Why did you choose psych nursing?

verene, MSN · Dec 22, 2019

I like to think psych nursing chose me. I had no idea when I applied for a position at a local ALF as a new CNA that the ALF was for individuals with SMI. They offered me the position and I was desperate for a job at the time - I had doubts but figured I could do anything for a few months while looking for something else. I ended up staying nearly 2 years and was hooked on working in mental health. It is this experience that opened the doorway for me to psych nursing - I doubt I would have considered this field with out that experience.

I think having had family and friends impacted by mental illness, as well as some of my own experience with stress/anxiety/burn out probably helped me adapt to working in this field, but if anything having individuals in my personal life affected was one factor that made me initially reluctant to work in mental health - I wasn't sure I would be able to separate my personal experience from my professional role. I think it does keep me mindful though that my patients are far more than their current acute presentation - I am in all likelihood seeing them at their worst - and my job is to help them get back to who they are at their best.

I believe people are people and everyone is doing more or less the best they can with the resources they have available to them in that moment. I think "good" vs "bad" when speaking of people is completely inappropriate - all of us have potential for both, and what is "good" or "bad" in one situation may be the opposite in another.

It would be impossible for me to say that my spiritual beliefs have no impact or influence on my work, however my role requires that the *patient's* spiritual beliefs come first in my day-to-day interactions. I have enough familiarity with other faiths that I can engage in surface level dialog around a number of different traditions and will refer to my colleagues in Spiritual Care as needed. If any of my coworkers or patients can accurately identify my own personal beliefs and religious identity I would be very, very surprised as it isn't something I bring up at work.

FloForLyfe, BSN, CNA, RN · Dec 22, 2019

I noticed your word choice for decision making. ✅

Before learning about nursing I tended to be pretty judgemental. Being perceived as callousness or cold-hearted does not help others to feel accepted. Learning that compassion is not a simple word has been interesting and difficult. I have learned from you response, thank you.

GeriLPNtoPsycchRN, CNA, LPN, RN · Jan 12, 2020

On 12/22/2019 at 4:47 PM, FloForLyfe said:
I noticed your word choice for decision making. ✅
Before learning about nursing I tended to be pretty judgemental. Being perceived as callousness or cold-hearted does not help others to feel accepted. Learning that compassion is not a simple word has been interesting and difficult. I have learned from you response, thank you.

"Before learning about nursing I tended to be pretty judgemental."

This is absolutely me. I went into the nursing field (CNA) at 19. I was soooo judgemental. And ppl actually called me "stuck up" a LOT.

Today, after 20 years, 1 as a CNA, 18 as a LPN and now as an RN, I have seen so many things, situations and different people that I am now the least judgemental person at my job.

Seeing people at their very worst gives you insight into humans. Nursing is the best thing I've ever done.

FloForLyfe, BSN, CNA, RN · Jan 12, 2020

Ah, so true. Most days I am pretty non-judgemental, but every now and again my judgemental personality reemerges. I originally wanted to be strictly a psych nurse, but I changed my mind pretty quick. It is tough though, because in a med-surge environment it is easy to identify who the psych patients are in a timely fashion.

penelopelp · Jan 13, 2020

My mom has severe mental illness. I’ve had my own challenges with depression/anxiety, and I’ve had friends with various mental illnesses.

I don’t necessarily believe that there are “bad” people—in general. I mean, Jeffrey Dahmer was very evil. However, when it comes to my patients, I don’t ever think they are bad people. Some of them just make some really bad choices. Plus, I work with teens and most of them have suffered quite a bit of trauma.

I don’t know that I have religious beliefs that guide my practice that much. I sometimes pray before a shift and I’ve been known to pray to myself when I’m with an escalated patient.

verene, MSN · Jan 13, 2020

2 hours ago, FloForLyfe said:
Ah, so true. Most days I am pretty non-judgemental, but every now and again my judgemental personality reemerges. I originally wanted to be strictly a psych nurse, but I changed my mind pretty quick. It is tough though, because in a med-surge environment it is easy to identify who the psych patients are in a timely fashion.

I'm curious what initially drew you to psych-nursing and then what drew you away? My personal experience is that it is much more difficult to manage psych patients in non-psych settings because of workflow, lack of support/resources, and rooms that are not set up to be safe environments for the suicidal or highly agitated patient, as well as general stigma against mental health including a LOT of judgementalism from staff and lack of staff comfort in managing patients with mental health diagnoses.

FloForLyfe, BSN, CNA, RN · Jan 13, 2020

I was initially drawn to psych nursing because I have been an inpatient psych patient about four times. Therefore, I am maybe more familiar with some of the stories leading up to mental breakdowns, loss of moral fabric, hopelessness, and general pessimism. It hurts my feelings sometimes knowing how good all of "nurses" have it made. We are able to make basic decisions every day that we completely take for granted. The sharp pain of not saying anything to confront a seeminly cold-hearted nurse because I know that it will interefere with my job -- intereferes with my job. Ironically these statements can be made not only in (without?) regard to psych-stigmatized statements but also simple actions such as an audible rolling of the eyes, withholding information, justifying the condition of the patient, or --sad to admit it-- the dreaded "what are we doing here"?

