What is psych nursing really like???

Specialties Psychiatric

Published

I've been an RN for 3 years and have worked med/surg-tele, ICU, and ER. I'm now thinking of making a move to psych because I can honestly say that I hate traditional bedside nursing.

1) I am sick of constantly having to clean up feces, urine, emesis, and other ungodly bodily fluids. That I know of, psych patients perform their own ADL's.

2) I'm tired of having to deal with obnoxious patients and family members that think you are their personal servant/slave.

3) I'm completely over doing all the disgusting medical nursing tasks like cleaning pressure ulcers, changing dressings, inserting foleys and rectal tubes, etc.

I am assuming these things won't be an issue is the psych unit, but you know what they say when you assume. I don't want to make the switch and later find out that it is not what I thought it was. That being said, every time I've been to a psych unit, the nurses have seemed pretty relaxed and content. Definitely not stressed out like in other depts.

Any input from experienced psych nurses as to what it's really like to work on a locked down psych unit will be greatly appreciated. No sugar coating. By the way, I'm a 26 year old male, so dealing with psych patients does not frighten me and will not be an issue.

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Specializes in Home health, psych.

I'm new to psych nursing and love it. I never felt overly passionate about procedures so this seems like a great it. I always knew peds was a passion and mental health and peds really have a lot in common when you get down to how you work with the population. I work in an acute adult unit and the patients are till needy and assume you at there to fulfill their ever loving request. The flip side is they perform their own ADL's and if a med consult comes back needing further med assistance they are sent to ER. Time met is necessary bc we hv 8 patients and the meds/assessment take about 30 min per patient. When you add that to new admits and dc the day can get away from u if u aren't organized. I really enjoy he doctors we work with as well. Overall I don't think you'll know until you try it.

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Specializes in Nephrology, Dialysis, Plasmapheresis.

I too hate bedside care.. I simply can't do it and admire those that do. Have you ever thought about a specialty like cardiac cath lab, surgery, or dialysis? With your experience, you could prob do a lot of things. i only say that because psych nursing has lots of bad sides too from what i hear. I do acute dialysis. I come to the rooms, do my treatments and all the other stuff: I am not legally allowed to do. It is challenging, technical, and if you work a lot of overtime, can be great pay!

It sounds like maybe you want to stay in the hospital? If not, why not do some outpatient stuff. I don't know about other hospitals, but the ones I've seen, you still get med surg type patients on psych floors, so some bodily fluids will still be around. I hear cardiac cath lab is a dream job...

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Thanks for the responses guys. I've actually been considering cath lab, OR, and dialysis as well. Basically anything that takes me away from traditional bedside. I just don't want to keep bouncing around to new depts. It looks bad. I want the next dept I choose to be the one I stay in.

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Specializes in Nephrology, Dialysis, Plasmapheresis.

Dialysis is somewhat of a revolving door. People either hate it or love it. Maybe somehow you could shadow in those departments to get a real feel for the job. Dialysis is great in acutes because you have complete autonomy and independence. I am a traveler and sometimes i never even meet my supervisors! You have 1 patient at a time and you can plan your own day. Some places even let you come in at 10am as long as you get your assigned treatments done. I find it challenging with the technical aspects and also sticking difficult patients. Things are always different. You're all over the hospital. I also love chronics (outpatient dialysis), because the patients are walkie talkie and it's like one big family that gathers three times a week. Not to mention no nights or weekends. This may be too routine for some. Other down sides include being wayyy too busy in outpatient and not being busy enough at the hospital. I get bored doing acutes at times, sitting there watching the clock, but I know I'm being envied by many other people.. It has it's downs. Clinic work is challenging and fun. I never sit down. It is scary though to be in charge of 20 patients and 5 techs who you don't always trust.

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Thanks for the responses guys. I've actually been considering cath lab OR, and dialysis as well. Basically anything that takes me away from traditional bedside. I just don't want to keep bouncing around to new depts. It looks bad. I want the next dept I choose to be the one I stay in.[/quote']

I'm a cath lab nurse. Love/hate job ~ loooove this type of nursing! But sometimes HATE being on call for STEMI's - you get chained to the phone. But a very "immediate gratification" once you help save a life :)

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Specializes in Geriatrics, Adult Psych.

I have been an inpatient psych nurse for over 6 years, having come from being an LNA in LTC. I don't deal with lots of procedures and body fluids anymore. I DO deal with lots of people with psych issues and/or misaligned attitudes. Milieu management (relationship redirection and education in a safe and controlled environment) takes up most of my energy on a daily basis. I love what I do, but I know it truly isn't for everybody. Those of us who work comfortably and successfully with psych patients unsually have a history of confronting and overcoming our own personality disorders first........ and continue to face them down again daily.

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I work in geri-psych and deal with stool, urine, spit, vomit, blood... oh, everyday ;).

I'm always worrying about my old folks' BP's... geeze, I just sent one out to ER and it turned out she turning a wee bit septic :wideyed:.

They may be declared "stable" when we get 'em, but sometimes not so much!

I have my share of dressing changes, foleys, colostomies, casts and imobilzers and IV's and I'm still toileting and helping out with showers when I can.

Some days... I dread looking at my labs.

But that's my elderly for ya... a lot of medical issues on top of psych issues.

Most nurses hate floating to my unit... heh heh.

