Wednesday, February 22, 2006

That's Just Crazytalk

Oh wow.

What a weird career I'm having so far! I never planned to jump from specialty to specialty, but the experiences I'm having are amazing.

I started at the psych hospital last Thursday and I thought I'd put off posting until I had a good feel for how things worked. My very first day was like "awwHELLno!" and I thought I'd gotten in over my head, but the second day (Friday) was pretty cool, and Monday and Tuesday went well also. Today I think I can give a good overview of what it's like.

The first day I followed the LPN (a current RN student and very nice young woman) as she did med pass. She set up a mobile med cart sort of backed up into the seclusion hallway so that no one can get behind her. Patients lined up to get their meds, and it went smoothly until a female patient (who had to sit in a chair next to the med cart for 20 minutes for cheeking precautions after taking her meds) went off on her verbally. I mean, this patient was spouting insults, hostility, swearing and calling the LPN every name in the book and insulting her in any way possible - some very personal. It was not only bad, but it went on for 20 minutes! I could tell the LPN was just barely controlling herself, and practically shaking with anger, but she was professional. In retrospect, although that exchange really made me mad and frustrated that nothing could be done about it, it was a great learning experience and a very good example of what I may have to go through myself. There were also 2 shows of force that first day, and maybe the attitude of the whole unit was thrown off by that early-shift hostility-fest. A lot of patients seemed to be screaming about one thing or the other for the rest of the shift.

The second day I was put on an hour's duty of line-of-sight for a female who was on self-harm precautions. We got a chance to talk, and I enjoyed that. Later I did another hour on an underage female who basically had to have a chaperone wherever she went because the rest of the patients are adults. We had a nice conversation also. I'm quite aware that not all of my exchanges are going to be cooperative, many patients are hostile and delusional. I honestly felt much safer at the jail, because there was always an officer right there. That day was much nicer, patients were a lot calmer, and as I walked around on the unit, I was able to meet several of them and introduce myself.

A major difference in psych nursing for me is that sometimes there is just nothing to do but go out into the unit and talk to patients. The charge nurse is very nice, and she's making sure I get a good orientation and learn what I need to know. She said "I know it's weird, and I had a little trouble with it myself at first, but sometimes the job is just going out and interacting with patients. You feel like you should be doing something more to earn your wage, but being out there and connecting is really important also." It makes perfect sense, it's just that I guess I expect to have to chart everything, and I don't. I redirect patients, make sure they're using their coping skills, try to get them involved in groups, reorient them if they're delusional, and sometimes just listen.

One of the nurses precepting me told me to make sure I don't stay in psych nursing too long or I'll lose my other skills, and I believe that. I'm going to work on getting my BSN in the evenings. I'm not anywhere near as exhausted after work as I was at the hospital, and this will be a great time to do it. The program that I'm looking into requires 10 credits of a foreign language as a pre-req and I'll see if I can get that this summer. I've always wanted to learn spanish! :) I've got to do statistics also, but they say that can be done concurrently with the BSN program.

That's all for now. I think I'm going to put up a bunch of new blogs tonight, so stay tuned. I'm sorry I didn't get to NurseBlog of The Month last month, but think about some nominations, because NBOTM is happenin' this month!
Posted by HypnoKitten at 10:56 AM

Anonymous Joan, at 7:33 PM  

You may be suited for it. Good luck! We need some good psych nurses. Any one of us may need you some day :)

Blogger genderist, at 3:54 PM  

I hope you continue to enjoy it all! And I'm glad to hear that you're doing well...

Blogger unsinkablemb, at 3:59 PM  

Good to hear that you're enjoying yourself. Take care!

Blogger jenny, at 9:01 PM  

glad to hear you like the new field. the diversity of areas to work in has always been one of my favorite things about nursing.

Blogger HypnoKitten, at 10:56 PM  

Thanks, guys!

I don't really know if I'm suited for it. I mean, I have the capacity, but I don't know how long it will hold my interest. I know I like to fix things, and this isn't exactly the specialty that can do that.

But, yeah, it is interesting, and I feel like I'm getting to experience a whole 'nuther part of humanity. It's probably like a medical mission to the Congo in that you sort of know what you're in for, but nothing can compare to really being there - and now I'm there. It's dirtier than I thought it would be. And bleaker. And more hopeless. Thankfully, there's a lot of experience to be had here, and some patients who just make my day. :)

Blogger Third Degree Nurse, at 5:13 PM  

Never a dull moment in psych nursing, that's for sure!

I've met some really sweet people, some much more interesting than others, but I have a heartbreak every day in the adult hospital. I prefer kids. Somehow I have hope for many of them.

By the way, unless you really love math, you might want to get statistics out of the way before nursing school. Doing it concurrently would have been very tough for me.

Blogger Nurse Practitioners Save Lives, at 1:23 PM  

Psych can be interesting but I agree with losing your skills.. Congrats on starting your BSN!!! Hang in there!! You will do great!!!

Blogger missbhavens, at 1:10 PM  

Oh, Never, never, NEVER a dull moment in psych, for sure! Psych was my #2 choice after L&D--I hope you keep on enjoying it. You sound well-suited to it already!

Anonymous Anonymous, at 6:05 PM  

For those of you who say there is never a dull moment in psych nursing, you must not be working for the VA. There are lots and lots of dull moments. Of course, there are a lot of exciting moments too, like yesterday when this client runs full speed ahead into a concrete wall. Just seeing him fighting to get up off of the floor with me trying to hold his head together where he had just split it like an over ripe watermelon was nothing even approaching dull. Suffice it to say that 1 hour earlier I had dozed off I was so bored. That's psych nursing...either it's really happening or it's quiet on the ward.

Blogger Kim, at 7:07 PM  

My definition:

Psych nursing: where being just yourself can be theraputic!

I loved it. Did it for almost 2 1/2 years and then began to miss the ER.

I worked nights. Funny, there seemed to be less "game playing" at night, the goal was sleep, sometimes to talk for awhile. No manipulating to get a prn. I really enjoyed my patients.

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