Would you change to psychiatric/Mental health Nursing ?

maureeno · Nov 4, 2002

I am a psych nurse. worked as a mental health worker before that. and began my interest as an 8 year old visiting my grandfather in VA hospitals. after 42 years of interest in the field and 30 years as a worker [22 as a nurse] I am ready to move to another field of nursing because of the over-reliance on drug tx. Mental health is about lots more than chemicals.

sanakruz, ADN · Nov 4, 2002

Right on Heidi!!!!!

I would recommend psych nursing. You can really make a difference. I find it very rewarding. I have had people with schizoprenia say some of the most poetic and poignant things I have ever heard. I think some nurses dont like psych because of the high risk of assault. This is real. Never corner (even figuaratively) an acutely psychotic paranoid person- they will lash out. Still, theres a craft to it and it can be learned. And just because these folks are not physically ill for the most part does not mean its safe to stafff 12:1, another concern for the nursing community at large and something else to drive newbies away

sanakruz, ADN · Nov 4, 2002

I must add something- the latest treatment modalities focus on wellness and recovery, much like a 12 step program. The responsibilty to stay well is the individuals. The latest meds are a boon. Group and individual "talk" therapy is a kick to me. I do see progress made! Yeah didactic behavioral therapy!

sjoe · Nov 4, 2002

"Originally posted by CliveUK

No patience with people who 'won't help themselves'?? Hmm - I think having an illness that affects their thoughts, emotions and perceptions might just get in the way sometimes - I dunno, I'm just guessing here.

These people are not 'wilfully' ill - they don't choose to be psychotic. It's as much their 'fault' as diabetes and hyperthyroidism are those people's 'fault'. "

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We know all that. I am glad that so many people felt free to express their emotional reactions here on this BB to being around the mentally ill. Emotions are usually not based on logic or "book learnin'" and are usually not PC.

I, for one, couldn't stand to work around burn patients all day, for example, whether it was their "fault" or not has nothing to do with it. Corrections or mental health, however, are no big deal for me. To each his/her own cup of tea. IMHO.

CliveUK · Nov 4, 2002

Absolutely Joe - I couldn't work with burn patients either, but I'd hope I would not use judgemental language about them. Yes, I understand people are just "venting", but so am I! These kinds of attitude are part of what keeps my patients isolated, marginalised, unemployed, poor and generally socially disadvantaged, not to mention vulnerable to actual physical assault on the street.

NICU_Nurse, BSN, RN · Nov 5, 2002

I absolutely loved my psych rotation in nursing school!! I had such an amazing experience, working predominantly with schizophrenic patients in an acute setting. We were encouraged to spend as much time with the patients as possible, thrust in there to mingle, talk, sit, hold hands, listen, play games, whatever. We were responsible for designing group activities and therapeutic group discussions to be held every afternoon, and when we weren't leading, we were able to support our other classmates with *their* activities. We weren't allowed to pass meds on the unit, so the bulk of our time was spent chatting and getting to know the residents for the eight weeks we spent at the hospital. I LOVED it, and felt such a remarkable connection and empathy for the patients I met. I felt very validated and felt that the work we were doing was essential- these people are the ones that others seem to forget about. We go on about our daily lives and are basically oblivious to the fact that some people struggle so to make it through a single day. (And when I say 'we', I don't necessarily mean us- the nurses- who have more awareness than the average person...) However, the more time we spent on the unit, the more I realized that the nurses did not do what *we* were doing. They had so many other responsibilities (medication compliance, care planning, safety issues, charting, etc.) and we were basically serving as counselors. It was the counseling aspect of the job that I liked the most, because I felt that some of these people needed desperately to be taught, with a gentle hand, how to live and how to take care of themselves, or how to control their emotions in a socially acceptable way. Though the nurses seemed to have precious little time for this (on this particular unit, it was left up to social workers and the like), I still wanted to go into Psych. When I was close to graduation, I discovered that NO ONE in this area would hire a new grad to work a psych unit/facility. NO ONE. It was very disheartening, so I was, by process of elimination, left with my equally desirable choice to work in the Maternal/Child area (I'm a gemini- I'm allowed to have two of everything!). I still think about going into Psych some day, and that could come sooner or later, but I do wonder how frustrated I would be having to deal with chronic patients all of the time, many of whom do not get well. We live in an instant gratification society, and I admit that it FEELS GOOD to send a baby home who is well or recovered, and know that, at least a little bit, my nursing ability will help provide some chance at a fulfilling life.

mageean · Nov 19, 2002

Hi Adrienurse. Hope all is well. I tried to e-mail you unsuccessfully. Locked units for Alzheimers sufferers still baffles me although I accept the necessity for a secure environment. We tend to use confusion handles etc and diversional techniques. What is your nurse(RN) patient ratio. I would be interested in developing this discussion.