Through my inpatient and outpatient programs I have been enrolled in many classes for mental health, mindfulness, and cognitive-based methods. I even enrolled in a college-level class. In nursing school it became morally damaging to hear the other nurses speak down on this specialty, or at least how I percieved statements such as "I became a psych nurse because I could not get a job anywhere else", "once you become a psych nurse it is hard to break out of the specialty", "I could never be a psych nurse", and "this rotation is so annoying". I also found that my clinical instructor was seemingly particularly emblazened to find every possible critique about my assignments and school work.

My mom said a few times that she wishes I could go to school speciafically to become a psych nurse. Thank you for asking, Verene.

The0Walrus, BSN, RN · Feb 26, 2020

I actually didn't want to do psych nursing. I got into it because my mom had a TIA and wanted to learn how to take care of my mom as she got older. My friends told me since I didn't have a BSN I would never get work in the ER, ICU or oncology and to just go to a nursing home until I finished my BSN. I was an EMT & ER tech and thought it would have helped me. I applied to all positions at most hospitals. Everyday my job was to apply to 5 jobs each day. I applied to psych thinking I didn't want to work there but nobody was calling me so I just went with it. I half-assed the interview thinking I didn't want it and got hired! They loved that I was an EMT and they said I must have had many experiences with psych patients. They loved how I handled the psych patients I had dealt with. Go figure..

As for good & bad people I think there are good & bad people based on my belief system. By that I mean because I think someone is a bad person it is because of my own personal beliefs. For example: in my psych unit there is a girl who is 8 months pregnant and had cocaine metabolites in her system. She is also bipolar. I think she's a bad person because she does cocaine while being 8 mths pregnant. I still care for her if I have her and ironically she likes me because I don't just medicate her with Benadryl & haldol. I try to redirect as much as possible. She always has listened, but when you read about her history you can see why she is who she is (father abused her, molested her).

I'm not religious. I'm culturally aware of my Judaism and very proud of my culture but I'm not religious. For my work-life balance I'm out with my girlfriend on my days off, studying and practicing Jiu Jitsu & Judo.

Safety Coach RN · Mar 25, 2020

Been sober 32 years from drugs and alcohol. Multiple suicide attempts with bouts of depression/anxiety. Juvenile criminal record/ adult felony arrest for involuntary manslaughter, which I served out 5 years probation and off my record.

Psych nursing was a 2nd career for me. After I sobered up, I had to make money to support my children and ended up in management to running a business for 9 years.

The most fulfilling job I ever had though was working with B.D. children as a teachers aid.

I ended up with an opportunity to take a few years off work, paid cash for my BSN once my older children started leaving the nest.

More of a calling than anything. 4 years inpatient adolescent psych, 2 years inpatient adult psych and now a year as an intake coordinator.

I love what I do.

boochohandsup · Aug 11, 2020

I just wanted to get on the jump wagon as a psychiatric aide at a mental clinic. I first applied to the psychiatric aide position because my awesome nursing mentor was an RN for the company. I chose to work as a psychiatric aide over working as a CNA. During my mental health clinical, I was impressed by how mental health professionals and nurses attempted therapeutic communication with patients on the inpatient unit. My mentor worked at a crisis clinic, where ER patients requiring drug rehab, medication management, or domestic crisis were referred to the crisis triage.

I enjoyed working at inpatient unit for some adrenaline rushing time where multiple staff needs to pay attention to a patient's not medically threatening mental crisis. At that time, while attending nursing school, I was still uncertain about my goals. Initially, I enjoyed communicating with patients in mental health facility, but I feel like the depression, anguish, and mental illness started creeping in me. Maybe, I just did not have a personal answer to the origin of each patient's crisis. Whether an middle adult was suicidal, or the same mental patients returned to the crisis unit, expecting them to make better choices.

At my facility, as I worked closely with peer counselors, one bottleneck problem I found was housing is becoming more expensive, and these folks have hard time finding a job. It is my personal thought, but is also supported by Dr. Paul Conti M.D a psychiatrist from Johns Hopkins University and a guest on Joe Rogan Experience said that medications should not be the first level treatment for patients with mental illness. I heard from the podcast that Hydrocodone is one of the most prescribed antidepressant.

What struck me was patients often perceive sadness and depression as unnatural. Of course if sadness and depression are the default feeling, it is a problem. However, people like Viktor Frankl, a Jewish survivor of Holocaust or some grandparents who witnessed WWI and WWII or were born in the era survived a lived a good life. Of course, Viktor Frankl is a rare survivor, but isn't his popular enough for people in crisis or mental health professionals to guide patients to Dr. Frankl's own logotherapy? If patient had horrific trauma from their family, shouldn't we address problem at the familial level?

The above is part of my thought where I began thinking why are patients receiving too much medications for depression. By the way, I am a male and identified as an introvert, regular built. I had several depressive episodes, but I never used medications, but sought college therapists and church young adult virtual groups. I am doing way better and became a believer of minimalist approach that "you can do more with less." Based on minimalist approach, I just cannot imagine how more antipsychotic medications will solve depression or crisis in young adults. Also, I also became aware that I feel the pain for people who don't have enough wealth, but I also believe that wealthy people do deserve that money.