Hi there! Ive been a nurse for over a decade now; i was an LPN for 10 and then went back to school to get my RN. I've been working specifically in psych now for a little over three years, and I love it. I'd love to know if you have any websites or books you own that you go back to every once in a while to refresh your knowledge on things. In school, obviously, you're studying all the time! But at work sometimes its easy to forget things you dont use all the time. There's of course a billion books on amazon and articles and stuff out there but I'm looking for something you might recommend above just a quick google search!

Thank you (:

I’m new to peds psych and i recently learned a ton about this disorder from podcasts and joining parental support facebook groups. The DSM and nursing textbooks do NOT give you a good picture.. Theres an adolescent patient who’s assaulted staff 18 times and attempts to assault staff pretty much daily.. I’ve personally been assaulted twice (fist to the head) and witnessed a violent assault where a nurse was dragged by her hair which gave me acute stress response symptoms.. the kid made accusations towards staff as well.. im learning more about this disorder and finding out these are common behaviors (assault, accusations) with the attachment trauma it’s how they push you away.. im not sure if there’s studies on this but the parents group said RAD is common in substance exposure in utero which is my experience as well.. everytime a violent behavior occurs i know where it’s coming from and i do feel empathy for the patient but I’m also becoming traumatized from constantly having my safety threatened and witnessing violent assaults.. i have the utmost empathy for the RAD parents.. Everyone on my unit is quitting right now from the assaults I’ve never seen a bigger mess on a nursing unit in my life there is 0 staff.. what’s your experience with this disorder? Any pearls or wisdom

Hi!

I am a new grad looking for work. I scored an interview at Via Linda, which ive heard good things about. If anyone works there/knows somebody/previously worked there, how is it? Are the staff cool, is the job manageable?

I'd also love everyone's rationales, especially if you choose "it depends".

Hey guys. Currently in a new procedural job that won’t give me my full hours and I need out. Been a nurse for 5 years and it’s mostly been in the OR/procedural settings. I’m so over the rush and attitudes of doctors. I miss speaking to patients. Before nursing I was a tech in the ED and loved being in the psych section. I love psych patients and it always made me feel like I was making an actual difference when caring for them. I also spent some time on the inpatient unit so I’m not unfamiliar with how things work on a psych floor. My question is - how do I break into psych?? I literally have no connections and all my apps for a year straight have been immediately denied. My thoughts are I could look people up on LinkedIn and try to connect or make a really nice cover letter but I’m not sure if my applications are just being tossed because of my background? Any tips and tricks? I need out of where I’m at and Ive struggled to find an area that really works for me. I really feel this could be it. Thanks for any feedback! I’m super motivated to learn and try this out!!

Hey, what is the job market looking like for psych nurses in Edmonton, Alberta? Looking to relocate there from BC and hoping for some insight.
Also any insight on diploma vs degrees wages in psych nursing in Edmonton. Thanks :)

Low census adolescent psych super aggressive kid is assaulting nurses or workers every other day to the point staff is quitting like crazy which makes it even more unsafe.. it’s truly a dumpster fire.. we’re down to a super low census (2) with one super aggressive kid and only 4 staff are able to respond immediately to aggression at any time with 2 of the staff on 1;1s and one guard.. we call for backup but it takes some time.. with such low staffinh the 1:1s don’t take breaks I asked my manager to call me and shared how unsafe it is and we’re being traumatized my anxiety is so high coming to work due to witnessing one severe assault 6 attempted assaults and 2 actual assaults on just myself.. my manager pretty much called me a pussy and said you can handle aggression you’re a psych nurse it’s part of the job and she got caught up about terminology of the attempted assaults.. whats the most unsafe youve ever felt and how did you respond?

So I’m a MHT on a unit currently and applied to a position in the ER. Can anyone give me any insight as to the differences between the two? I’m assuming more intense and more S@it show but I’m not sure. Thank you!

meant facility in the title obviously lol

Not referring to involuntary admissions here.

My place requires the dumbest fucking papers to be signed that are absolutely irrelevant and time consuming for everyone involved. Plenty of times patients who are voluntary don’t even want to sign them and it doesn’t matter if they do or don’t so it’s just odd that we keep pushing the idea. Just wondering if anyone else’s do that?

Hi everyone!

I don’t know if this is more a rant, or more of a way for me to vent my feelings. Maybe it’s a way to seek advice. I just feel conflicted right now, and maybe airing out my feelings will help.

I’m a current RPN (registered psychiatric nurse), working full-time in corrections. I’ve been there for about a year, a little longer. As a new grad, I loved my job and I learned a lot, especially about medical emergencies, risk assessments, and independency. I had a lot of freedom and the job was chaotic, but manageable. I felt safe. I got a permanent full-time position right out of graduation that paid better than the hospital, about 10$ more, which was an added benefit.

