I've posted a few times on here...anyways, I have been a RN for 4 years now. When I was in nursing school and before that I wanted to do Psych nursing at one of the local psych hospitals here (strictly for psych, not a med/surg hospital with a psych floor). In college took abnormal psychology and loved it. I was the only student in my class that loved the Psych rotation but hated the L&D/Peds rotation. Everyone else was opposite.
When I graduated from school there were NO psych nursing jobs...I thought I'd work Med/Surg to do my skills and eventually make my way to the Psych ward at the trauma hospital. I ended up leaving before I reached that because I was so burnt out of the hospital floor with pts collapsing and whatnot nonstop. Since then, I've done clinic, OR, and now Home Health. I'm trying to stay in this position for 2 years since I have a poor track record so far on my resume with longest held job at 1.5 years. However, there is currently a psych nursing position available at the hospital that I was initially interested in. It's been on the market for a year now!!
Aside from the initial interest in psych and enjoying my psych rotation at the VA, I really don't know exactly what a pysch nurse does. Can someone please try to explain to me in a few short sentences. Maybe what a typical shift is like, 8 or 12 since I've worked both, but preferably days, I've never worked nights. :)
I understand its stressful, like all jobs nursing or not. I don't think its stressful like busy med/surg floor nursing. It's probably similiar in stress levels to my other jobs in Home Health, Clinic, and OR. But the thing I like about psych nursing is that it's not about med/surg but more about medications, groups, and talking/listening to pts. I'm an excellent listener.
I'm thinking of spending a day at the hospital to see what its like, but a heads up before I go would be fantastic!!
Either respond to this message or email me at ap517 at yahoo dot com
Wow, thanks for that reply -- insightful and interesting. I hadn't given much thought to outpatient or more community-based mental health nursing, only because they seem to be cutting and cutting that area in the state I live in. Still, though, I can see where that would be rewarding, and it's good to hear that you like your job so much.
Like I said, the only experience I have so far is with a state hospital and a psych floor of a private hospital. Very different between the two -- at the state hospital, typical census 25 or so on a unit, there's one or two RNs, another nurse who does most of the medications, and a couple nurse techs (who do routine vitals, finger sticks, room checks, and deescalate incidents + care for the patients a lot 1:1 with getting drinks, socks, laundry, etc.). The RN seems to do a lot of delegation and management of the other employees, plus admissions, assessments, discharges, a group or two with teaching, and notes, especially if there's only one RN working. At the private facility, census was often way low, but at this facility, 3 or so RNs were on for 10-15 patients, each RN had a set number of patients (3-4) and did more complete patient care (meds, assessments, etc.). Many of these nurses seemed to be a lot less busy than the state hospital nurses, though it depended on how acute the patients were. Maybe some were also a lot less motivated? I can't tell if it's an individual hospital culture thing, or if it's the norm....
Sometimes I wonder if there's much time for RNs to do a lot of patient interaction. I've asked and I hear often that "there's no time to do much of that" (aside from the assessments and brief progress assessments). Again, I don't know if that's just typical employee griping, or if that's reality?
I think I'm going to stick with trying to do psych. Like I said, I had a good career in a completely different field and I quit it to go back to school because I specifically wanted to do psych nursing. I don't think I'd want to take another type of job unless I had to, though I'm definitely going to look into more community based stuff. I wish there were a list of what all you could do with nursing in this area...I know there's probably more with domestic violence type stuff and substance abuse.
I just feel like I wasn't trained so well in my psych rotation to know what it's all about. It makes me nervous...I'm hoping they will train more "on the job."
All of you nurses have wonderful experiences, thank you for sharing. I am entering into a somewhat distance RPN 2 year diploma program here in BC in January 2011. I have been an LPN for two years already but I have a passion for psych nursing ever since I was a little girl. Anyway my question is if you are all RNs or RPNs, and do you find there is alot of work for RPNs out there?
