will it get any better?

LisaNICUrn, BSN · Feb 17, 2018

Hi, I truly hope it gets better for you. Are you understaffed every day? Is management in the process of filling positions or does it seem that that's the norm and nothing is going to change? Like you, I feel a big part of psych nursing is talking to our patients and not just passing meds and doing assessments. I was in psych for 2 years (I've been out 3 but start again in a week), and we never took care of that many patients. We were an acute facility. When people were picked up by the cops they were brought there. The other facility would be a long term facility, and I believe they take on more patients, more like a nursing home. I don't know what kind of unit you have, and it's ok to have a few bad days here and there and be short staffed if someone calls in or something, but to feel horrible every day you come to work, is toxic. You're new, so that can definitely explain having to stay late to finish charting or what not, but that shouldn't be an every day thing either. I hope you have other co workers who can possibly help or let you know if it's the norm so you can make a better judgement of your future. Good luck

wingding · Mar 1, 2018

The work arena does not get better, however, you will get better at what you do & that will make you more able to handle your workload. Overwhelmed is an understatement for how any new psych nurse feels. I was in mortal shock & dismay for at least 1 year but had an intense desire to understand. After that it was more about learning & doing more pt. care with increased ratios (now at 11:1 at my facility). I believe in what I do, I believe we help people even though they won't maintain it, we help them. If you are hating your life, dreading going to work, you might look into a different avenue of nursing. The amount of "warm & fuzzy" feelings are very few & far in-between. Best days for me? Seeing the psychotic patient make a turn & start making sense or the hopeless person D/C with real connections & F/U care. Otherwise, it can be just another day in the neighborhood.

umbdude, MSN, APRN · Mar 1, 2018

I'm sorry you're going through this.

UHS is well known to have the worst psych facilities in my area. This for-profit corporation won't hesitate to throw RNs under the bus when bad things happened, and bad things happen a lot at UHS. One facility was shut down after numerous violations last year. The only reason they are still opened is because there's a desperate need for psych beds.

No matter where you go, inpatient psych is probably going to be very busy. But being busy is not the same as being unsafe. I've worked in 2 inpatient facilities and both have security on site, and each RN gets no more than 7 patients. Both jobs were incredibly busy, but I never felt like I could lose my license. I felt well supported by both nursing and medical staff.

I encourage you to start looking elsewhere now.

Meriwhen, ASN, BSN, MSN, RN · Mar 15, 2018

UHS is for-profit. And the problem with for-profit facilities is that they will do whatever it takes to maximize profits. This means they will cut corners wherever they can...and staffing is often one of those corners that is frequently cut. Yet they expect you to do it all in 8 hours, and with minimized resources.

Try to last the year if you can, then move on.

zephyr9 · Mar 15, 2018

I work in a UHS facility in a big city. We are chronically understaffed for MHTs and occasionally RNs. I frequently imagine what it could be like if we were adequately resourced.

I understand what you are going through. I am running continually the whole time I am there. It has gotten a little easier for me because I deal with the patients better. The managers are good and there are a lot of good staff. But I don't see it changing. I don't know what the root of the problem with the staffing is. They hire people but they don't stay.

For me it's like, 5% great shifts, 85% so-so (just gotta get thru it) shifts, and 10% **** (I got to get out of this place) shifts. Many have been total crapshows and one or two have been traumatic. All in all I feel an increased sense of competency.

There is a lot of room for improvement at this place. I admire many of the people who stick around there.

hrnurse · Mar 21, 2018

Have you thought about working in a clinic or outpatient setting ? I liked the learning curve in inpatient but it was always too much rush rush rush and burn out.

macfar28 · May 3, 2018

I worked at a UHS facility for a day and a half and turned in my badge and keys. (This was a prn position to supplement my full time psych RN job.) They planned to give us 5 days of orientation for 8 units and our psych techs 3 days for all units. Many of the pysch techs had no experience. I also couldn't get a straight answer from anyone about what the ratios would be. Too many red flags.

UHS is very unsafe and many locations have had sentinel events in their facilities (do a google search.) Even though you are new and still getting your feet underneath you, some of what you experience is inherent to the for profit model. Find another, safer environment in which to practice. Don't give up on psych if it's your passion. Best of luck to you!

Kittenx · May 8, 2018

Agreed, that is an obscene workload. At most I get 7 patients in a tertiary care facility.

I would find another job where the ratio is more appropriate. Or learn to do the best you can with what you have. For me, I would feel bad leaving patients that needed good experienced care. But also the risk to your license is quite high when overworked like that. I would feel conflicted in leaving the place for that reason, but you have to take care of yourself first before you can help others.

My suggestions:

Rotating well-practiced and condensed assessments on clients when working several days in a row... Triage these assessments and utilize time-limits with the client: "Hi patient A, I was wondering if we can chat and catch up on how you're doing. I have 10-15 minutes to meet with you..." Ensure you're doing assessments while giving medications especially on the ones you will not get to meet one-to-one.

Find a way to condense and modify the delivery of your therapeutic interventions. Whether that be referring to resources, giving out homework for the clients, handing out printed out information on crisis services, coping tools, ensuring you follow-up and that you are holding longer-term clients accountable for being part of their own recovery and on developing their skills etc. Relying on multidisciplinary care involvement when you can.

You will rely a lot on your social skills and therapeutic skills with patients to soften a blow of a nurse without enough time to give to everyone. You will have to set those boundaries on time in a safe manner- or cut to the chase and increase the support needed for a patient who is at risk via utilizing seclusion, one-to-one, sitting in the day room rather than dragging it out.

No doubt its a very challenging job, but just some ideas.

BeenThere2012, ASN, RN · May 18, 2018

Wow, Zephr9! I feel exactly the same as you! I too work in a UHS facility.

For the one who posted the question...The moderator said it best.