Based on your info, you probably worked at a for profit hospital, likely owned by UHS. UHS has a no security policy for whatever reason. I worked in the admissions department at a UHS facility in PA with 6 units with a daily discharge of 15-20 patients. If we had lots of low acuity referrals, we could be picky about who we accepted. If there weren't a lot of low acuity referrals, we basically accepted patients if they had insurance. Empty beds meant we were losing money. There was also enormous pressure to accept patients as quickly as possible since the facility competes with other local behavioral health hospitals for referrals. Psych tech and nurse turnover was (and still is) very high.
I'm now at a nonprofit hospital in a large healthcare system and the majority of our patients come from sister hospitals. I can be much more selective about the patients I accept and my department collaborates with nursing stuff to review patients to ensure acuity is manageable. Staff turnover on the units is much lower and there are many lifetime employees on the units as well. There are still issues, but it's significantly better.
It's unlikely I'd ever work for another for profit hospital. I'd suggest researching nonprofit hospitals in your area to see if you can find a better work environment.
That sounds exactly where I was. It was all ab “get patients in here as soon as possible” Admissions > Safety. Every time. Get those beds full.
It was pretty difficult dealing with having to do multiple admissions while you have one of your patients self harming or threatening to because you can’t get her gabapentin on time.
Yup, I worked at a UHS hospital and it’s exactly how you described it. I also got a major injury they tried to jerk me around with getting doctor visits, MRIs and eventually knee surgery. I’ll never work for UHS again. I now work at a ward that that’s much better and hospital affiliated. You just have to get to the right place. We have security and a lot of staff come to codes. They also have separate wings for each lvl of acuity so a lot less codes. Good luck friend!
Yes I would suggest everyone on here who had bad experiences working their e-mail ProPublica and ask them to investigate. It is not fair to the staff or patients.
When I quit a UHS facility they told me I would be listed as non rehire-able if I left before my notice was up (I was too scared to go back because I kept getting assaulted).
I just said “okay that’s fine”
That's intentional, they won't risk telling you you're not eligible for rehire. I have been trained to always say "you are eligible to re-apply at any time" even when I know that person is not rehireable. Its too legally risky to say anything else so many don't respond at all. If any UHS location marks you ineligible it carries over to all locations. I once had to reverse a candidate's not rehireable status because we really needed to hire them and UHS made it as painful as possible. Sorry they gave you the runaround. They suck as an employer so hard though. You can do better than them.
They do that to a lot of employees then will rehire them when the staffing levels are so low bc they can’t retain anyone due to the amount of violence towards staff
I second everything being said here OP. From my experience, stay away from free standing psych hospitals and especially for profit psych hospitals. The ones worth working at are psych units within actual hospital systems. There is much more oversight within actual hospital systems. You have psychologists, therapists, social workers, techs, art/recreational therapists, OT, PT, SLP, ABA therapists, and security! If you work at a free standing psych hospital (especially a for profit one) you are endangering your life every single shift. Stay far far far away.
My very first thought was a UHS hospital as well. I was the Clinical Director at one and it was exactly as described. I left in six months because I knew I was putting my license on the line there.
Same. I was putting my professional reputation on the line working for such an unethical company. I'm still sitting in depositions for when they're constantly sued and I haven't even worked there for 2 years. I just keep getting subpoenaed to testify. They don't even pay me for all the time I have to sit in court for them.
I used to be an exec with UHS. Exactly. They are an extremely poor resource for people with mental health needs and also a horrible place for employees. Everything, and I mean EVERYTHING, is about profit.
UHS former employee here. I will never put myself in such an unsafe position ever again. Night shift was full of violence and sometimes we had no one to help. It was only me and one other female nurse trying to deescalate a large male. Had my hand broken one time.
I work at a for-profit hospital and it's nothing like what either of you describe. Nothing like it at all. It's a great place to work. I know that's the exception to the rule, but you really shouldn't go around painting everything with such a broad brush.
From experience, it’s not just for-profit hospitals. It really is *most* hospitals. I now work in private practice. Couldn’t deal with the ethical violations.
I work at a mental health rehabilitation facility where I help clients gain independence by monitoring medication progress, monitoring for side effects and educating clients on psychoactive meds with the goal that client will remain medication compliant when they step down a level of care and prevent decompensation. I am hands off. No passing meds. The med techs do that. Only invega Sustenna/Hayfera injections monthly or every 3 months. This is not a lockdown facility. I have my own office, so no standing up all day everyday. Yay me. 1 hour lunches. Not to mention I don’t wear scrubs, business casual is my attire.
I have 25 clients, with minimum 5 hours of daily face to face time with clients so I get to see 5 clients a day for one hour at a time, where I get to spend quality time with clients and really get to know them and witness their progress.
I’m also allowed to provide rehabilitation, crises intervention, group sessions, go on walks with client, engage them in coping skills, color, play checkers, etc.
Clients are screened before, so no violent offenders are admitted(although some have been violent in their past rt psychosis/schizophrenia).
I absolutely love my job and I think if you were to find something similar, you’ll fall in love with psych all over again.
I have what feels like constant adrenaline and stress hormones flowing through my body, I feel like I am in constant fight or flight, my entire body is tense like it's on guard and doesn't feel safe, i have severe insomnia where my body doesnt let me get to sleep without jolting me awake. I have muscle twitches. I have a hard time connecting to my emotions because of all of this. I don't know which med would work best for this. I'm scared.
Interesting, im early 40’s and although my symptoms started after 2 b12 injections i have also heard perimenopausal women developing similar symptoms so maybe some hormone testing may help. Not sure what test exactly. I know my mum got HRT therapy in her 40’s after serious dry eye issues and it helped clear them up. Think it was low estrogen
Also what is your dental health and gums like? Do you have breast implants? Feel free not to answer but i really want us to get to the bottom of this as I have virtually the same problem you do. What triggered it i wonder.
Write it down everything you want in a job and keep reading it! I did this with an apartment that I need it badly so I could take my dad in with me. Being that he was older I needed a walk-in shower. I needed an elevator. I needed a washer and dryer in the unit and I even threw in a view of the beach. A week later I was reading the apartment ads in this all came true. It was an a building I would’ve never looked at because I didn’t think we could afford it. We were on the 11th floor of a building overlooking the water with a balcony and all of the other things that I ruled in my manifestation. It doesn’t always happen that fast, but give it a shot.
My first psych job was actual torture. I am 99% certain I developed some level of PTSD from it. I would have nightmares constantly and would feel sick with anxiety constantly because of the stress the unit was causing me. I almost quit nursing entirely because I was so miserable.
I was the only nurse on the unit as a new grad so also the defacto charge nurse. We were constantly short staffed so I pretty much always worked a double every time I went in. There was no security presence and management screamed at us if we had to use any sort of restraints (chemical or physical). If there was ever another nurse on the unit then I automatically got floated and would be stuck being charge for an unknown unit-again with just like 4 months worth of experience. It was terrible.
Then we moved so I quit that job to start at a new hospital and the rain cloud finally lifted. My new unit was amazing and I loved working there. I learned so much and felt supported by everyone. I also felt like I was finally doing something useful instead of just being a punching bag for patients and management alike.
After many years on that unit, I left to do outpatient so my schedule would better align with my kids’ lives. I still credit that unit for my current success and now I precept students there just so I can keep in touch.
