June 9, 2013

Reasons NOT to become a psych nurse

A while ago, I told you why to become a psych nurse...now here's the reasons why NOT to do it.

Note that these are not necessarily automatic exclusions.

You have psych issues.  If they're unresolved psych issues and you see being a psych nurse as a means of treatment or therapy, turn around now.   If your psych recovery is less than a year old, proceed with caution.  If you've got a good handle on your recovery, still proceed with caution.

Working in psych isn't going to cure you.  It's no substitute for doctor visits or therapy.  Nor does your having psych issues mean that you'd be a good psych nurse, no more than my having given birth twice means that I'd be a successful L&D nurse.   Keep in mind that just because you had a certain experience with mental illness doesn't mean a patient with the same diagnosis will have the exact same experience, or that your experience is right and theirs is flawed.

You have issues with people with psych issues.  You need empathy to be good at this job.  It doesn't mean you have to be a pushover, but you have to have more than a "suck it up and get over it, it's all in your head" mentality.  If you have issues with psych issues, no matter how hard you try to mask it, it's going to come across in every single patient interaction.

Psych patients have something in common with kids:   both groups pick up more from what you say and do than you may realize.

You won't use as many of your medical nursing skills.  Unless you work psych-medical or geri-psych, you will be starting far fewer IVs and Foleys, doing fewer blood draws, staring at far fewer cardiac monitors, doing less suctioning of trachs, doing less managing of drips, and performing fewer of all of those other fun tasks that are primarily medical in nature.  If IVs, drips, Foleys and tele monitors are the reasons you want to be a nurse in the first place, you may be rather disappointed in psych nursing.

Psych patients DO have medical issues, so you will be using more of that medical knowledge than you think.  And don't be too disheartened about not using the medical skill set, as those skills can be easily relearned...after all, you learned them from scratch in nursing school, didn't you?  And if you are truly worried about losing the medical skills or want to make sure you have maximum marketability while in psych, get a PRN job on a med-surg floor.

Remember, in no specialty are you losing your "nursing skills."  You are just utilizing different skill sets.  The skill set for psych is different, just as the skill set for L&D may not be the same as that used for med-surg.

You think it's less physically demanding.  What, you think its just the techs that get down and dirty in codes while you sit back behind the nurses' station?  If you're the nurse, it's YOU leading the charge of the light brigade.  Understand that a code in psych is rarely medical distress and more likely out of control or violent patient.  Refuse to participate in a code or run in the other direction--and you will lose both the respect and trust of your coworkers because we'll all know that we can't trust you to have our back in a crisis.

Being female/old/young is no excuse for not getting involved in a code.  If you are pregnant/disabled/injured, then you have an bona-fide excuse for not getting hands-on...but you damn well better be doing crowd control or drawing up the meds.

Mind you, if there's a weapon, all bets are off:  then you are allowed to run and take cover while someone dials 911.

And of course, there's the usual physical nursing tasks.  You didn't think they all went away, did you?

You think it's easier/less stressful than what you are doing now.  This is really relative:  depending on what you've come from and how you are naturally wired, it may be easier/less stressful...or it may not be.   But don't think that it's automatically easier because there are less tubes, wires and monitors involved.

Ever see seasoned nurses cry because of working in psych?  I have.

Hepatitis C.  It seems like every other psych patient has Hep C.  Hep A, Hep B and HIV are there too, and so are bedbugs and scabies.  But there are vaccines against Hep B, Hep A resolves itself with minimal problems in most patients, and HIV is a fragile virus that survives for less than a few minutes outside of its host.  Vermin can be treated with a good de-lousing.

Whereas Hep C is badass.  It can hang around on things for days.  Even dried blood can be an infection risk.  There's no vaccine for it either.  I fear that infectious disease far more than the others.

Of course, if you practice universal precautions you can drastically minimize the risk of exposure.  However, if you are of the extremely paranoid type, you may not be entirely comfortable with the high levels of Hep C...actually, that paranoia might not be a bad thing.  The hepatiti are not fun to contract.  Hep B and C are with you forever.  Hep A is at least curable.

And if you're a chronic needle sticker, for the love of Doritos, LEARN how to deal with a used needle and/or deal with any klutziness before entering psych.

Dealing with family members.  Unfortunately, family members of psych patients can often be far worse than the psych patients.  Many have misconceptions about psych illnesses.  Many don't understand psych meds. Many don't understand that psych patients, even involuntary ones, have rights including the right to refuse treatment, as well as the right to exclude family member involvement.  Many think we should keep psych patients locked up until they (the family) are satisfied.

Granted, you won't have to deal with family in person as much as you will over the phone, so if you have good telephone skills, you'll be OK.

You don't always get to wear scrubs.  A lot of psych jobs want you in "civilian" gear, so if you like wearing scrubs for either the comfort or the air of authority they give you, be prepared to part with them.  Civilian gear also usually means no street clothes (read:  jeans and sneakers) but business casual.

You'll become paranoid.  You'll get into the habit of pulling doors shut behind you and checking if they're locked, even in your own home.  You'll look at surroundings in terms of what regular household/hospital/office items here could be used as a weapons, and where the escape routes are.  You may even start checking your family members for cheeking.  I automatically flinch and assume a defense stance if you put anything in my face...unfortunately, little one #1 doesn't understand this yet.

Also, most psych patients look just like you and me.  You'll start wondering if anyone you know has been a psych patient.  And once you've seen what patients who are "just like you and me" are capable of experiencing,  you'll be a little less quick to think that they couldn't have psych problems just because they look "just like you and me"

No comments: