What is my "unit" called in english and what profession is it in the USA?

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Hey everyone.
I'm a german nurse and I work with people that have several different kind of disabilitys.
I assist people with cognitive, developmental, intellectual, mental and physical disabilitys, basically a mix of everything.

Every patient has the diagnose "intellectual inferiority" inplus other side psychiatric diagnoses such as "bipolar affective disorder, personality disorder, borderline and a ton of obsessive compulsive disorder". Not everything in one patient, but all have other problems.

Here an example of a client, I'll try to translate the stuff to english...

She is 24 years old, intellectual inferiority (70-80 IQ), has obsessive compulsive disorder (wants to be locked in the room after every hour for 5 minutes or else she starts showing autoaggressive tendencies or if you don't lock her in her room quick enough for 10minutes she starts biting other patients), has addiction to food and starts stealing food from other patients if you don't watch out for her or she starts digging around the neighbours garbage.

Thats basically one out of 16 patients I assist daily.

I'm a nurse but I basically have nothing nursing skills related to my job. I just assist them, talk a lot and basically help them in their day to day life (washing them, go shopping, educate how to use money, how to behave in public etc.)

Another Patient is this guy:
He is 44 years old, addictive to alcohol and smokes a lot, use to work "normal" but drank so much he is kind of slow and is verbal aggressive, has bipolar affective disorder and is sometimes psychotic/ delusional (for example, he didn't shower for 3 weeks because he thought gas is coming out of the showers and got so scared he didn't leave the room for a few days), if you don't calm him while he verbal aggressive he CAN get aggressive towards patients and nurses. He keeps telling us we are giving all the clients poison when we pass meds.

Basically every patient is kind of like that, but some are very quiet and don't do a lot.

Its not a psychiatric unit, we are mianly a group home for handicapped people. Any ideas what this is in the usa and can I consider this job still as being a "nurse" eventhough I do nothing really nurse related (IV's, catheters, ...)? I feel like I'm not in a real nurse job anymore.

My team is a mix of "Gesundheits- und Krankenpfleger "(Health & Healthcare Nurses, basically a normal nurse) and social workers (maybe curative education nurses?)

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Specializes in school nurse.

In the US, your current job would most closely equate to Development Disability nursing (which often overlaps with psychiatric nursing). Here, also, clients such as you've described live in group homes.

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So my job is still nursing related? I sometimes don't feel like a nurse anymore if I compare my tasks with ICU or ED etc.

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What makes a nurse different from an aide is what is going on in your brain more than what you are doing with your hands. You are educated as a nurse so you are a nurse regardless of your current skill set.

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Its just so weird. I asked a friend of mine that works ICU currently if I could join him a day or two at work (no profit) and check it out. A lot of things I kind of "relearned" after trying it 1-2 times but I'm sure I couldn't do a shift alone at all. I don't even know all the basic tasks required nor have the knowledge of that stuff anymore. If I think about it I'm not even sure if I could work on a lot of different places, especially dialysis. I remember setting up all the machines in the morning, I have no idea about that stuff anymore.

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It comes back.

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In California, the state runs 3 facilities that sound similar to what you describe. Registered nurses and other healthcare staff run them. Technically the units/level of care are called Skilled Nursing Facilities and Intermediate Care Facilities for the Intellectually Disabled.

https://www3.dds.ca.gov/services/state-facilities/

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Specializes in ER OR LTC Code Blue Trauma Dog.
7 hours ago, Grogon said:

So my job is still nursing related? I sometimes don't feel like a nurse anymore if I compare my tasks with ICU or ED etc.

It's a nursing specialty, just like any other specialty. You are working with a community of cognitively impaired individuals, and therefore an understanding of their disease process is required to perform your job function.

It's challenging in the fact you will be required to learn various nursing skills to effectively interact with them. You may be required to assess and determine their psycho social status in an effort to document and maintain records of your observations. You may be required to assist in the development of individualized nursing care plans. You may be required to ensure they have a safe physical environment. You may be required to monitor and document their nutritional status. You may also be required to consult with their physicians and provide them input about clinical therapy and treatment intervention options etc... etc... etc...

Yup, sounds a lot like nursing to me. ?

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Specializes in Dialysis.

To me, sounds like a nursing and social work blend for Psych and Developmentally disabled. If you enjoy the work and have a job that pays a wage that you can live with, it's the best that you can hope for. Nowadays, so many don't have that

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Specializes in Psychiatry.

Hallo Mein Freund!

So, disclaimer in advance, I am not an American nurse and can't really speak to the particulars of the type of nursing you do in the USA, BUT I hope to address your insecurities about not feeling like a "nurse" because you haven't done IVs and such in a long time.

The type of area you work in currently is recognized as a specialty area of nursing (in Canada at least). The area here (Canada) is called Dual Diagnosis Psychiatric Mental Health Nursing (Dual diagnosis for short). Now, a quick look on google shows that this area exists as well in some states of the USA.

So, you would technically be classified as a psychiatric nurse. Your skills are highly specialized to this area. You may not think this is psychiatric nursing, but believe me, this is psychiatric nursing.

It is normal for you to feel "out of place" in an area such as ICU when you have practiced for the last many years in an area that is unrelated to ICU. But trust me, your skills are very useful, valid and important in this day and age with mental health getting more recognition.

If you are considering changing to ICU and more acute care nursing, perhaps you can take a re-orientation course or a specality course that prepares you for this area of nursing. These exist in Canada and would almost bet they must exist in the USA (as the USA tends to have better educational initiatives for nurses).

Hope this answers some of your questions and addresses some of your insecurities! ?

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Thanks all of you the quick and nice answers.

I get paid "okay", which means I get the same amount of money I would get if I were to work in a normal hospital as a nurse (in Germany we don't get a lot of money), a bit more than the total average income.
So moneywise I'm quite fine.

Its good to hear that my area has a "name" lol. I think I'm kind of depressed currently even though I love my job.

For example I go to work at 6 in the morning, get the patients ready (wash them, prepare breakfast with them (show them how to use the knife etc.), either show them how to eat the prepared breakfast correct (lol.. sounds funny, is actually funny sometimes..), pass morning meds and get them ready for work. I bring them to work by bus or we walk - depending on weather and then its already 8 a clock til I get back to the group home. At this time I have only 4 more patients that have to go to some program as "prework" because they can't really work yet. They learn easy stuff such as bringing the news paper away, draw, sing songs etc. just for the concentration.

So the thing is, once I bring them to that place I'm alone from 9 - 11 and can do whatever I want. Most of the time I'm on the computer reworking their "development plan" (what worked out, what didnt work out, what should he/ she be able to do in the future, how can we reach that goal etc.) so basically easy things for 2 hours and then I pick em' back up and we eat lunch and after that they take a break and the lateshift comes and I leave.

I think why I'm feeling kind of not like a nurse is because of the big spare time from 8-11 I have... I could actually watch TV or play on my smartphone and nobody would care.
The lateshift is basically the same just the other way around (2-3h computer, telephone, ...), pick em up from work, prepare dinner/ help with dinner, pass meds, play games or take a walk etc., get them rdy for bed and chart about 10-20min.

Next month a co-worker and I will be going to austra for a week with 5 patients and hike. It sounds fun, it is fun most of the time but 3 patients are kind of complicated in public (yell around or if you turn around and get something they are gone, or maybe (happend once) they just pull the pants down and poop...)

In the end my day isn't as stressful as in the hospital. Sometimes I take a patient to the cinema and even get money for that. In Germany I get free entrance to the movies as well and I'm allowed to write the time I'm out with my patients as work time because my boss says "its work. You are doing something with him/ her, they are having fun and learning something and that is work - period." so yeah I basically worked 5 hours longer today cause I went to the movies with my patient that wanted to watch lion king and didn't have to pay a penny for it. I'm not even sure if I can tell that anyone. I mean not all days are like today. Sometimes I come to work and already hear every patient SCREAMING and I'm like "Oh dear.." or sometimes they jam their heads against a wall, yell around that they are getting poisened, or sometimes I get a call from shops why we didn't pick the item up that we ordered and I'm like "WOW! we didn't order anything, it was that patient we told you guys he can't order anything" ... etc.

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7 minutes ago, Grogon said:

I think why I'm feeling kind of not like a nurse is because of the big spare time from 8-11 I have...

In the US we would kill for that amount of time to chart and do care plans which is exactly what you’re doing. It may not seem like it but what you’re doing IS nursing.

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