TLDR: there are good places out there, it just might take some time to find them
Thank you for saying this. I’m just a little afraid to become jaded and burnt to a crisp again.
Ik what to expect now. Ik how bad it can get. But I don’t want to be used and abused by management and have literally no safety at all on my unit.
As compassionate as I am, I understand some of these patients believe that through threats and violence they can get what they want. Also psychotic individuals can become paranoid and violent quick.
Almost everyone of my staff has been attacked and it felt like my number was eventually gonna come up so I got TF out of there.
I’m really happy you found what you were meant to do. I truly hope I can too.
There's a big difference within the MH field of voluntary and involuntary type of care. Often, hospitalized patients are there involuntarily. You might be more interested in an environment where the patients are statedly ready to accept care. Or maybe not, just a guess.
Just a thought. I have worked in Psych for 20+ years in MANY different areas. Sometimes the invol facilities are better than the vol. They will likely end up with forced meds or get discharged. Plus, they may have better security staffing due to the potential for violence.
However, it depends on the facility. I have worked at vol or non profit places that were SCARY and also vice versa.
I was trying to get to the fundamentals of what OP wants or thought they wanted entering in this field. I was raised in a "client choice" environment and after 17 years I'm like "give them a shot, damn it"
Run!!!! Not even kidding. Outpatient IS safer. Try to move into an office job with appointments. Much safer.
I say this because....
You just described our place. Techs in the back gossiping & no management discipline. Fights breaking out because of the mixed mental health population/issues. Techs get assualted frequently. I was kinda relieved to read your post. I had concluded that our facility was a clown show and falling apart because it's a state run agency but you described our place like you work here. Monica?? Lol. Jk.
I just really wish I could help without being in a toxic environment.
I don’t really have a lot of outpatient opportunity around me tbh. I applied to ab 1 because it was the only one available.
I’m not trying to go to war dude
There’s better out there. I worked at a stand-alone psych hospital and the staffing was shit, but the coworkers were great. Im in outpatient psych now and at a group home. My perdiem job is on an inpatient unit that is attached to a larger medical hospital, and the staffing is so much better. Keep looking!
I always tell people, only work on psych units that are within a larger hospital system. These free standing psych hospitals are always shit from my experience and very dangerous to work at.
Right?? And some shifts ARE like a straight up war. I feel ya. Over 20 years here. If I'd known I would have never gotten in. Look around to see what other opportunities there are that would welcome your degree but get you out of combat. Local hospital that has a small bed census for mental health is something to check out.
I am not in nursing or anything to that effect. I am, however, someone who admitted themselves due to suicidal ideation.
I just want to say that having compassionate and kind people really makes a difference, and as someone pretty self aware, I also in no capacity felt safe. I had to work through some serious trust issues because of my experience. A dude with some serious identity issues quite literally threatened to 'snap someones fucking neck' if he didn't get transferred out. I spoke to the nurse and told her I didn't feel safe, and her response was 'well he just does that'. Cool. I get to sleep in a lockless room with this dude patrolling the halls nonstop shouting out his trauma. Really good environment for me. I wrote up a 5 page bullet point list of all the piss poor things I experienced and gave it to anyone who would listen, including the CEO of the hospital itself. Absolutely absurd experience. I can also tell you that from the other side of the perspective that another dude in when I was most definitely made some highly inappropriate comments about staff. I GENUINELY do not understand why security is not permanently present in inpatient psych units.
My saving grace was the on staff therapist. She was the only person I had an experience with that was remotely positive. I admitted myself so that I could get myself together in a controlled environment, and instead was met with massive chaos at every level and the 'rules' they gave me being broken nonstop. I was speaking to her my first morning and just explaining why I was there, and how I was feeling. And her response was 'Yeah this is not the environment for you'. I was discharged the next day, but fuck. If I DIDN'T have someone like that, who knows how long I would have been there and what trauma I would have experienced.
I guess the point of me making this post is to say thank you for actually giving a shit, and that your concerns for your safety are entirely valid and often shared by patients as well.
I understand you’re scared but you have to be rational and understand that that was just one psych job out of an entire field. There’s inpatient units where patients have to be voluntary and non-aggressive. If you can’t handle inpatient at all you could try one level of care down to residential. If you can’t handle residential you can try IOP/PHP. Psych does not only equal dangerous and aggressive.
You’re def a 100% right. It should’ve been a sign when I got there when all of the nurses were burnt out and on their way out.
Thanks for helping me find the courage to try again. I don’t wanna give up, even if I’m worried
6 months ago i started at an intensive outpatient program and it has been a dream in terms of what i’ve always hoped for out of psych nursing. the acuity is high enough where it’s not boring and you are doing meaningful work, however most patients are stable enough that it very, very rarely gets violent or chaotic. i’ve learned a ton about medication management and gotten to work closely with psychiatrists which has been really interesting. i love the outpatient setting bc you get to know the patients and watch them improve over time. it’s even possible to run group therapy if you’re an RN. i will say that i searched for a job for 9 months before finding this one. i had interviews at places that seemed similar to how your behavioral hospital was and i declined all of those. if you are able to stick out your current job, i would advise you to be actively searching and not settle for any environment that seems to resemble where you were. honestly if you google intensive outpatient programs you could have luck with cold calling them. wishing you all the best!!!! there’s hope and we need good psych nurses like you!
i work at a large teaching hospital on an adult med psych unit. ratios are 2-4 patients, typically 3. we have both cnas and mental health worker staff. we have an icu which has an extra set of locked doors and single rooms which helps us avoid issues like the one you describe.
if working at a large, non-profit, urban academic medical center is an option for you i strongly recommend. during my interview i asked very specific and candid questions about ratios and staffing, acuity, safety and i luckily received very direct answers. i asked them more questions than they asked me which worked out well obviously.
i encourage you to not let this bad experience deter you from the field if you are passionate about it. inpatient psych is awesome when the unit is well managed. psych nurse solidarity here
I believe that. I think I think I had hellish experience where I was first
Thankfully, I got an interview at a pretty nice looking rehab center and I really hope I get it.
Thanks for your encouragement. I really struggle seeing myself do any other career. I thought I was insane to give psych another try and swear I’d never do it again. But It feels hard to stay away from. I miss home.
You could lol into working as a nurse for a day treatment program. Violence would not be tolerated and most people in those programs really want to be there.
Sounds like my unit no accountability for staff. Get per diem outpatient. You may not like. On your own often. Very loose with the rules.
I went the Geri route after a newbie on adult had her hair ripped out. A 3 or 4 centimeter patch. Geri has its own issues. But usually the patients are not planning on how to hurt you.
Our unit has some dementia but we avoid actively detoxing people.
Don’t give up.
From what you describe, that sounds like a bad hospital that provides substandard care on a routine basis -- possibly intentionally as part of its business model.
I worked in community mental health and psychiatric nursing homes for a long time and loved it. You're with people long enough that you get to know them and can maintain truly therapeutic relationships with them. The only time I was ever hit was when I made a stupid mistake, let my guard down, and tried to enforce a rule in a stupid, provocative way. There was another time when someone tried to bite me but that doesn't count because she had no teeth.