Best wishes. Damian.

KRVRN, BSN, RN · Nov 19, 2002

First of all, I will never do psych because I love NICU too much to leave it. If I did leave I would probably end up in PICU or maybe L&D.

What I remember from psych is that so many of the pts were helped but were not fully functional. Or they could function fully but had many side effects from their drugs, which made them feel terrible, plus the public could detect them and so they were still stigmatized. They had these major illnesses that they took drugs (some, many drugs) for and still couldn't carry on normally. Between the society's stigma, the inability to work, the lack of support from families, the inability to afford rent, etc etc that some of them faced it was just so overwhelming to me. Maybe I just saw some of the sadder cases where no matter what we do they may act better but still won't be able to live a "normal" American type life that everyone wants. Then there was always a handful of pts that COULD have better outcomes but refused treatment or refused to help themselves or whatever.

It's hard to explain but it just didn't seem to me that there were many successful, full recoveries. Too many chronic, sad cases. I guess I just like seeing happier endings. And I like babies.

Sleepyeyes · Nov 19, 2002

OK, so call me weird.

I've worked with Alzheimer's pts. I like them, and I'm pretty good at working with them. Our "locked" unit was actually like a maze, 3 halls and an outside courtyard. There was enough space for the pt to satisfy that restlessness without feeling "locked in."

However, I could never take care of adult psych patients because I cannot deal with manipulative or outright psychotic behaviors. My scariest encounter was with a "young" elder who'd had his psych meds abruptly DC'd and then was completely out of control. Although I was the only one he'd let near him, for the hour and a half that I had to dodge various heavy items thrown against the wall while he tried to "free the hostages" were the most frightening of my life. I was so scared of him after that, I was unable to care for the pt for a few weeks til his meds were fixed, and even though he was then a real pussycat, I still broke into a cold sweat going into his room to give him his meds. He was strong enough to really hurt someone and it seemed like nobody cared about those of us who could've been hurt.

So Alzheimer's yes-- but MH, no.

SmilingBluEyes · Nov 19, 2002

I will tell you why I won't........ It is something I learned in nursing school during my psyche rotation...**ALL** nurses are PSYCHE nurses on occasion (sometime more then we would want to be).........no matter what area we work.........who has NOT had to deal with schiz., severe bipolar, substance abuse problems, or other issues in patients (or their family members) in their care areas at one time or another? True, I work in OB...Not generally a psyche floor.....but I have dealt with some SERIOUS psyche issues nonetheless....often folks either who are noncomplaint with their treatments or unrecognized to be ill....either way, the little psyche nursing I do in this area alone, is more than enough for me. I will stick to the area I am working in and continue to respect (VERY MUCH!) those that choose to care so well for psyche patients in their milieus. It's just not for me.:)

BadBird, BSN, RN · Nov 19, 2002

I stand by my feelings even though I have offended some, of course true mental illness is a disease just like any other and deserves full treatment. What I meant but did not state properly is that I am tired of fake suicide attempts tying up ICU beds just because someone had a fight with a significant other and wants attention, This happens so often it makes you head spin, they take up valuable ICU beds, and before your shift ends are crying and saying they just wanted to make their boyfriends/husbands/ etc. show them some attention. I guess I am used to people who are on deaths door trying so desperately to live and I just don't have patience for people playing games. Last night I had admitted a patient to ICU for observation, he was about to be arrested and told the police he tried to kill himself, so off to ICU

he goes, of course he told me he just didn't want to go to jail. This is what I mean by people who need to be accountable for their own actions. Part of the problem is the inappropriate admissions to the unit but that is a entire different thread.

ptnurse · Nov 19, 2002

In school I really looked forward to Psych. rotation and then just as quickly I hated it. My rotation was made up mostly of patients with problems like cheating spouses or other family based problems. Most of the problems could be solved by the patient just growing a backbone and standing up for themselves in the problem relationship. I realize that this unit did not depict true psych disorders, just people with a hard choice to make. As for truly sick psych patients, I just never felt very successful in taking care of them. The failure rate/rehospitalization rate is so high for the folks. I just never feel like I really accomplish anything with them.