I am an LPN in BC for the past two years and am entering a registered psychiatric nursing program here in bc in january 2011. I have always been very fascinated with psych and am looking forward to my schooling. My question is whether most inpatient units are staffed by RNs or by RPNs? In my research I have talked with RNs and RPNs and each have their own views and ideas and I would like some clarification, please.
PS I was also wondering about the job possibilites, I live up North so it might be harder to find work here then in a big metropolitan center?
Do the places where you guys work use a medication window or whatever they call it. A window where patients line up to get their medications.
Also if your facilty uses a mdeication nurse can a person just be the medication nurse every time.
I remember the place where I did my psych rotation used a medication window and had a nurse that always gave the medications. Medication nurse seemed like a fun job when I there. Is this common in other facilities or was it just the facilty where I was at.
Specializes in med-surg, post-partum, ER, psychiatric.
I have been in psych/mental health nursing for awhile now, having come from Med-Surg, ER, L&D (and still working EMS as medic/RN). I was working, till about a month ago, day shift. I am on one of the most violent and active units of our entire psych hospital. Currently we have over 20 patients. When I worked days, I was the ONLY RN on duty except one day/week then I was doubled up with another day shift RN assigned to our unit. Our make up is, (if I could digress for a second here), 3 day shift RNs and 2 night shift RNs assigned to our unit. We all work 12-hour shifts and have one shift that is our 8-hour to get in our 80-hour pay period. Our shift time is 0600-1830 hrs/1800-0630 hrs. Day Shift has rotating shifts with working every other weekend. Night shift has more set shift. Ok, that said. When I was working days, as mentioned above, I was essentially on by myself (the otehr two day shift nurses were doubled up most of the time.....of which a lot of the times, one of them would get pulled to another unit). We do our CofS at 0600 hrs (RN-to-RN), then at 0630 hrs Day Shift RN will do CofS with day shift Psych Techs. Once get them going for the day, then review emails, check staffing assignments, do med watch (if not doing own meds.....usually there is an LPN assigned to the unit....and on our unit, the LPN also serves as the unit clerk). Staff meeting is generally at 0900 hrs. Once a week, we have patient staffing and that is at 0930 hours where the entire treatment team and those affiliated with the patient meet to review specific patients staffed for that particular day (each patient is staffed monthly). On our unit, we have an enormous amount of seclusions and physical holds/restraints of which can get up to as high as 20/day. Day Shift RNs chart on DOS, 1:1's daily, do any PIRS for seclusions and restraints, RN data notes, as applicable. IF there is time, RNs do RN groups of various sorts. I had about three different groups I did........not as regularly as I would have liked to have been able to do, but with how our unit is, I was busy doing charting most of the time. It was RARE if I ever got a lunch break at all. Essentially never. No coverage essentially. At 1430, another CofS with afternoon shift psych techs.....get back to the unit a bit before 1500 hrs...........get patients ready for their various scheduled groups........and this time period is THE most hectic time period/most chaotic until 1530 hours. That transition period.................and most challenging especially when therapists do NOT show up on time and patients are anxiously awaiting..............that is one of the time periods we have seclusions/retraints increased..........On our unit, due to the design/set up of our type of unit, we do it ALL: housekeeping/cleaning (except once a week, housekeeping comes in and does the "deep" cleaning), laundry for patients, meals (hospital kitchen sends over meals, but we are responsible for cleaning up/washing everything to be sent back to the kitchen) .....we do it ALL. We also have several DOS/1:1's and a lot of time we barely have enough staff to adequately cover our unit. If we have a seclusion (and we have multiples), it really taxes our staff immensely. Another CofS at 1800 hours between the RNs (one going off and the other coming on). Throughout the day, we are constantly monitoring patients, caring for any who have medical conditions/illnesses, etc. This is just the tip of the iceberg for Day Shift. Night Shift is a bit less hectic and less stressful. The most stressful time period is from the time the NS RN comes on at 1800 hours till patients go to bed around 2000-2100 hrs. During that time, there are still on-going groups/activities for the patients, on-going cleaning, laundry, et al that didn't get done during the day shift. NS RN has charting on all