I started my second semester of nursing school this week. I am taking psych nursing this semester. I was excited to get away from med surg for a while, but, after my clinical orientation, I am PETRIFIED of the patients. The facility I am in is fantastic and I trust the staff to step in if anything goes wrong, but for some reason, I am scared of the patients. On our tour, I had a chance to talk with one of the patients and she was so nice, as were the other patients in the wing. So, to those who work in psych, did you go through this? How did you get over it? I get my first patient Monday.

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Hi!

I am currently at the end of grad school getting my doctorate in clinical psychology and have worked with clients with more severe diagnoses, as well as more higher functioning clients. I can understand how it may be a little scary at first and you may feel apprehensive. There are times, especially in inpatient hospitals or treatment facilities, where clients can become violent or aggressive but it's not a regular occurrence and in places where it is, such as inpatient units, the staff are trained to restrain clients and most of the time you won't be allowed alone with them unless you're trained.

With that said though people who have more severe diagnoses are probably more scared about the things going on for them then you are of them, or then they are of you. I think compassion, patience and understanding can go a long way with all types of clients, but more specifically more severe clients. It's best to never disagree with delusions or hallucinations and just do whatever you can to keep them safe from themselves and others. Trust your gut and if you feel unsafe, it should tell you something. In my experience I always felt safe, although in the beginning of my training a little apprehensive like you, but if you can stay grounded and calm it can really help the clients to stay grounded and calm as any client can feed off of your energy.

It's great work that you are doing and I hope you end up enjoying it! One of the smartest people I have worked with so far was a psychiatric NP. I wish more people had the compassion and empathy that nurses have. Feel free to let me know if you have any questions!! Good luck!


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I assume you are doing inpatient?
I hated my psych rotation. And I think it is okay to admit that it isn't my niche.

Be nice to all of the staff - if they like you, it will be much easier. Remember that they all know way more than you do.
You will survive it, we all do. And it may turn out to be something you like.

I am a nurse myself and not matter what area of nursing you are is Psych. will be part of it.

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I do what I like and like what I do. Yorkies- Cozy (4/1/06), Roxy & Zoey (2/11/08), Lucy (4/6/09); Golden- Buddy (4/13/09- Rescued 12/11) Maine Coon cats- Mika (1998) and Tallulah (2000)

I took my nursing training many years ago and I remember feeling just as you do now. Remember that you are new to the field and that for the most part, your instructor won't choose a complex client for you the first while. We were assigned to multiple clients with varied diagnoses but the really severe and or violent clients we always paired with staff.

It is actually an interesting field and a great way to practice those communication techniques we learn in class.

Some people love psych and others find it's not their field...I found it is not my field but I earned valuable skills that I used daily in palliative care which is where I found my "home"!

Good Luck,

Jenn, Murphy and Sassy Saffron

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"Ever consider what they must think of us? I mean, here we come back from a grocery store with the most amazing haul --chicken, pork, half a cow. They must think we're the greatest hunters on earth!"
~Anne Tyler

I think when you get in there and get a feel for things you will relax. I stared my nurses training in 1969! My first rotation in the hospital was neuro-surgery. I looked up this section in my med- surg textbook. Staring out at me from that book was a scary picture of a bruised, droopy eyed woman who had had some type of neuro procedure done. I was scared to death. Of course, the patients were fine, we had a great instructor, everything went well.
I'm sure you won't be put in a position where you are uncomfortable, you're there to learn, there should be lots of others around to help.

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[SIGPIC]

Thank you all for your help. I know my issue stems from the fact that they spent 2 days telling us "If you wear a scarf, they will take it off of you and strangle you...if you wear hoop earrings, they will rip them out of your ears and stab you with them...if your hair is down, they will grab it and rip it out of your head.." I understand they are trying to make us understand the seriousness of the situation, but, now, I look at every resident, as kind as they all are, as the many ways they could hurt me.

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Oh boy does this post bring back memories. I am a nurse too and I remember my inpatient psych rotation well. I was working on a locked unit in a very old and notorious state hospital and we (as groups thankfully) had to walk through underground catacombs to play therapeutic games of volleyball with the criminally insane (there were no large burly guards to protect us)

It was not my favorite rotation but it was eye-opening in many ways regarding the severity of the problem of mental illness in our society ( just look at the news lately) I know its hard but If you are fearful try not to show it ( fake it if you have to) but do not put yourself alone in a situation where your safety can be jeopardized. Also I second not feeding into the delusions and hallucinations of the patients...oh the stories I could tell about this. Also for the mentally ill religious topics seem to be real triggers as well so be ready to re-direct when the conversations start to head that way.

By the way... I became a maternal child nurse.

I'm not a nurse but I work 2 jobs - one at a school with special education students (autism, behavioral problems, etc.) and a part-time job with adults with mental retardation and/or mental illnesses.

I think it's normal for you to be nervous since you've never worked with this population before.

The best advice I can give you is this:

1) Don't let your guard down. People can be unpredictable and react to things in ways you wouldn't expect. The advice you got about removing scarves, jewelry, etc. is good.

2) Most importantly, treat patients with RESPECT. When working with adult clients, the staff who tend to get attacked are the ones who act bossy and condescending to the clients. I work really well with clients that other staff find very difficult and scary. The reason these clients work better with me is that I treat them as I would want to be treated. Not saying I will never be attacked by one of them, but kindness and respect good tools to use.

Bless you for entering the nursing field.

Not every person has the same degree of mental illness. From experience, theres lower and higher grades. Some with a lower grade illness could hurt you while someone with higher may not. It all just depends on what they are suffering from, meds they are on if any at all, alcohol in their system, illegal drugs their state of mine at the time.

I will admit, I suffer from bipolar disorder and severe anxiety. There have been a couple people in the waiting room at my Doctors office that *I* have been terrified of.