I am really interested in nursing, particularly psych nursing. I know that I can do it, and do it well. But....then I read things like this (in my area).
It is really intimidating! I have three children, I can't risk getting stabbed at work and possibly killed? Thoughts? Experiences? Am I being naive thinking it's OK for me to go into psych nursing? Is this type of thing the norm? Is psych nursing dangerous?
I was actually interested in working with rehab or addiction patients (and it sounds like those are the ones that tend to get violent), or youth.
I find that my detoxing patients are rarely violent because they're too sick from detoxing. Drug-seeking addicts presenting to the local ED/clinic to try to score some narcotics are more likely to get violent.
Now kids...they can act out more often and more violently than adults do. Then again, it's all about staff acting to head off escalating behavior ASAP. In psych, you can not be reactive--you need to be proactive.
Honestly, got hit a few times and kneed in the jaw once and I had a few patient's threaten to hunt me down and kill/rape/sodomize me when they got out, had a patient bite himself in the tongue and spit his blood at me yelling "here's some HIV (Expiltive)!" - overall though I was never seriously injured. I had behavioral codes that resulted in S/R multiple times a day because patient's would attempt to assault staff/another patient or be so disruptive to the milieu that they became an imminent risk to themselves and others. My team was a very, very special and skilled team and we were all super focused on personalized behavior plans for all of our patients.
This wasn't to say that the unit was without injuries. Sadly, we were often understaffed (I worked for the state and state government would not vote us more staff positions) so we relied heavily on the float staff and often times they didn't have the training or experience to work on the unit. I can't blame them, unless you start off in max and are use to the pace - it is extremely overwhelming. I would have staff come from the community transition units (patient's so stable that they could hold jobs in the community and only had to check in at night) and freeze up when they were faced with some of the behavioral codes. We're always with a buddy and if that buddy doesn't have experience than sometimes they run away and hide in the chart room while you're on the floor getting beat.
My unit was actually pretty good, we had a brain injury, broken bones, many bites, some broken faces and messed up joints. Hospital wide though, sometimes patient's on the lower security units would just flip. In max we were pretty prepared for it because it was our specialization. However when a patient from the medium security units - where they have much more freedom of movement and can have personal items- loses it, it could get brutal. We had a tech get stabbed in the face, neck and head with a pen, we've had patient's cut their arms open (known blood born disease) and shove it in a staff member's mouth, we've had patients put batteries in socks and beat staff and so on. Usually those are the cases where my team and I would show up, contain and transfer the patient back to my unit.
Can Violence happen in Psych? Yes. Some units, departments, hospitals ect. have more violence than others. It really depends on what type of floor you are on. However, you will encounter violence in all areas of nursing and quite frankly there is a potential for violence in all areas of life. As a psych nurse - especially one that works mainly with violent behavioral patients - it's all about knowing how to prioritize, personalize, create a cohesive team with your staff, and try and come up with personal behavioral plans so that you can prevent assaults, increase the patient's coping skills and safely contain it if the patient cannot redirect using least restrictive measures.
It is like you read my mind. I was just talking to my husband about the time he came out of anesthetic swinging without even realizing it. So, no offense taken. I am definitely aware that there are risks in other areas of nursing as well.
It is like you read my mind. I was just talking to my husband about the time he came out of anesthetic swinging without even realizing it. So, no offense taken. I am definitely aware that there are risks in other areas of nursing as well.
That actually happened to my father too: he was coming up from anesthesia and got violent. He didn't remember it and initially didn't believe my mother when she told him what he had done.
I worry about violence too...I'm now working a mixture of inpatient and outpatient, but primarily outpatient. As part of a local brand-new ACT team, we're seeing clients in their homes and in the community. So far we have a very small caseload so I haven't been in too many dicey situations. I honestly feel more comfortable seeing clients in their home than I do on locked, secured, inpatient units. I don't feel "scared" of our clients but the other members on my team are really, really uptight about never seeing anyone alone, thanks in part to our therapist being a former women's self-defense instructor. He doesn't even want me to go just deliver meds to a client alone, even if I just knock on the door and hand the meds over. I find it pretty over-the-top and a huge waste of staff time, personally, since one person is just sitting around a lot watching things happen.
What I get most nervous about is someone going off the deep end and coming into the outpatient building and attacking people. In that case I guess it would just be random dumb luck or lack thereof if I happened to be around and get shot or whatever. It does make me a little nervous because yeah, I don't wanna be taken from my kids or anything, and I think the risk is significantly higher than just some random setting like at the grocery store or something. But what are you gonna do...just hope for the best, I guess.
Thanks for responding umberlee. That is my concern, my kids. I am very interested in psych nursing for a career, but I don't want to risk dying when I have three little ones that need a Mommy. I worry too about getting badly beaten and coming home looking horrible and them being upset by it. It really is the only thing holding me back at this point from just going for it.
Specializes in LTC, assisted living, med-surg, psych.
I was working OB one night when a fellow who had a restraining order preventing him from seeing his wife and newborn baby (domestic violence) came up to the floor with a gun in his hand and threatened to shoot anyone who got in his way. Thankfully we had a "panic button" behind the desk to summon security, and I hit it while trying to talk the guy down; security was there in less than 30 seconds and the police weren't too far behind them. They were able to disarm him and get him out of there quickly, but the experience was pretty scary. Just goes to show that violence can happen in ANY healthcare facility, on any unit.
Specializes in LTC, assisted living, med-surg, psych.
He never got that far. Another nurse came out to the nurse's station and we kept him distracted long enough for the muscle to get there. The patients didn't see or hear a thing till it was all over. :)
I am a new grad who sought out a psych RN position....been on the job 3 months. I currently work in a state psych facility and yes, there is frequent violence. I have already been rattled a couple of times and there have been a few people (staff) who needed to be sent to the hospital, plus patient to patient violence a few times a week. We have, in my opinion, a few patients who do not belong in our unit and not a lot of support to manage their behavior. Also staffing can often times be a joke. However, the place where I did my psychiatric nursing clinical rotation for school was a much calmer and therapeutic place where violence is a very rare occurrence, but they don't hire new grads...so I'm doing my time. On the upside there is a lot to learn, we have some of the sickest patients with complicated issues and the majority are not violent, in fact they are far more likely to be victims of violence. It's a shame to have them in the same facility with the few and very disruptive people who have no business being there in the first place. So it depends, but mostly I think unless you are in a poorly run, underfunded state facility (like where I am!) violence should not be an issue :)
So it depends, but mostly I think unless you are in a poorly run, underfunded state facility (like where I am!) violence should not be an issue :)
State/county facilities do tend to have more of the chronic cases and subsequently potential for violence. I work per-diem as such a facility and like you said, the majority are actually NOT violent. But there are a few live-wires there, and all it takes is a couple of patients acting out and the media to get hold of and sensationalize an event (let's be honest: the media tends to spin the worst when it comes to psych, AEB tons of B-grade horror movies)...
Meriwhen, ASN, BSN, MSN, RN
4 Articles; 7,907 Posts
I find that my detoxing patients are rarely violent because they're too sick from detoxing. Drug-seeking addicts presenting to the local ED/clinic to try to score some narcotics are more likely to get violent.
Now kids...they can act out more often and more violently than adults do. Then again, it's all about staff acting to head off escalating behavior ASAP. In psych, you can not be reactive--you need to be proactive.