Working as a Psych Nurse as a new grad RN?

Sheryl18 · Nov 16, 2014

I think it depends on where you live as far as places that hire new grads. How are you with conflict? I am just wondering how you would respond in a code situation, it can be very stressful and intense. Patients can lose control and be assaultive/aggressive etc. I just don't know if that would cause you anxiety, you know yourself best so only you can answer that. Being a good listener is a wonderful trait that you will need. There are also injections in psych, some in a code situation, some as scheduled like Risperdal consta and of course there are always some insulin dependent diabetics. I am sure in time you will get more confident in clinical, it's ok to be clumsy and slow at first, especially when you have an instructor watching you, it will become second nature before you know it. Good luck in whatever you choose!!

Pangea Reunited, ASN, RN · Nov 17, 2014

I work in a med/surg/telemetry unit that gets assigned every patient with a psychiatric diagnosis, too. While some of the patients may love to talk, their communications are not always accurate, and sometimes they make no sense at all. The listening and giving advice that you speak of sounds more like something that would occur in a psychological setting as opposed to a psychiatric one.

We also give a fair amount of forced injections to restrained patients. They're often screaming and attempting to fight because they're so confused. It's intimidating at times, and could be even more intimidating to someone who's not comfortable with injections to start with.

I thought about starting out in psych, but a lot of places wanted at least one year of med/surg experience. Psych patients can't always tell you what's going on, so it's important to have developed strong assessment skills. There are places that will take you straight out of school, though. Some people start out in psych, do well, and absolutely love it. There are probably less volatile units than the ones I've had experience with, too.

Whispera, MSN, RN · Nov 17, 2014

Listening to people's stories is something a psych nurse does, but a psych nurse doesn't give advice. That's not therapeutic and not what we should be doing. In fact, it's one of the "no-nos." The idea is to get them to figure out for themselves what they would be willing to do to help work through their problems.

I'm shy too, and had trouble at first, jumping right in to talk to patients. It comes with experience, so don't worry about shyness.

You will be doing hands-on care in psych. Psych patients have medical issues besides needing emergency injections and conflict resolution (including restraints sometimes). They have diabetes and need insulin and to have their sugar checked. The have labs drawn, have breathing treatments, enemas, tube feedings, and dressing changes, and physical assessments. In one place I worked, my psych floor had the only peritoneal dialysis patient up to that point, so we all had to learn how to do that. Don't assume you won't be doing med-surg things just because you're on psych.

It's kind of usual for a new nurse to be worried about his or her skills. They come with experience. I started as a psych nurse right out of school, and learned as time went on. It's totally do-able.

Michelle King · Nov 17, 2014

Listening to people's stories is something a psych nurse does, but a psych nurse doesn't give advice. That's not therapeutic and not what we should be doing. In fact, it's one of the "no-nos." The idea is to get them to figure out for themselves what they would be willing to do to help work through their problems.
I'm shy too, and had trouble at first, jumping right in to talk to patients. It comes with experience, so don't worry about shyness.
You will be doing hands-on care in psych. Psych patients have medical issues besides needing emergency injections and conflict resolution (including restraints sometimes). They have diabetes and need insulin and to have their sugar checked. The have labs drawn, have breathing treatments, enemas, tube feedings, and dressing changes, and physical assessments. In one place I worked, my psych floor had the only peritoneal dialysis patient up to that point, so we all had to learn how to do that. Don't assume you won't be doing med-surg things just because you're on psych.
It's kind of usual for a new nurse to be worried about his or her skills. They come with experience. I started as a psych nurse right out of school, and learned as time went on. It's totally do-able.

Yea, I definitely agree about the advice thing! It might be ok with friends, but patients are a different story

Oh no, I didn't mean to say there will be no med-surg care - I thought there will still be some med-surg care in psych, but I figured it wouldn't be encountered as frequently.. Unless I'm wrong?

But thanks for your answer!! I appreciate it.. Was it hard for you to find a psych nurse job right out of school?

Pangea Reunited, ASN, RN · Nov 17, 2014

There are different types of psychiatric units. In some, the patients have to be medically cleared before they're admitted and you won't do much beyond hand out routine PO medication. In other units (like mine), you do everything that would be done in med/surg along with dealing with the psychiatric issues.

Whispera, MSN, RN · Nov 17, 2014

Where I've worked the nurses have done everything that didn't require machinery that could be thrown or used by the patient to hang himself. Sometimes we even did those things, with the patient in full view until the gadgets weren't needed anymore.

I got my job as a psych nurse right out of school, but I had worked on the unit as a tech during school.

If you are a person with a strong, assertive presence, I think you're more likely to be hired than someone who comes across as nervous...

LisaNICUrn, BSN · Nov 18, 2014

Well psych is a wonderful field to work in. I started out in psych right after graduation. I precepted there and loved it from day one. I understand being nervous, that's normal for any new nurse. You have to be honest with yourself if you don't want med surg because you are so overwhelmingly nervous or because you just don't want to do med surg. I've been in psych about 2 years. We definitely have our share of medical, but nothing like a main floor. We mainly do accuchecks, vitals, IV lines once in a while, a lot of wound care from self-inflicted wounds, falls, and fights. We definintely give injections, and you have to be willing and ready to give them in an emergency sitution while 5 people are holding a patient down and he/she is fighting, yelling, cursing, and be ready to act like it didn't happen later on because you have to treat the patient the same, just cautious at all times.

I wanted psych too, from the beginning of nursing school because like you, I loved to help people, listen to them and give advice. I learned very quickly that we are not the therapists here. That is what the actual therapists are for. Now don't get me wrong, we listen to our patients, but we never give advice, and you just don't have time to listen to an hour long story from each of your 9 or 10 patients in a day. It can definitely be stressful, but if you don't like much of the nursing aspect of being a registered nurse, then psych is an avenue for you to take.

RatchedAfterMidnight, MSN, APRN · Nov 19, 2014

I started in psych straight out of nursing school in May, and so far it has been one of the best decisions I've ever made! The pressure to take a med-surg or critical care GN internship is so strong in DFW, so I was terrified to leap outside of what every other new grad does and try psych first.

One year ago, I would not have described myself as someone who would have made a good psych nurse. I soaked up as much content in as I could in class but was slower to take on patient care. You aren't done learning those skills when you graduate nursing school. If you want to think critically and quickly, develop leadership and management skills through milieu management, and master communication techniques, you will be trained and you will develop that confidence. If you know in your gut psych nursing is what you're supposed to do, do it :)

dream61792 · Nov 21, 2014

I can agree with you. People think I am weird for liking psych and potentially being a psych nurse after graduation but I had my Behavioral rotation this semester and I love it.Especially working on the adolescent unit. While other students are struggling with psych questions they come natural to me. I am just scared that if I do decide to go into psych straight out of nursing school my med-surg skills will suffer and I won't be considered a "Real Nurse"

TerpGal02, ASN · Nov 22, 2014

You sound a lot like me in nursing school LOL! Felt like a deer in headlights in med/surg but got to psych rotation and thought, "ahhhhh". LOL! I went straight into psych almost 3 years ago as a new grad and have no regrets. One of the things I like about psych is you really can see it all. You can have med/surg like stuff with detoxing pts, geropsych, or medical/psych units. You can take care of peds-little, little guys right up through. You really can see it all and I have in my 3 years. I love it.