of the 1:1s/DOS's as well, any data notes, as necessary, then (only on our unit) it is the NS RN who does all the RN weekly charting and treatment assessment notes (TANs- monthlys) in that Day Shift simply does not have the time. On other units, that are far less hectic than ours, they divide up the Weekly's and TANs amongst the RNs and shifts. We have enough to keep us busy throughout the night although we do have more down-time during the night shift compared to day shift overall and it is a bit less stressful overall. I have found that I am far MORE busier working psych than I ever was during Med Surg et al (and before switching to night shift, far MORE stressed out). It is a different type of work overall...........and everything is relative.............I would suggest having a strong Med-Surg background before coming to work in Psych though.....in that have to be on top of your game with being able to do thorough assessments on patients and being able to differentiate between somebody who is being somatic or one who truly is having a bona fide medical issue. I have know of cases of patients who have died as a result of not getting adequate and thorough assessments because of their reputation of being very somatic.........you know the old crying wolf "syndrome"..............There are so many of the psych meds that cause medical issues and some mimic other things..............I know there's been an age old argument about there's not that necessary "need" to have med-surg before coming to psych..........I had kinda thought that once, too..........but since then I have seen the light..........and see the results of such..............so..........just saying.............Psych is truly rewarding..........psych is NOT for everybody........it takes a special person to be able to do this type of job.........and have that compassion and understanding of our patients........even the Borderlines................At any rate, I gave you a somewhat idea/overview of what we do.............but there is a LOT more we do do on a daily basis.................Best of luck to you in your decision...............
I haven't worked in psych for many years now. However, I use to work in state psych hospitals which I found to be extremely dangerous places to work at that time. We were all constantly breaking up fights and staff were getting injured on a regular basis. People at that time would ask me "What do you do for a living?" I would always say "I am a "bouncer at the state hospital."
manchmal
61 Posts
Wow, thanks for that reply -- insightful and interesting. I hadn't given much thought to outpatient or more community-based mental health nursing, only because they seem to be cutting and cutting that area in the state I live in. Still, though, I can see where that would be rewarding, and it's good to hear that you like your job so much.
Like I said, the only experience I have so far is with a state hospital and a psych floor of a private hospital. Very different between the two -- at the state hospital, typical census 25 or so on a unit, there's one or two RNs, another nurse who does most of the medications, and a couple nurse techs (who do routine vitals, finger sticks, room checks, and deescalate incidents + care for the patients a lot 1:1 with getting drinks, socks, laundry, etc.). The RN seems to do a lot of delegation and management of the other employees, plus admissions, assessments, discharges, a group or two with teaching, and notes, especially if there's only one RN working. At the private facility, census was often way low, but at this facility, 3 or so RNs were on for 10-15 patients, each RN had a set number of patients (3-4) and did more complete patient care (meds, assessments, etc.). Many of these nurses seemed to be a lot less busy than the state hospital nurses, though it depended on how acute the patients were. Maybe some were also a lot less motivated? I can't tell if it's an individual hospital culture thing, or if it's the norm....
Sometimes I wonder if there's much time for RNs to do a lot of patient interaction. I've asked and I hear often that "there's no time to do much of that" (aside from the assessments and brief progress assessments). Again, I don't know if that's just typical employee griping, or if that's reality?
I think I'm going to stick with trying to do psych. Like I said, I had a good career in a completely different field and I quit it to go back to school because I specifically wanted to do psych nursing. I don't think I'd want to take another type of job unless I had to, though I'm definitely going to look into more community based stuff. I wish there were a list of what all you could do with nursing in this area...I know there's probably more with domestic violence type stuff and substance abuse.
I just feel like I wasn't trained so well in my psych rotation to know what it's all about. It makes me nervous...I'm hoping they will train more "on the job."