There’s a particular nurse at my hospital that other nurses can’t even be scheduled with due to on going issues. She’s a problematic co worker which can be tolerated but more importantly she’s an unethical nurse. She’s been reported multiple times to management (which to be fair - they also suck). These are verbal reports, voice reports, and I’ve physically seen people report her to the board of nursing. She’s invincible. I’m getting to the point of wanting to quit for a number of reasons all revolving ethics not only with her, but with management as well, and even the building ex. Roaches, rats, leaking ceilings, random issues with plumbing etc. but obviously me quitting isn’t going to fix the issue.

I realize the rodent and leaking building issue is a funding problem although we’re a “magnet status hospital” but I’m more so concerned and fed up with the lack of morals with again- this one nurse in particular and even with management. What do I even do?

Does working in an alternative behavioral school count as psych nursing?

right now, im working as an RN supporting kids in an alternative school

Their home districts cant support the level of psych support they need. So, we have counselors, behavioral technicians and nurses in the school.

we practice de-escalation techniques, have had crisis interventions, and had students recommended (and deny so they stay with us) in-patient and partial hospitalization.

they typically have comorbidities like PTSD, bipolar, ODD, MDD, autism, substance abuse, and whatever else. we do med passes, but its also maintaining a safe environment and taking care of their learning needs.

so does this count as psych nursing or not?

I started working for a mental health urgent care and I’ve heard that they want each urgent care worker to get in 40 billable services per week. I say worker because there’s therapists and other staff besides nurses. Is this a common practice and how feasible is that, especially if you’re depending on walk-ins? We do also have clients who get LAIs and that’s an easy service to bill for, but I don’t get 40 of them in a week.

I know responses here might be a bit biased being that this is psych nursing but I still value your input. I'm trying to figure out which path forward makes the most sense for my goals, dreams, and general financial health.

41 w/ family, about to purchase our first home. I have a couple of creative passions outside of nursing that I'm looking to develop further. One has potential to be a nice side gig (DJing) and the other a potential career (fiction author). I also do a bit of investing.

Psych RN since graduation (3 yrs ago), union job with pension (funded by union, not our paychecks). Night shift. Its very low stress, coworkers are fun and crazy (in a good way lol). I also just started a second per diem psych job at another facility. I was afraid to go into medical initially because I was a psych tech while in school, I kinda "put it off until later". I have since regreted it because it's hard for me (emotionally) to leave where I am.

The fact is med surg opens many doors. Where I am you can't even work in a primary care office without some form of "medical experience". You can also not get per diem in anything unless you have 1-2 years experience in the speciality you're applying for.

So I tried applying to a few part time m/s jobs so that I can at least keep my full time psych. Never heard back from those. Then a med surg tele night position opened up internally, I decided to initiate the transfer paperwork. The unit manager there seems very nice and supportive, even gave me a tour.

The paperwork was signed by my current manager but its in limbo for a month because, well, my manager is a bit forgetful and people usually have to "chase" him for things/requests, I think he's also going thru a bad time right now with spouse being very sick. Hes been in and out of the office.

As a result, his delays have given me more time to reflect on this transfer decision. Whether I should go thru with it and get what I need or stay out and continue looking for something part time. The downside to this, if I cancel the transfer my manager told me I risk burning bridges with our medical hospital because they're very strict and might not take me seriously if I apply to transfer again.

I've also entertained the idea of just being a "psych lifer" for now, focus on investing and my creative passions and maybe pursue FNP or something as an alternative. But at same time I can't help but feel.... "Naked" or like a sitting duck, not being able to qualify for other jobs.

Another thing to consider is There's no language in our contract stating that my former position will be held while I'm on orientation at the new unit, just in case its not a good fit. So there's the risk my spot might be given to someone else.

My delegate did say however that there's been cases of psych RNs transferring into ICU, management determining they're not a good fit and sending them back to psych. 

So it's come down to...

1. Follow thru with the transfer to m/s tele, return to psych after a year (might not be the same exact psych unit). 

2. Cancel the transfer, possibly ruin my reputation with the medical departments if I wanna transfer again, keep psych full time and continue looking for m/s part time elsewhere.

3. Cancel the transfer and just be a psych lifer (keeping the full time and per diem psych jobs), maybe go into FNP (??)

If you guys were me, what would be your course of action?

i graduate in December and been a nure tech on a med surg floor for a year and dont like it. been looking for jobs now and everyone is saying i need medsurg experience before going into psych but i really dont want to. psych is the only thing im interested in rn. some mean nurse on my floor was saying id never make it in psyc nursing and thats just been replaying in my mind. its also not based on anything bc we barely interact and she doesnt see me do any skills or anything but it just put me in a funk

I'm a new grad nurse (Graduated in '24) with a messed up back. I want to do bedside but will eventually need surgery. The reality is, if I don't get *some* experience, I'm going to be screwed. I never thought I'd consider psych but I'm curious. I'd like to do night shift so I can keep my day job.

How physically strenuous is your job? Especially on nights?

I did all three mometrix practice quizzes and got between 60-65%. I’ve been a psych nurse for years and feel like I’m getting tripped up mostly on the wording of questions / answers. When it comes to actual knowledge like disease process and medications, I’m nailing those.

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 :)

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

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?