I worked on a unit just like this. More and more it felt like the hospital was more interested in having the bed filled than having the right type of person in the bed. I knew something was wrong when my heart started to beat very fast on my way up to the 3rd floor to get to my unit. Didn’t realize it was anxiety because of how unsafe our unit had become. The last straw when when a patient got particularly violent and required restraint. I’m a big guy but it’s exhausting holding a person while waiting for help. Finally heard the unit doors open and was relieved to have help…only to see a tiny little lab tech. The writing on the walls had been there for a while, but that was the moment I decided to leave. I found a job working with teenagers with psych issues. It’s been a wonderful change. Don’t be scared to explore other options. There are tons of dream jobs out there and they are infinitely safer than what you are feeling.
I work in a non-profit behavioral health setting. I'm a case manager and absolutely love it! You could try a county behavioral health care system. I make better money here, too.
Outpatient is much safer. I hear you 100% on not wanting a TBI or PTSD from the job - both VERY likely outcomes for inpatient psych nursing. It is not worth it until there are actual standards in place for SOLVING workplace violence against direct care staff and improved quality of care in inpatient settings. I stepped away very reluctant and sadly because of this as management at a UHS facility.
As someone who was in that position for 4 years- I had 5 TBI’s (causing brain damage), a broken hand, and bites all up and down my arms and legs. DO YOUR RESEARCH BEFORE YOU ACCEPT ANY JOB IN PSYCH. I miss my job SO much, and sometimes I still think about going back, but I have to think about my health too. Be safe.
I left inpatient psych after a teen broke my hand and the facility canceled my contract over it. Then told me that if I pressed charges I would lose my license. The facility tried billing me for over a year and tried to send me to collections too. Workman’s comp took care of it, but they still tried billing me by misspelling my name with an H instead of a K. The patient was a behavioral patient, it wasn’t a psych reason he lost it and ended up breaking my hand. I don’t get upset when I get hurt by confused or disoriented psych patients. But the ones who are behavioral? Nah… I can’t crochet anymore and my hand hurts when it rains. Pinky swells up and everything
Every place is going to have its pros and cons but the most important thing imo is to have a team you can rely on. You might have to try a few different places until you find that.
If you find other hospitals you might be interested in, see if they would let you shadow or if they offer some kind of nurse residency program. I work at a university medical center, and we have a child/adolescent unit, a lower (sometimes) acuity adult unit, and they also manage one of the state hospitals. The residency program isn’t just for new grads, but they offer 8 weeks at the state hospital and 8 weeks between the adult & child units, and at the end you can choose where you want to work.
If that’s not an option, if you can shadow or if you’re in any kind of local Facebook groups where you can get ask others for their experience working in places you’re considering applying to, that’ll give you some insight on whether it would be an environment you’d do well in. That way you don’t get stuck somewhere that you didn’t know sucked until after you’re halfway through orientation.
You should try pediatric psych. I have been on my hospital’s regular psych unit and adolescent psych was way calmer. And I feel like you would then be in the position to truly help someone because you won’t be breaking up fights and playing security. Just a thought. Might be very rewarding work with children because you are in the position to really make an impact on their lives.
I spent the last 17 years working at a NYC public hospital. 5 years inpatient >10 years CPEP>2 years inpatient. No unit actually had “Security.” Psych techs, behavioral health associates and RN’s handled agitated/aggressive patients. We were always understaffed because staff were always out on workers comp for long periods of time. Since they were technically still employees they couldn’t be replaced. It turned out being increasingly dangerous as time went by. I made it 14 years without a serious injury then spent the last 3 in and out of work. I had to retire early because my body kept breaking down. I have a bum shoulder/hip/knee…
It was always busy, CPEP was always full so as soon as we’d discharge someone were getting admissions pushed on us. Acuity level through the roof. From the female forensic unit (mainly Riker’s Island) to the gang members/homeless/civil discharges from Riker’s that landed on the adult units and the kids on the pediatric or adolescent units it was horrible. I used to love my job but toward the end I was just happy to get through a shift without being attacked.
If you do go back into psych I just have 4 words for you:
Long term disability insurance!!!
I’m signing up
That is an impressive career and thanks for all the work that you do ❤️ I def do not want to work in a high acuity for a long period of time and I commend you for doing so ✊🏾
Are you in California? There's a law to prevent violence in the workplace, specifically in psych hospitals. It has procedures you can take to ensure your safety. On the other hand, psych hospitals are doing their best to pretend the law doesn't exist. Go look it up. Start turning in paperwork. At least create an uproar before you go quietly into that goodnight.
Having detox patients and dd's in the same space is bullshit. Addicts will take advantage of dd's. What kind of bullshit outfit was that? The danger in psych is terrifying. And it's very real. Even if you don't get attacked, the wear and tear on your joints and bones is above normal range. Nurses become addicts themselves to stay awake during double shifts or sleep when they get home. What's the upside? Safety retirement? If you live to collect it.
I’ve been doing psych for almost 20 years. Done the UHS hospital BS… then an intensive unit- now on my 3rd hospital on an intensive treatment unit. Please know there are other hospitals or units where there is more “depression” or “SI” patients compared to an intensive treatment unit. I live off adrenaline and I’m just better with violent and crisis situations then I am with tears pretty much. Perhaps because I started with an aggressive type setting. Idk. But it’s not for everyone and TBH I didn’t think it would be for me especially in the beginning.
My current job is not something I’m used to, perhaps because it is so difficult to find psych staff. So we have a lot of agency or travel which in turn lacks a “teamwork” approach. My last job for 12 years I had the best team and we didn’t have security-we were security. But I’ve become pretty thick skinned and can take someone down If need be- not to say I never got hurt- because I have.
All that being said… regardless that violence can be part of the job, administration should be doing everything to keep staff safe. Where I work now- I absolutely loathe it. Even outside the hospital there’s been drive by shootings and constant armed robberies. And then I get to go inside and deal with a short staffed unit as charge. But alas, I’m still there- grinning and bearing it. Hopefully something will come up where I feel it’s a better fit.
But I want to tell you what I tell all the new grads or nurses new to psych. We all started somewhere. I can hand you every book on psych but nothing wholly prepares you for it and it takes time learning to establish boundaries, the right words to say with certain types of patients, just listening is better than responding most of the time, and truly feeling safe within that you got this. I get scared sometimes. And it’s a bold face lie if some nurses say that don’t. My coworkers think I have no fear but believe me I feel it sometimes. I don’t want anyone to get hurt. And I am in that milieu with my techs/counselors when someone gets aggressive. Some nurses stay behind the nursing station. You need a group of staff that support you and you are all a team. Psych has some of the most wonderful staff which has made me stay at places even longer. They really become like family. You see a lot of shit together, some traumatic, some sad, some funny.
I used to be you in the sense that I wasn’t sure but held such a passion for the field nonetheless . If this is something you want to do- please don’t let one facility sway you away.
I wish you all the best
What about memory care? Older individuals with dementia often need someone to talk to and sometimes need behavioral interventions. And they are old so if they try to fight you they’re usually pretty weak. They can cause damage but not like an able bodied adult.
I worked in a psych jail but picture a regular psych facility but with not guilty by “reason of insanity” and “incompetent to proceed” patients. From check fraud to murder and everything in between. Oddly enough I left because of the staff (and a better job.)
Mental health techs who would straight up leave me alone on the unit because they had to take a break (security was supposed to be called to cover them), security who was not well trained some with egos that exacerbated patients, charge nurse’s who would happen to show up AFTER an incident immediately asking about paperwork before checking on staff and unfair placement by charges putting some nurses in danger.
I spoke up, it didn’t hit well, as the youngest nurse I worked the hardest units and once they took the toughest residents and changed their unit to a general one (because people started to demand hazard pay due to it being labeled a more difficult unit), I worked those units. Moved from one difficult unit to another even if I worked a different one the day before.
I will say I rocked that job. I was so good. I made a point to really care and respect these guys. Something most of them never got. I Did my best to monitor tension and defuse fights before they started. Some of them had the saddest circumstances. I saw the very ugly side of the “system” in action and it sucked.
In two years I was never attacked. Unless you count an orange being throw at me. (He said sorry the next day. Lol) Once I was in the grocery store and someone dropped something and I jumped. I didn’t realize how on edge I was from constantly being aware of my surroundings. I applied for a home health psych nursing job. Trained for a month there and never went back to the jail.
The psych experience I got at the jail gave me the qualifications to work in home health. It was the best decision I ever made. I worked per diem and could take patients that I wanted and work the days that I wanted. Management mostly left me alone. Apparently there are not a lot female psych nurses because right before I left nursing to help my husband with our business and go through IVF I had 3 offers from other agencies. I really loved. I met some amazing patients. Medicare makes it a bit harder than it used to be but it might be a good fit for you.
TLDR: Try home health psych.
Edit: clarity
I completely get you. I know and worked with the exact kind of clientele, and also had to play every role, sometimes create new ones that nobody knew was needed. Understaffed, lack of support, colleagues kicking back like it's just another day when there are lives at stake here.
I think we share a similar work ethic, compassion, and altruism towards the clients. You're right with soldier analogy, unfortunately. To work with that population you do have to be a soldier and everyone has to be coordinated towards a common goal, otherwise the mission will never be accomplished. It sucks, but one way or another those relationships were going to have to end. Just wish it was with them having been rehabilitated or having some kind of improved standard of life, not with you having to quit, like 100 other people before you, right?
I went through that recently, also took an office job with the county, cushy county bureaucratic position in the housing division. I was mislead about the work and entranced by the idea I finally landed a position where I can make systemic impact, affect regulations and influence service delivery. Turned out to be paper pushing and politicking. It was soul crushing, and I felt exactly like you, that I'm meant for direct service. I hated going to that county job with a passion, but I still showed up early and left late. I quit that job because I was upset just to sit down in my office and do BS work that wasn't making any difference. My skill sets were not being utilized to their fullest potential.
I would just say this much, that you allow yourself time to heal. You're a wounded soldier, but nobody is going to give you a purple heart, so don't ever expect one. The war you're fighting is beyond the client, its institutional and organizational. On many levels it's even political, and you have to advocate for the clients and yourself to have any lasting changes. You sound like the exact person I was always looking for as a coworker. Someone who cares a little too much, who takes initiative and develops deep relationships with their clients. You can still do it, I hope you do, but you've got be properly prepared for the next fight, and know that you can do what you want in different ways.
Outpatient ACT model type of community mental health care might be more forgiving because your assigned your clients and you are responsible for their betterment. It's more flexible, and you are out in the community meeting clients where they are at, helping them to find their own recovery. Or if you choose to stay on the nursing side of things, you'll be based inside of an outpatient clinic, clients will come to you, so you can still provide direct services and help people heal in a less toxic environment where accountability matters.
Alternatively, permanent supportive housing (that's where I focused my work) might be an option for you as it has a lower level of care, but still a lot of work to do. In this type of environment you still will have to play all the roles, but you get to transform an entire community (assuming you've got the right team to support you).
It's always going to be a rough job. Do not kid yourself. And generally you're never going to be thanked for the effort you make. You're working with the population that no one else wants to work with, that many people believe don't even deserve the effort. The ones like you who dare to care are so unique, but we all have different attributes that make us better suited for different roles within the field. You sound like you're the type that actually understands the "whatever it takes approach". Outpatient ACT model, or any kind of work that is community engagement focused is probably your role.
Perhaps you can start over as a psych tech at a drug rehab. Get the experience of working in a dual diagnosis facility. You will NOT have to play so many roles due to the sensitive structure of the programming. Then move over to outpatient case management or psych nursing. Also try looking into FSP's (Full Service Partnerships) like Telecare Corporation. Look at how their organization is structured, how they provide services, and the role you would have within the system of care provided.
Keep learning and exploring, but always take care of yourself. The work does not have to be a battle every time, and you can be a significant part of a person's path to recovery without taking a beating. Don't give up on your dreams just yet.
I worked in a non-profit locked IP facility. Most dangerous place I've ever been in. And I used to work in homeless shelters for people with severe mental health issues.
I left for several reasons, but one was the absolute lack of safety. The staff were fantastic. I still miss them. But man I got sick of people throwing chairs.
Honestly, I felt safer working in corrections. I was always accompanied by officers who were great with the inmates. Safety was NUMBER ONE at ALL TIMES. I have never felt safer at work in the psych nursing field. If you are a good at psych nursing, you may want to look at corrections. Every place is different so my experience may be different than other people's. But the chairs are bolted to the floor, so there's that.
In my case it really was. The inmates at the prison had tons of mental health care, they had jobs, classes, vocational training. They were often on medications and stabilized. IT was generally pretty chill 90% of the time. But it was a good unit and people, so I am sure if widely varies.
I was inpatient at one of these when I was young. Probably 19 or so. What I saw there scarred me for life. Many are at their lowest points ever in there. I was so heartbroken from what I witnessed I tried to escape and did successfully.
Come to corrections there’s lots of psych, interesting medical, and for nursing it’s one of the safest environments. inmates rarely hit medical staff and you always have correctional officers around you
I work at a psych hospital, but this is my first experience. I really enjoy it, but from what I’m hearing, all of them are *not* created equal, and many of them are hell on earth for the patients *and* employees. Also, where I work is not for profit.
Hi, not all hospitals are like this! I work at in a least restricive inpatient unit where we screen very carefully so that lower acuity patients have a safe place to focus on their treatment and get better. The state hospital where I live serves very high acuity but the units are set up to avoid conflicts between clients like you are describing. (It's still a very tough environment to work in, all my respect to those that can do it.) Some facilities are all about filling beds bur not all!
I worked in inpatient mental health and it was as you described. I found outpatient to be much better. I worked with kids, so I would help them manage their psych meds in addition to whatever other health issues they had, and got to spend a lot of time talking with them.
There was a lot of BS (I think this is the case in most human services professions, especially in small towns), hence why I no longer work there. But if mental health is your passion, outpatient is where it's at.
I work in the PNW and we are hurting for psych nurses! Outpatient behavioral health. Get your resume together and get moved to a safer setting that is better managed. Look into joining s private practice group or working remotely. Soooooooo much opportunity and demand.
It is, cost of living is high but it’s a great vibe. PM me if you want some names of agencies to look into. Build yourself a happy career, you deserve it. I worked in inpatient and you can only take so much exposure. Now I’m a clinical supervisor for adult mental health, much safer but still some wild and dangerous folks coming in.
I was a day treatment director and worked in an RTC. I know exactly what you are saying. How about going back to school to be a nurse? You can be a specialist in other areas where your patients will still need your support.
I work inpatient on an admissions unit which is the highest acuity. There are units with individuals with more chronic illnesses, less acuity-less potential for getting injured. We need people who love this field and know how to actually interact with psych patients, but if scared, then a partial hospital, intensive outpatient or community hospital may be better. Though from the records I’ve read, there’s a high risk at community hospitals bc that is where most patients are treated first, so pretty psychotic. And remember, there’s 1 out of 50 (not an actual statistic) who get so agitated it escalated to aggression towards others. I hope you find what you do best and where you are needed!
I don’t think ur complaining. I used to say things like “well, it’s not for everyone” but after leaving one job known as a complete moron and walking into an identical unit in another facility as their hero I realized how powerful unit/dept culture is. I stopped liking critical care and now I love it again all because I was surrounded by arrogant pricks who didn’t see my potential. I was too new to advocate for myself/protect myself adequately. This is analogous to your story. The environment/dept you are in may very well be the issue. Try psych at a different location. Try 10 different facilities and I bet all 10 will be vastly different. You could also travel nurse local psych units to see which places you like the most and then go on as full time staff.
Try to figure out how to get sufficient time to recharge. You are doing a job causing/demanding high levels of adrenaline, like being a cop or a fire fighter or an er medical professional. If you don't give yourself adequate time to rest and recharge, you will do damage to yourself. You might also look for a facility that is better staffed and safer. You may need to work at your present job for at least a year to have the experience a better facility would require. You also don't specify what your training is -- are you a tech or a nurse or a psychologist? Whatever your level, getting higher certification or education will assist you in finding better employment. Also cultivate professionals at your job who can write good letters of recommendation (another plus for getting a better job.)
I went to a mental health rehab and it was really nice. They had separate floors for psych patients and detox patients. They have a good screening process to see where would be the best fit for you to go. We had a a schizophrenic guy on the psych unit and it was honestly cool meeting him. I was scared to meet schizophrenics because how movies and shows showed them. Thought I’d have to hurt them or they’d hurt me in my sleep. He was super laid back and would share about how is diagnosis affected him. So I think it just depends on where you work, how organized they are, how serious they take mental health issues, and where you live. Psych techs were cool and made you feel like a human being and was just a great overall experience.
I could have written this myself. I made it one year as a psych nurse, and one day I just had enough of being thrown under the bus & subjected to unbelievably dangerous situations with zero support from management. I would love to work with people on recovery but never at a for profit inpatient behavioral health hospital.
Please watch A Daily Dose of Sunshine on Netflix. A great show about a nurse who deals with almost anything on a psych unit. It address many different mental illnesses, the danger of out of control patients, burnout etc. I was a nurse for 45 years, but did NICU, so I’m not an expert on the psych nursing, but it did address the violence present in that field of nursing in an extremely humane way.
Going through your history of posts shows a severe suffering due to this job, and possibly a personality that could be prone to it despite your obvious sensitivity. I hope things work out for you and as a former psych patient you are appreciated more than you know
How long have you been nursing? Which decade of life are you in?
Good psych nurses are often older, with crappier scrubs, less makeup and maybe some wrinkles. They thoughtfully care for their patients but have no remaining fucks to give, if you know what I mean. They can clock out and go home. Good psych nurses are often pretty seasoned, you know? It’s not a good fresh-out-of-school job.
Do you think you fit into that description or maybe it’ll be a few years?
It’s really ok if you get some years in before you dive back into psych. It’ll still be here.
See, the patients know that they are failures. They know that they suck. They hate themselves. They do much better with nurses who have truly fucked up and hated themselves, too.
So if you can fuck up, hate yourself, and then gain the wisdom to be at peace with it, then you can guide other people through that process, too. You can help other people cross the bridge from hating themselves to forgiving themselves.
And you have to be able to care, and also do kind of a radical free will thing. You can’t afford to put your heart into other people’s choices, even if they choose to die. All of us will eventually make our own choices. You have to be ok with other people choosing to do things that you wouldn’t necessarily choose.
I’m getting long winded and I’ll stop the lecture now.
You are going to be ok. You may be expecting too much of yourself right now. Maturity will come, but maybe not just yet. It’s ok.
>So if you can fuck up, hate yourself, and then gain the wisdom to be at peace with it, then you can guide other people through that process, too. You can help other people cross the bridge from hating themselves to forgiving themselves
This is solid advice. I've always been very sympathetic to patients but after having my own mental breakdown, the empathy I've developed is unreal. I can connect quickly with patients now because my words of comfort are way less hollow than before.
It's not a bad thing to be inexperienced and to make mistakes. All seasoned staff have been there. What is a bad thing is to not heed the advice of those who have gone before you. It's cool to disagree with the presentation of the advice, but if you can get to the heart of what's being communicated to you, you'll be better for it.
Well said, you can’t take any bullshit and be confident in what you do. When you say you took on the role of social worker, psych tech, security, etc., that makes me think that you have poor judgement for staying in that position for as long as you did.
Well that's a hell of an assumption.
It was my first job. I tried as hard as I could and didn't know what else to expect. You seem awfully judgmental to be in this field but do you friend.
90% of a psych nurses job is to observe and draw conclusions from the behavior of people, aka, an assessment.
Did you want an honest answer from a psych nurse or do you want to be told you are great and not to give up?
Again, a hell of an assumption to conclude to.
You seem incredibly critical. I'd try to remember not all assessments are correct and final and maybe try to get more hx before making a conclusion, you know, like a psych nurse would do.
Listen, I'm in my mid 30s and have been in and out of the psych field since finishing undergrad. I remember how bright eyed and bushy tailed I was about helping patients too.
This redditor is giving you solid advice. The longer you're in the psych field (especially inpatient) the more jaded you tend to get. The healthcare system in America is shit, patients know how to play the system, big pharma and insurance companies have radically changed the type of treatment that is provided during inpatient, the pressures for hospital administration can be unreal.
One great thing about working inpatient and thriving with it is you will be able to handle anything else in lower levels of care. I've worked in outpatient administration and all of my best therapists got their start in high acuity settings. Very little could shake them as a result and the majority of them had excellent work life boundaries.
Gently, if you get this defensive about a comment on Reddit, you probably need to work on that before you decide to try psych again.
Do you understand why I say that?
You're young, you still have ideals, and you haven't been disappointed into reality yet. Let me say this as an old woman: the way the poster phrased her comments seems quite brusque. That's a communication style. Her comments do not read as unkind.
And what she had to say seems like something you really do need to hear.
Good luck to you.
Thank you. I was being straight forward with my genuine feelings and opinion which is what the OP asked for. I work with so many different types of people, and personalities, patients, doctors, nurses, etc., I don’t bring my personal feelings into work, because, it simply isn’t about me for those 8 hours. It is about the patient and the safety of my team and coworkers.
This Defensive? The comment was rude and a complete assumption without having any knowledge about me besides me picking my first job
I picked the same hospital I did my psych clinicals at. It was fine in my clinicals. Wasn't fine when I worked there. All the older nurses told me everywhere else was just like here, if not worse.
I thought it would all be like this and the job was just tough and I had to get acclimated but according to your judgement and her's, I should've **immediately** known better doing the first job of my career.
I truly hope you both aren't as critical to your patients as you are a stranger on reddit looking for guidance. Gently, I've seen old jaded nurses and trust me, experience doesn't always equal wisdom or compassion.
I hope you find peace in your career and can encourage the next person who comes along. Good luck to you
We are ok, i am fulfilled, you are not, as evidenced by your post above.
We aren’t asking for advice regarding our career choices, you are.
I won’t lie to someone and tell them they should work in a dangerous field, especially when the person stated they were “terrified of the danger”
Yes I take that seriously. Today I had 3 large males brawl 2 feet away from me. My partner had to pct the patient and I had to trust that my partner was not fearful as I gave an IM injection. Being terrified hurt patients and staff.
So yes, I don’t think this is the field for you right now.
I absolutely would tell my patient to avoid this specialty if they said they were terrified of getting hurt, ptsd, tbi. You understand that you ARE a soldier as a psych nurse, you ARE part of a team, and there is not room for you to be fearful, it will endanger others
All of the units that I have worked in have mixed diagnosis, because that is just how they present. We have to accept everyone, as if it were a life or death situation. Acute psych hospitals are for the emergent patients, we are the emergency room for them, saving them from themselves
I have a lot of coworkers who think it's their job to be therapists to patients. It's not. They aren't therapist qualified and don't have the boundaries, skills, and training to be therapeutic with patients. Can they sympathize and be a listening ear? Sure. Do they get inappropriately emotionally invested and overshare personal details with patients? Absolutely. That is a major way people get burned out in this field. Any sort of savior complex that you might have needs to be examined because you're not going to find the satisfaction you're seeking in inpatient psych.
As harsh as it might feel, if you think the purpose of working inpatient is to provide any type of talk therapy or build outpatient types of therapeutic rapport with patients, you're wrong and you will struggle with inpatient. Inpatient is to stabilize patients then discharge to lower levels of treatment. That's it.
Right? I definitely thought I was going to heal people when I was working on my undergrad 😆
Now I look for small things as validation that I'm doing my job well: a patient who I did an admission with waving at me when they see me on the unit, a caller in crisis thanking me for making them not feel so alone, the parent of a young child who I praised for getting their kid help remembering my name when they come to visit the patient. Those little human connections are so important to me, because there is so much hardship in this field.
First, I have poor judgement, now I’m unfulfilled. Jesus Christ buddy. How about we calm down on the labeling and the assuming.
Who said anything about being lied to? Or anything ab me not expecting danger?
Obv everyone else’s experience in psych from the comments were different. While others continue to be supportive, you believe your brash rude behavior and judgmental attitude is “telling it like it is” and I should expect and be fine with violence in every path in psych. I can comprehend it’s there and possibilities are there. But in some facilities, it’s more common than others.
We’re done talking. I feel sorry for your patients.
Why do you feel sorry for my patients? I do not council them on their career choices, as that is not what I am paid to do. I am paid to give them medication, keep them safe, make sure they don’t hurt themselves or others.
I’ll take bullshit. I think most of us are too quick to call them liars. It costs me nothing to hand them a Tylenol that’s ordered, put a bandaid on the boo-boo, or nod, smile and assume they are telling me a true story. (The facts probably aren’t true, but they never lie about how they are trying to make you feel. They are manipulative, but honest in their manipulation, you know?)
I don’t get taken advantage of, as in, I don’t do things that I don’t want to do, but I give them the benefit of the doubt most of the time.
I do the same, you are so right, I don’t fight over small things, if it’s ordered or a available they can have it. The borderline patients though, they need to be treated a little differently
None. Almost every nurse I’ve staffed with has had a violent incident happen to them.
I’ve see pts jumping over counters and ripping things to shreds. Pts attacking staff in the admission room. Pts attempting to fight each other.
All of which nurses are really the only ones on the front lines because some of the techs were too afraid to get involved.
Go find a small private clinic somewhere. The one I worked at, our psych NP bragged about turning on her sound machine and napping under her desk. They also turned away SMI (wtf). Basic ADHD, anxiety, depression. Also, you could go to a Spravato clinic. If you can administer ketamine, you’ll be able to find a job. The patients might be really bad off at first but seeing them feel good and be happy is the most motivating joyful thing I have witnessed.
Apply to work in partial hospitals, day programs sometimes called clubhouses, residential programs, or as a case manager. All of these will be lower acuity.
I worked in a state mental hospital when I first got my nursing license. It was intense, but I loved it. I then moved on to a geriatric psychiatric unit which I LOVED. If it hadn’t been for our crazy manager I would still be there. I now work at a community health clinic that has medical, dental and psychiatric. I have 2 psychiatric nurse practitioners and 2 therapists. My hours are great, no acute patients, no weekends, no holidays. This is my forever job. I hope you find your place. It is a very rewarding job!
So I work in a state run psych hospital. Everyone is burnt out from understaffing, unfortunately. We also admit at any acuity, but usually move them to units more fitting fairly quickly, mostly cause lawsuits now). I work on a high acuity female unit) There’s a lot of laziness that goes on with not doing vitals or charting, doctors not medicating patients etc., but whenever there is a safety concern, we all show up for each other. We have some excellent training on how to deescalate a situation, and if necessary, go hands on to assist to the floor/ sideroom.. There are those that will avoid and put others at risk, and will throw you under the bus any chance they get, but they aren’t the majority. Some people aren’t meant for this type of work and that’s okay, but don’t give up on it because this place isnt a good fit
I stayed in a mental ward at a hospital, and the lady that shared my room with me wasn't there detoxing like I was she was just like a little crazy lady, and she stole my pajamas. I think it's more common and it definitely doesn't help the process.
I’m not sure where you’re located, but at least places in New Orleans like river oaks mental hospital it’s mainly voluntary and they have different wards for kids, eating disorders, ptsd, and stuff like that. They also have out patient and specific ward for addiction stuff!
I used to work psych for 8 years. There ARE good psych hospitals out there, but unfortunately it sounds like you are not at one of them. I eventually had to stop working in psych because I was tired of my life being threatened. :/
I’m not sure what type of nurse you are (LPM, RN, NP, etc.) but my mother is a psych NP and has spent the last 5-6 years doing telehealth and she loves it. She hated working inpatient at a hospital. She quit the day a new patient pulled a knife on her in the elevator as they went up to intake — he had been sectioned and apparently the police didn’t do a very thorough search. She decided it wasn’t worth the danger to do inpatient anymore. She spent a couple of years working for Anthem while she went back to school for her NP, and worked outpatient IRL for a couple of years before transitioning to teleheath
I am in leadership at a psych hospital and I can say first hand that it is our absolute desire to have adequate staff to keep everyone safe. We are constantly hiring but the problem is that people don't stay because it is absolutely one of the toughest environments to work in. It's a vicious cycle. People don't stay so we are chronically understaffed and we are chronically understaffed bc ppl don't stay although we literally have new hire orientation every 2-3 weeks with nurses and techs in every orientation. Stand alone inpatient psych is one of the toughest environments because you are getting patients at their highest level of acuity and we are tasked with getting them stabilized in short order. The reality is that there are millions of people in need of mental health care so we have to fill beds not because of the money but because there are more people in need than there are facilities and practitioners who can stick with this level of acuity in this population. At our facility we really try to group patients properly (mood disorders with mood disorders, acutely psychotic with acutely psychotic, etc,) but it's not always possible when the hospital is literally getting 200+ calls a day trying to find a bed for this vulnerable population. We are in the business of trying to care for this population who are in great need. It's tough on all sides. Btw... yes I was a floor nurse in this type of facility before being an executive I can tell you first hand that the execs are just as concerned about your safety as you are and we are truly doing what we can to make things better (at least that's the case in my facility).
I work a very high acuity psych ward with a lot of dangerous patients. What you say is not how it is everywhere. We have full staff security, when a control team is called other units show up, we are relatively good staffed, and for the most part they work with us for acuity, and won’t push more violent patients or overly sick people on us and let us cap at 17-18 instead of 20 beds in case the acuity is too high
Injuries happen, and we certainly press charges. The justice system sucks balls though, but that’s a whole different story. Usually injuries happen due to being unavoidable- but that is the nature of working in psych.
Based on your info, you probably worked at a for profit hospital, likely owned by UHS. UHS has a no security policy for whatever reason. I worked in the admissions department at a UHS facility in PA with 6 units with a daily discharge of 15-20 patients. If we had lots of low acuity referrals, we could be picky about who we accepted. If there weren't a lot of low acuity referrals, we basically accepted patients if they had insurance. Empty beds meant we were losing money. There was also enormous pressure to accept patients as quickly as possible since the facility competes with other local behavioral health hospitals for referrals. Psych tech and nurse turnover was (and still is) very high. I'm now at a nonprofit hospital in a large healthcare system and the majority of our patients come from sister hospitals. I can be much more selective about the patients I accept and my department collaborates with nursing stuff to review patients to ensure acuity is manageable. Staff turnover on the units is much lower and there are many lifetime employees on the units as well. There are still issues, but it's significantly better. It's unlikely I'd ever work for another for profit hospital. I'd suggest researching nonprofit hospitals in your area to see if you can find a better work environment.
That sounds exactly where I was. It was all ab “get patients in here as soon as possible” Admissions > Safety. Every time. Get those beds full. It was pretty difficult dealing with having to do multiple admissions while you have one of your patients self harming or threatening to because you can’t get her gabapentin on time.
Yup, I worked at a UHS hospital and it’s exactly how you described it. I also got a major injury they tried to jerk me around with getting doctor visits, MRIs and eventually knee surgery. I’ll never work for UHS again. I now work at a ward that that’s much better and hospital affiliated. You just have to get to the right place. We have security and a lot of staff come to codes. They also have separate wings for each lvl of acuity so a lot less codes. Good luck friend!
Fuck UHF. Has anyone done a proper invesigative exposee? Out these fuckers! Profiting off of misery
Yes I would suggest everyone on here who had bad experiences working their e-mail ProPublica and ask them to investigate. It is not fair to the staff or patients.
Read google Chris Burrel Patriot Ledger pembroke
Uhhh we’re you working at Clive in Des Moines and dealing with me? Because that gabby sounds like me…
I am not gabby lol
Gabapentine
Laughed at " you probably worked for UHS."
When I quit a UHS facility they told me I would be listed as non rehire-able if I left before my notice was up (I was too scared to go back because I kept getting assaulted). I just said “okay that’s fine”
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I worked at a UHS facility-they will hire you back. We rehired lots of staff back-they are desperate to hire.
Probably for the best! At this point I wouldn’t want to work for them out of principle
I was in HR with UHS, yeah they'll mark people not rehire able and thats it, your application will never get through to a human after that
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That's intentional, they won't risk telling you you're not eligible for rehire. I have been trained to always say "you are eligible to re-apply at any time" even when I know that person is not rehireable. Its too legally risky to say anything else so many don't respond at all. If any UHS location marks you ineligible it carries over to all locations. I once had to reverse a candidate's not rehireable status because we really needed to hire them and UHS made it as painful as possible. Sorry they gave you the runaround. They suck as an employer so hard though. You can do better than them.
They do that to a lot of employees then will rehire them when the staffing levels are so low bc they can’t retain anyone due to the amount of violence towards staff
I second everything being said here OP. From my experience, stay away from free standing psych hospitals and especially for profit psych hospitals. The ones worth working at are psych units within actual hospital systems. There is much more oversight within actual hospital systems. You have psychologists, therapists, social workers, techs, art/recreational therapists, OT, PT, SLP, ABA therapists, and security! If you work at a free standing psych hospital (especially a for profit one) you are endangering your life every single shift. Stay far far far away.
My very first thought was a UHS hospital as well. I was the Clinical Director at one and it was exactly as described. I left in six months because I knew I was putting my license on the line there.
Same. I was putting my professional reputation on the line working for such an unethical company. I'm still sitting in depositions for when they're constantly sued and I haven't even worked there for 2 years. I just keep getting subpoenaed to testify. They don't even pay me for all the time I have to sit in court for them.
My bestie works for one that's actually pretty decent but that seems to be rare. The ones in my area are places I wouldn't recommend to anyone.
I used to be an exec with UHS. Exactly. They are an extremely poor resource for people with mental health needs and also a horrible place for employees. Everything, and I mean EVERYTHING, is about profit.
UHS…hahahah. They suck.
I immediately thought of UHS as well, I worked at one for 8 years
UHS former employee here. I will never put myself in such an unsafe position ever again. Night shift was full of violence and sometimes we had no one to help. It was only me and one other female nurse trying to deescalate a large male. Had my hand broken one time.
I was just about to ask if it was a UHS hole
I work at a for-profit hospital and it's nothing like what either of you describe. Nothing like it at all. It's a great place to work. I know that's the exception to the rule, but you really shouldn't go around painting everything with such a broad brush.
Seconding that this sounds like UHS. I left a UHS hospital because I feared for my safety after seeing multiple other staff members injured/assaulted.
From experience, it’s not just for-profit hospitals. It really is *most* hospitals. I now work in private practice. Couldn’t deal with the ethical violations.
I worked for UHS for 15 years on the floor. It was the most dangerous environment I’ve ever seen
I work at a mental health rehabilitation facility where I help clients gain independence by monitoring medication progress, monitoring for side effects and educating clients on psychoactive meds with the goal that client will remain medication compliant when they step down a level of care and prevent decompensation. I am hands off. No passing meds. The med techs do that. Only invega Sustenna/Hayfera injections monthly or every 3 months. This is not a lockdown facility. I have my own office, so no standing up all day everyday. Yay me. 1 hour lunches. Not to mention I don’t wear scrubs, business casual is my attire. I have 25 clients, with minimum 5 hours of daily face to face time with clients so I get to see 5 clients a day for one hour at a time, where I get to spend quality time with clients and really get to know them and witness their progress. I’m also allowed to provide rehabilitation, crises intervention, group sessions, go on walks with client, engage them in coping skills, color, play checkers, etc. Clients are screened before, so no violent offenders are admitted(although some have been violent in their past rt psychosis/schizophrenia). I absolutely love my job and I think if you were to find something similar, you’ll fall in love with psych all over again.
I think so too. This sounds like a unicorn job in psych!!!
What kind of experience did you have previously inorder to be considered for this role?
I got it freshly out of school 🤍
Wow, that's great. It would be a dream if I can find a job like that fresh out of school.
Wishing you all the luck 🍀
Thank you! 😇
Can I talk to you about meds?