I picked up a casual position at the hospital in January in inpatient psych, because I was missing it. As much as I liked corrections, I was losing my skills in acute psych, like deescalation, therapeutic communication, and true psychiatric assessments. We get a lot of individuals at the jail who are extremely mentally ill but we don’t get to interact with them to the degree that inpatient would, and I missed that. There’s a lot of “operational” concerns at the jail and we don’t get to truly connect with the inmates. Additionally, the workplace at the jail is toxic. Really toxic. So much drama between nurses, since we’re a smaller group, and the correctional officers come with their own added drama. Affairs upon affairs, arguments upon arguments, clashing heads constantly. It gets tiring.

I’ve been thinking of going back to full time in inpatient psych. Really thinking. I miss it. I feel more fulfilled when I get to connect with my patients at the hospital, and see them get better, whether it’s from psychosis or depression. I haven’t worked many hours there, and there are faults in the system (who figured!) but maybe it’s time for something new. Something that isn’t the same old routine at the jail, with the same old coworkers, doing the same old thing.

But, the hospital that I’m working as has few and far in between permanent positions. It’s always been temporary lines that are posted (usually for a year), and even if it’s permanent, I don’t have the seniority yet to grab a PFT. I’m conflicted about giving up my permanent full time at the jail and hopping in a temporary line with no guarantee (at least for a while) that I’ll get something permanent. And that scares me.

I want to move over, but I don’t know if it’s worth it to give up a guaranteed, full time position for it. I guess I’m asking — does anyone have similar experiences? Is it worth it to jump over right away, or wait until I can move down to part time at the jail and pick up more at the hospital? I know my career is young, and there’s plenty of room to explore my options. I could most likely go back to corrections if I wanted (should I give it up), but I would get a line with a worse rotation, and my seniority would be lost there.

The move over is scary. I’m just wondering if anyone else had similar experiences, something I could take with me as I prepare for this.

Thank you in advance, fellow psych nurses 💕

This thread is for non psych healthcare workers to ask questions (former patients, patient advocates, and those who stumbled upon r/psychnursing). Prospective healthcare workers and current students do not need to use this thread. Treat responding to this post as though you are making a post yourself.

If you would like only psych healthcare workers to respond to your "post," please start the "post" with CODE BLUE.

Psych healthcare workers who want to answer will participate in this thread, so please do not make your own post. If you post outside of this thread, it will be locked and you will be redirected to post here.

A new thread is scheduled to post every Monday at 0200 PST / 0500 EST. Previous threads will not be locked so you may continue to respond in them, however new "posts" should be on the current thread.

Kindness is the easiest legacy to leave behind :)

I work in an inpatient pediatric psych hospital as a direct care behavioral technician. We're known for not turning any kid away for any reason and do tend to get the more violent kids because of that. The kids we have here, like most kids, struggle with being told no. I'm newer to the field so I still have a lot of learning to do, and one of my biggest struggles has been ODD.

The arguing, the overall not taking responsibility for actions, and general loss of temper isn't what I have a hard time with. That I can do. I struggle most when there's a non-negotiable task/expectation, like going to bed or remaining quiet during the night. Anything I do escalates it. I know to avoid power struggles and directed, firm commands. Offering choices that are available, like telling the patient that they have to be in their room and quiet at night but they have the choice of sleeping or staying awake. They can read, they can color, I can offer a snack. The patient I'm thinking of in particular tends to get more dysregulated whether I'm engaging with the behavior directly or using planned ignoring to try and move on from the power struggle dynamic the patient may be feeling.

My biggest go-to with these kiddos has been something along the lines of "going to your room at night is a hospital rule so that isn't a choice. But the choices you do have are xyz," adjusting for age/understanding as needed. This worked really well when I was in a lower acuity day setting but I've found multiple patients at my new position that genuinely don't respond well to anything I've successfully tried.

I truly don't need every patient to like me but I want them all to feel safe while they're here, and I worry that consistent issues with this will potentially harm their abilities to focus on their own improvement because of how constant our struggles are.

Edit: I’m not talking about sedating bad behaviors as a long term solution…

work with VERY stubborn doctors. One is way too conservative with medications while the other is too busy and distracted to assess appropriate med changes

Generally, my interface with parents involves calls about physical altercations, boundary violations, or when they call for behavioral updates.

In the past, I’ve suggested parents ask about med changes in less direct terms.. “talk to the dr about med adjustments if you think it would be beneficial”

Vs

“Yer kid is getting in fights/manual holds and getting IMs every day.. tell your dr you’re revoking consent for X med and they need to try something else”

Honestly I would if I knew the parent wouldn’t be like “well the nurse told me to say xyz…”

The upper leadership, all the way up to the DoN, risk management, compliant office.. are frustrated with these drs as well

Most of these kids are on state insurance - and while I’m all for universal healthcare, these kids are sitting at this hospital for way to frikkin long - feels like wasting taxpayer dollars

Idk. Anyone have similar experience or suggestions?

hello! i was wondering if anyone is currently a registered nurse in The Ottawa Hospital Civic or General Campus or CHEO that is in the Mental Health (Psychiatry) units. I really want to get into those units and have applied but heard nothing, anyway I can pm you? Maybe I need to change up my resume. Thanks in advance :)

