interest in psych nursing. But as you all would know, once you actually get into nursing school, what you once thought you may love could very easily change to something else. So, down the road it could all change and that is okay too. Nurses are fabulous!

[Weeping Willow]

She might want to become a Clinical Nurse Specialist in Mental Health or a Nurse Practitioner in this field. I wish her all the best. If she cares about people, she'll be great no matter what area she chooses.:smilecoffeecup::Melody:

[aloevera]

I have been an RN for 30 years. Started in med/surg, then to home health, then to LTC, now for the past 2 years I have been in psyche and I just love it!! It is a combination of all of the above and more...Very good, thorough explanation from Weeping Willow above. She covered it perfectly.....:yeah:wanted to add that being a good listener, and being calm in rough waters is essential, and most important YOU CANNOT TAKE ANYTHING SAID TO YOU PERSONAL!!!!!

[darrell]

So, you wonderful psych nurses, what do you really do?

I'm a student graduating in May and headed for Psych with an intent to work in chemical dependency. I am also getting a certification from the state department that deals with this (OASAS in NY). My goal is to counsel and, eventually, to work into advanced practice or NP.

I work now in an inpatient unit as a tech. I facilitate groups as well as talk with clients in the milieu throughout the shift. With a nudge here and a question there, I help them feel their way from darkness to something brighter. It is a hugely rewarding field.

D