A REAL-LIFE "NURSE RATCHED." WHAT PSYCHIATRIC NURSES REALLY DO

I've worked in psychiatric settings  my entire career and I had someone ask me the other day what I actually do, during the course of a  shift. I realized that many people really don't know what psych nurses do, or even where they work. So, this is for anyone interested in the psychiatric nursing specialty.  Nursing students who are still unsure which specialty to choose can benefit from this information.

 

My days are full of challenges, but I absolutely love my job and get a lot of satisfaction from helping others.  There really is never a dull moment in the psych setting and you have to be able to multi-task pretty well.  Psych clients will often try your patience too, so you need to be a pretty laid back person to deal with these clients.

Where do psychiatric nurses work?  Well, there are both inpatient and outpatient settings. Private hospitals, inpatient state-run hospitals, homeless shelters, domestic violence shelters, correctional facilities, nursing homes, adult day-care..... and the list goes on. 

As with any illness there are different levels of acuity. Some clients are chronically ill and need medication management, but will never truly be "well" again. These clients are people like murderers, rapist and some veterans suffering from PTSD...etc. 

There are other clients that usually lead a normal life, but are experiencing an acute phase of depression or anxiety, that may be related to something that's going on in their life at the time.  

There are a lot of dual diagnosis clients with the mentally ill. People that are disabled and are unable to work.  There are also the chemically dependent.  

You can choose to work with children, adolescents, adults or geriatrics.

I work in a private facility with chemically dependent clients, who have voluntarily checked themselves in to rehab.  But I have also worked with adolescents and adults in the past.  

Psychiatric nurses do a lot of paperwork and we also refer patients to other services that they may need.  We are also in contact with the pharmacy to make sure we have all the medications our clients may need during their stay with us.  Often clients that are with us are experiencing very traumatic events in their life and the last thing they may think about is grabbing their belongings before they check themselves in to a mental health facility. It's our job to make sure they have what they need while they're with us. 

 

Our day may include suicide attempts or threats, altercations between clients or clients and staff. We hold group therapies and assist the psychiatrist and the nurse practitioners tracking down clients for individual therapy. 

We work in collaboration with doctors, nurse practitioners, pharmacists, social workers, police officers,recreational therapists,  correctional facilities, churches, Alcoholics Anonymous and Narcotics Anonymous.  

 

We are also responsible for assessment of physical complaints while the client is with us.  Policy and procedures must be followed to the letter in psychiatric units. It could mean the difference between life or death, if rules aren't followed properly. 

We do rounds on our clients every 3 hours and every hour for the first four hours they're with us.  We are also responsible for assisting with Electroconvulsive therapy (shock therapy).  Clients need to be monitored before and after these therapies. 

Clients who are experiencing withdrawals from alcohol and/or drugs may experience seizures. So we must be there when these occur and assist them if they need it.

I also work with family members of our clients to help them understand mental illness and teach them how to cope with it.  Therapy with the client may require family member's participation, 

Clients often become violent. So we are trained on how to deal with such situations. We must remain calm, so as not to escalate the event and we must follow strict rules on restraints and medication administration.  We can physically control the patient in a non-harming way if necessary. 

It takes a very special person to be a psychiatric nurse. A lot of patience is required. But I love what I do and wouldn't ever consider doing anything else. To me it's really rewarding when you can help someone out of the deepest, darkest depths of depression, so bad that they considered taking their own life. That makes my year!  

1 in 3 people experience some types of mental illness within their lifetime. It may not be them, but it could be a close family member. It's often a devastating time for them and I want to be there to help. That's what psychiatric nurses do! I guess you could say I'm a real live "Nurse Ratched" from "One Flew Over the Cuckoo's  Nest". I'm just a lot nicer!

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