What is Psych rotation like?

Finally2008 · May 4, 2008

Well, it depends on where your clinical is and also what floor/unit you are on. I was in the day hospital area for young adults w/substance abuse. They came to this area after they had spent their time inpatient for detox. They spent their days at this location in groups of various types and then they slept in the locked facility. I spent most of my day in their feedback groups or just talking to the clients casually (therapeutic communication). In this case, their meds were "self-administered" in that they just came up to the nurse's desk and filled out what meds they needed and I gave them the meds out of their drawer. I also did lots of paper work, filling out their chart from the information received from the inpatient unit. We could also do PPDs (I never got to) and we filled out the information for drug tests (urinalysis) and monitored them while they urinated. The mornings were spent in report with each of the counselors, the psychiatrist, and the social worker discussing any changes to any of the new cases or discussing any new clients. I actually really liked this clinical, but I have to say it can be very sad and very discouraging sometimes (like when clients make it through 6 weeks of rehab and being clean and then they just leave). Lots of sad stories, lots of young people with bipolar disorder or depression/substance abuse dual diagnoses.

crunchymomx3 · May 4, 2008

I agree it depends on the facility.

For me, I was at a facility that housed all ages of people suffering from a wide range of mental health issues but no eating disorders and it wasn't a rehab facility. We had 20 minutes to talk to our patient using therapeutic communication, 10 minutes if we were working with kids. The rest of the time was spent reading notes and doing paperwork. If we had extra time, which we usually did, we were able to hang out in the general area with the patients. Sometimes they'd talk to you and sometimes not. It depended on who was out at the time. These patients were all really bad off so it wasn't odd to see them talking to themselves, swearing, etc.

I actually enjoyed my psych rotation.Probably because I felt like it was pretty easy (for me personally, but I have a mom who suffers from severe clinical depression and a brother who is bipolar with BPD) and also because I felt like everything I learned in psych made it easier for me to really communicate with my patients.

BTW, we also have a summer rotation at my school. 6 weeks of the most intense med/surg rotation you can imagine. :bugeyes:

quiet_one · May 4, 2008

My psych rotation was great

It is alot different than the medsurg rotations, for me it was mostly observation and doing careplans on the patients I talked with. We did several different locations for this class, 2 different substance abuse hospitals and 4 days at a state hospital, one day in the ER, and one day at a nursing home. I learned so much from just interacting with the patients.

Good luck with your psych class :)

I love my cat! · May 4, 2008

Lots and lots of charting. During the rotation we also sat in on a lot of group discussions.

It was a bit frustrating at times.

One example that comes to mind:

The med passes were at the same times every day, yet nobody seemed to be able to remember them. We wasted so much time searching for people who had "forgotten" about their routine medications...

BUT...

The same people who always forgot about their meds and made it a wild-goose chase always managed to remember when their smoke, coffee breaks and meals were. They would be gathered around us 10-15 minutes early.

hinakhoja · May 4, 2008

Very interesting and sad as well.

I enjoyed my psych rotation a lot and that I can never forget. We were given one psych patient for a week and we had to learn all about his diagnosis, symptoms, treatment etc, we also had to perform a "mental status examination MSE". Further, It is all about therapeutic communication with the patient and at that time we used to conduct sessions for diversional / relaxation therapies for the mentally ill patients and after that they really feel relaxed. We were taken to a Navy psychiatric hospital at that time. On the other hand, in our hospital setup occupational therapist is also available and we had to accompany her in order to learn what strategies are being used to engage mentally ill patients in a very effective manner. Here they use their skills which is remarkable as they make paintings and all.

Though it has been a very good learning experience but its a very sad experience too as when you see very young patients with suicidal attempts, drug abuse, bipolar disorders etc having no control on themselves is very painful to experience. When I go for audits in psychiatric unit in our hospital and while checking documentation i have to read the history of the patient as well and sometimes it is very difficult to forget about the pain which the patient and his family may be suffering from.

on the whole a very good learning experience. Good luck!

BabySweetpea · May 4, 2008

In our rotation we spent 6 weeks in a state hospital. We were assigned 1 pt and had to do tests with them like the mini mental and others. We also had to attend groups with them, attend the inhouse court, rounds and come up with a teaching project for that pt. We did not pass meds or provide any "direct" care. It was mostly observational. As others said it was sad. Alot of these people had been there for years and years.

I do have a bit of advice though.... use the buddy system, dont put yourself in a position of being alone in a stairwell or elevator with a pt. Position yourself properly in rooms with pt's, such as not being able to be blocked from the door. :no:

NightOwl0624 · May 4, 2008

Thank you for your replies. I am starting this rotation next week, and I am really nervous, not sure what to expect at all!

I have had some personal issues with mental illness in my family. I think I am really nervous about being on the professional end, so to speak. I hope it isn't too emotional for me!

guy_nurse · May 4, 2008

I HATED it, I am not a psych nurse type.

NursKris82 · May 4, 2008

Mine was awesome, though I do agree it depends on your facility as to what you'll be doing.

I was at a hospital stress unit. The patients were all ages from 18-80 with all kinds of issues- mainly lots of depression, but also substance abuse, bipolar, havind hallucinations, delusions, lots of suicide attempts and thoughts of suicide also. We spent most of our time in groups. We had 1 1/2- 2 hours of talk therapy and then 1 hour of recreational therapy. Those took up a lot of time. Otherwise, we talked with our patients.

I do not want to go into the psych nursing, but I really liked this rotation. We did not pass meds (it's better for staff nurses to do because they may be paranoid and expertise with these patients and a rapport might be needed to administer the meds) or do any typical "skills", so there was less stress of having to be watched and so on. I learned so much about communication and really learned how to use thereapuetic communication practically and effectively. I was also surprised at my ability to see thru their illness to the person. I never thought when I started this rotation I would be able to listen to a woman tell me her clearly delusional story with a straight face.

You also learn that some people have crappy lives and crappy childhoods- the stuff I saw in the chart and heard in group is what scary movies are made of. It may make you more grateful for your life and your upbringing.

It just finished this rotation and really enjoyed it... I hope you do too!!

crunchymomx3 · May 4, 2008

I do have a bit of advice though.... use the buddy system, dont put yourself in a position of being alone in a stairwell or elevator with a pt. Position yourself properly in rooms with pt's, such as not being able to be blocked from the door.

We were not allowed in pts rooms at all. All of our interactions with patients were in direct view of everyone.

hinakhoja · May 5, 2008

in our rotation we spent 6 weeks in a state hospital. we were assigned 1 pt and had to do tests with them like the mini mental and others. we also had to attend groups with them, attend the inhouse court, rounds and come up with a teaching project for that pt. we did not pass meds or provide any "direct" care. it was mostly observational. as others said it was sad. alot of these people had been there for years and years.
i do have a bit of advice though.... use the buddy system, dont put yourself in a position of being alone in a stairwell or elevator with a pt. position yourself properly in rooms with pt's, such as not being able to be blocked from the door.

"good advice! i remember on the first day of our clinicals when we were also scared too our faculty advised the same thing and that i always remember as an incident had happened with one of our students. be careful always keep yourself near to door and keep a safe distance between you and patient during communication. otherwise no worries"