A nurse with your experience would be welcome with open arms, but if yo are sick of doing that stuff, stay away from geri-psych... which we lovingly call "mini med-surg".

The "sweetest" unit in our facility is Eating Disorders. It's like a picnic over there, but I detest it, personally. Not my bag.

No matter what area you work in psych, you will deal with obnoxious, non-compliant and drama-ridden behaviors.

On the plus side, we don't do a lot of sugar-coating and patients will get called on their behaviors.

You also have to be able to be firm and yet be able to be soothing and know how to deal with difficult behaviors (it's like being a snake charmer sometimes).

I love it but it's not for everyone.

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im new to nursing i work in a acute intake unit in a hospital based facility. we do not do much of the unpleasnt stuff like vomit etc unless a patient urinates or poops themselves on purpose. although we did have a involuntary hold pt tell us last night she would pee on us if we tried to medicate her haha we all know how that ended.

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I love psych nursing. I worked as an intern on a med/surg unit throughout nursing school and it was great getting experience with starting IV's, inserting foleys, etc., but med/surg is definitely not something I would want to do again. Can I handle it? Yes. I did great and my manager was irate when I quit. Do I want to handle it? Heck no. It's just not for me.

It's good to have some medical experience because many patients come to us because they went to the ER d/t a medical issue and then the ER staff noticed they were having hallucinations or something. I see a lot of high BP and there's a lot of patients detoxing which you know can be serious. Every now and then you'll find something or something will happen where they'll need medical attention, but they get sent back to the ER so it's nowhere near what you have to deal with in a med/surg or ER setting. At the same time, I feel like staff at the "regular hospital" tries to send patients to us before they're medically stable enough because they don't want to deal with the psych aspect. I know it can be hard working on med/surg trying to juggle all your patients when one of them is taking their clothes off or doing bizarre things. It's also frustrating for us when we have 10 patients who are supposed to be medically stable, but one of them has a blood pressure of 76/46 and we don't have IV fluids. We simply don't have the equipment/supplies to deal with medical issues. They aren't even in the supply closet. A lot of psych patients have positive symptoms because there's something medically wrong. So, you don't have to do all the hands on nursing skills in a psych setting, but you still need to have the knowledge. Just like when an elderly patient gets confused when they have a UTI, a psych patient who has been doing well may start having symptoms when they have renal issues or something. The hospital wants to send them to us because they think it's a psych problem, and we want to send them back because we think it's a medical problem.

You have to be a real advocate to work in psych. You get to know a lot of the patients because you see the same ones over and over, or you've gotten familiar with symptoms of a particular diagnosis even if you don't know the pt well. You can tell when Suzy is REALLY having abdominal pain even though she's been known to say there's a litter of kittens living in her belly. You can keep up on your medical skills if you want to. Just like a professor once told me, "If a nurse wants to sit at the desk, they can always find a reason to, and if a nurse really wants to be with the patients then they will." Every patient who comes in the door has to be assessed. It's not a requirement to do a complete physical assessment, but if you want to do one then you can. There are TONS of labs drawn in psych so if you want to draw blood and keep up on that skill then you can, but if you want to sit at the desk and let the lab guy draw labs for you then you can.

You won't know if you like it until you try it. I personally love it and never dread going to work.

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I work in a juvenile residential treatment facility for youth with drug and alcohol addictions and pysch issues. I felt I had found my calling when I was working on my psych rotation during nursing school. I never wanted to be a hospital floor nurse. There are days I wish I had the medical background of a hospital floor nurse. But for the most part our kids are healthy.

I pass a lot of meds. Do blood draws and take care of patients with diabetes. I do intake assessments. I patch up kids after they have gotten into fights, and I take care of their injuries from the gym. Sometimes we have kids who return from surgery. I don’t get to practice many “nursing skills” but I have yet to have to clean up any bodily fluids. I am learning the art of therapeutic communication though. I do hand out a fair share of bandaids, crackers and water.

Most days I love my job. I truly enjoy working with the kids and seeing them progress in our program. Then there are days when someone is DTO/DTS and life on the unit becomes pretty stressful. Sometimes they will just go up and down the halls kicking and punching walls, yelling and knocking over trash cans. When we cannot get them to de-escalate we have to put the kids into a CPI hold. Sometimes this activity sets off other kids on the unit. When we have to put a kid into a CPI hold it is hard on everyone. They kick, scream, cry, yell, spit and try to bite the staff. While injuries to staff are not that common, they do sometimes happen.

I love the moments when I feel like I might have made a difference, even a small one. I have comforted kids who were missing their parents because CPS took them out of the home. I have given compliments to many girls who have never had positive reinforcement from anyone. One girl told me that no-one had ever said anything good about her and her face lit up when I complemented her. A big part of my job is role modeling appropriate behavior.

I am new to psych nursing but I hope this gives you a picture of what I deal with on a daily basis. Most of our kids have been kicked around, beaten down, homeless and neglected. They just need someone who cares enough to help them through the hard times. I try to make each one of them feel valuable.

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Thanks again guys. I actually shadowed someone in the psych unit a couple of days ago and I quickly realized that psych is definitely not for me. I left within two hours of arriving. The place feels like a prison and the patients are beyond annoying, disgusting, and absolutely coo-coo for coco puffs (duh). Not my cup of tea.

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