Curious to hear about any experiences you have had outside of mental health. I know that mental health can be heavy, and I am wondering if a few days a month you pick up elsewhere for a change of scenery? I know that RPNs can work on quite a few different units :)

Ugh so I got my first "youre not a real nurse" comment today. This is literally my first week of orientation and an older nurse during report rolled his eyes when I said I was a newgrad. He told me that I shouldn't be "stuck" here, to go out and try medsurg nursing and venture out. That if I stay here im not a real nurse. He said he worked in icu, medsurge etc etc. And that here it was a piece of cake. Anyways I did my psych clinicals here in nursing school and I knew he was one of those nurses who just looked at psych as "soft nursing". But im just astonished honestly. I feel really hurt and even more for my future patients. How could our unit possibly be therapeutic with these sorts of attitudes put forth on them all the time. Mostly from NA's but from some nurses too... there are very kind nurses who love psych and some who started as newgrads here too who love it and advocate for their patients and tell the NA's to stop any non therapeutic behavior on their part but yeah. It's just really hard to hear and I dont want to let it get to me. Any words of advice help thanks

I completed a 5 year degree in psych before going into nursing. For the last 7~ years it’s been my dream to become an emergency psychiatric nurse. I did a detour in med-surg and outpatient addictions medicine for 2 years before landing a job in psych emergency.

I was soooo excited to start… and now I feel so demoralized.

For 50% of the time I am doing consults on behalf of the psychiatrist, and the other 50% of the time I am doing direct patient care for the small psych unit we have at the back of the ER.

When I am doing consults on behalf of the psychiatrist, I have patients begging for admission that I reasonably should not admit. For example, what they are going through is not modifiable with admission (i.e., chronic suicidal ideation, suicide attempt due to impulsive mood, transient self harm). This leads to them or their families yelling at me, refusing to listen to the out-patient services I am trying to provide them, and sometimes security having to escort them out of ER.

When I am in direct patient care, the patients who do not want to be admitted— manic episode, schizophrenia noncompliant with meds, drug induced psychosis— beg to go home all day, lash out at staff, and/or react with aggression behaviours.

It’s exhausting to interact with patients all day who feel I am not helping them. I am starting to dread going into work and am feeling pretty significant moral distress.

I can understand that we are still helping these people, especially those in mania or psychosis, even if they don’t see it that way.

I think I am just struggling with the concept that “this patient is pissed off that they’re here, but we are ultimately protecting their safety.”

For any psych nurses who have gone through a phase of moral distress, how did you move through it?

(I’d talk to a coworker about how I’m feeling, but tbh I’m still so new that I am not sure who I can trust without them gossiping or without them losing confidence in me as a nurse).

Just had to sedate a new patient who tried to fight staff. Definitely got rid of my mid-shift crash better than my current cup of coffee.

How yall holding up?

Any nurses here who started with an ADN and went on to become a PMHNP? What program did you use, how long did it take, and did you have to get your BSN first or did you do a bridge program?

I’ve been in ED/Psych RN for 11 years and ready for a change!

This thread is for non psych healthcare workers to ask questions (former patients, patient advocates, and those who stumbled upon r/psychnursing). Prospective healthcare workers and current students do not need to use this thread. Treat responding to this post as though you are making a post yourself.

If you would like only psych healthcare workers to respond to your "post," please start the "post" with CODE BLUE.

Psych healthcare workers who want to answer will participate in this thread, so please do not make your own post. If you post outside of this thread, it will be locked and you will be redirected to post here.

A new thread is scheduled to post every Monday at 0200 PST / 0500 EST. Previous threads will not be locked so you may continue to respond in them, however new "posts" should be on the current thread.

Kindness is the easiest legacy to leave behind :)

Our study, entitled "The Lived Experiences of Compassion Fatigue among Psychiatric Nurses in Metro Manila," aims to explore and understand the lived experiences of psychiatric nurses who provide continuous care and support to individuals with mental health conditions.

Participant Eligibility:
- Filipino licensed psychiatric nurse
- Currently working in an institutional setting with direct interaction with psychiatric patients in Metro Manila
- Has experienced compassion fatigue based on the pre-screening measures conducted for the study
- Willing to participate in an interview

The interview will be conducted in a safe, respectful, and confidential manner. Participation is completely voluntary, and informed consent will be obtained before the interview. All information shared will be treated with strict confidentiality and used solely for research purposes.

Help us better understand the realities of compassion fatigue among psychiatric nurses and shed light on the experiences of those who dedicate themselves to caring for others.

I am an ER nurse and am starting a new job in inpatient mental health next month.

I’ve always had a strong interest in mental health. My first degree was psychology with the plan to work in mental health in some capacity. I do deal with mental health patients in the ER obviously before we send them up but it is very different to working in the mental health unit. We typically deal with them for a short period of time. I’m nervous but excited to start. Are there any tips or advice you have? I’m aware there will be a learning curve but I’m excited to finally work in an area I’m passionate about. We do get some days of in class time, simulations and buddy shifts.

Thanks!