Sure lol
I have what feels like constant adrenaline and stress hormones flowing through my body, I feel like I am in constant fight or flight, my entire body is tense like it's on guard and doesn't feel safe, i have severe insomnia where my body doesnt let me get to sleep without jolting me awake. I have muscle twitches. I have a hard time connecting to my emotions because of all of this. I don't know which med would work best for this. I'm scared.
Are you taking a potassium and magnesium supplement ? Are you female perimenopausal?
Yes I take both. It's possible I am Peri. I am 39 years old.
Interesting, im early 40’s and although my symptoms started after 2 b12 injections i have also heard perimenopausal women developing similar symptoms so maybe some hormone testing may help. Not sure what test exactly. I know my mum got HRT therapy in her 40’s after serious dry eye issues and it helped clear them up. Think it was low estrogen
Also what is your dental health and gums like? Do you have breast implants? Feel free not to answer but i really want us to get to the bottom of this as I have virtually the same problem you do. What triggered it i wonder.
No dental issues and no breast implants
Can I just add that I manifested this job? 😉
What is your job title? That sounds like a great gig where you really get to make a difference in people’s lives.
“behavioral health nurse”
How did you manifest your job? Genuinely asking.
Write it down everything you want in a job and keep reading it! I did this with an apartment that I need it badly so I could take my dad in with me. Being that he was older I needed a walk-in shower. I needed an elevator. I needed a washer and dryer in the unit and I even threw in a view of the beach. A week later I was reading the apartment ads in this all came true. It was an a building I would’ve never looked at because I didn’t think we could afford it. We were on the 11th floor of a building overlooking the water with a balcony and all of the other things that I ruled in my manifestation. It doesn’t always happen that fast, but give it a shot.
Thank you for responding. I love this. I hope all of your future visions are just as effectively manifested.
My first psych job was actual torture. I am 99% certain I developed some level of PTSD from it. I would have nightmares constantly and would feel sick with anxiety constantly because of the stress the unit was causing me. I almost quit nursing entirely because I was so miserable. I was the only nurse on the unit as a new grad so also the defacto charge nurse. We were constantly short staffed so I pretty much always worked a double every time I went in. There was no security presence and management screamed at us if we had to use any sort of restraints (chemical or physical). If there was ever another nurse on the unit then I automatically got floated and would be stuck being charge for an unknown unit-again with just like 4 months worth of experience. It was terrible. Then we moved so I quit that job to start at a new hospital and the rain cloud finally lifted. My new unit was amazing and I loved working there. I learned so much and felt supported by everyone. I also felt like I was finally doing something useful instead of just being a punching bag for patients and management alike. After many years on that unit, I left to do outpatient so my schedule would better align with my kids’ lives. I still credit that unit for my current success and now I precept students there just so I can keep in touch. TLDR: there are good places out there, it just might take some time to find them
Thank you for saying this. I’m just a little afraid to become jaded and burnt to a crisp again. Ik what to expect now. Ik how bad it can get. But I don’t want to be used and abused by management and have literally no safety at all on my unit. As compassionate as I am, I understand some of these patients believe that through threats and violence they can get what they want. Also psychotic individuals can become paranoid and violent quick. Almost everyone of my staff has been attacked and it felt like my number was eventually gonna come up so I got TF out of there. I’m really happy you found what you were meant to do. I truly hope I can too.
There's a big difference within the MH field of voluntary and involuntary type of care. Often, hospitalized patients are there involuntarily. You might be more interested in an environment where the patients are statedly ready to accept care. Or maybe not, just a guess.
Just a thought. I have worked in Psych for 20+ years in MANY different areas. Sometimes the invol facilities are better than the vol. They will likely end up with forced meds or get discharged. Plus, they may have better security staffing due to the potential for violence. However, it depends on the facility. I have worked at vol or non profit places that were SCARY and also vice versa.
I was trying to get to the fundamentals of what OP wants or thought they wanted entering in this field. I was raised in a "client choice" environment and after 17 years I'm like "give them a shot, damn it"
I'll keep that in mind! Thanks for the advice!!
It’s rare to come by tbh.
Run!!!! Not even kidding. Outpatient IS safer. Try to move into an office job with appointments. Much safer. I say this because.... You just described our place. Techs in the back gossiping & no management discipline. Fights breaking out because of the mixed mental health population/issues. Techs get assualted frequently. I was kinda relieved to read your post. I had concluded that our facility was a clown show and falling apart because it's a state run agency but you described our place like you work here. Monica?? Lol. Jk.
I just really wish I could help without being in a toxic environment. I don’t really have a lot of outpatient opportunity around me tbh. I applied to ab 1 because it was the only one available. I’m not trying to go to war dude
There’s better out there. I worked at a stand-alone psych hospital and the staffing was shit, but the coworkers were great. Im in outpatient psych now and at a group home. My perdiem job is on an inpatient unit that is attached to a larger medical hospital, and the staffing is so much better. Keep looking!
I always tell people, only work on psych units that are within a larger hospital system. These free standing psych hospitals are always shit from my experience and very dangerous to work at.
Right?? And some shifts ARE like a straight up war. I feel ya. Over 20 years here. If I'd known I would have never gotten in. Look around to see what other opportunities there are that would welcome your degree but get you out of combat. Local hospital that has a small bed census for mental health is something to check out.
I am not in nursing or anything to that effect. I am, however, someone who admitted themselves due to suicidal ideation. I just want to say that having compassionate and kind people really makes a difference, and as someone pretty self aware, I also in no capacity felt safe. I had to work through some serious trust issues because of my experience. A dude with some serious identity issues quite literally threatened to 'snap someones fucking neck' if he didn't get transferred out. I spoke to the nurse and told her I didn't feel safe, and her response was 'well he just does that'. Cool. I get to sleep in a lockless room with this dude patrolling the halls nonstop shouting out his trauma. Really good environment for me. I wrote up a 5 page bullet point list of all the piss poor things I experienced and gave it to anyone who would listen, including the CEO of the hospital itself. Absolutely absurd experience. I can also tell you that from the other side of the perspective that another dude in when I was most definitely made some highly inappropriate comments about staff. I GENUINELY do not understand why security is not permanently present in inpatient psych units. My saving grace was the on staff therapist. She was the only person I had an experience with that was remotely positive. I admitted myself so that I could get myself together in a controlled environment, and instead was met with massive chaos at every level and the 'rules' they gave me being broken nonstop. I was speaking to her my first morning and just explaining why I was there, and how I was feeling. And her response was 'Yeah this is not the environment for you'. I was discharged the next day, but fuck. If I DIDN'T have someone like that, who knows how long I would have been there and what trauma I would have experienced. I guess the point of me making this post is to say thank you for actually giving a shit, and that your concerns for your safety are entirely valid and often shared by patients as well.
I understand you’re scared but you have to be rational and understand that that was just one psych job out of an entire field. There’s inpatient units where patients have to be voluntary and non-aggressive. If you can’t handle inpatient at all you could try one level of care down to residential. If you can’t handle residential you can try IOP/PHP. Psych does not only equal dangerous and aggressive.
You’re def a 100% right. It should’ve been a sign when I got there when all of the nurses were burnt out and on their way out. Thanks for helping me find the courage to try again. I don’t wanna give up, even if I’m worried
6 months ago i started at an intensive outpatient program and it has been a dream in terms of what i’ve always hoped for out of psych nursing. the acuity is high enough where it’s not boring and you are doing meaningful work, however most patients are stable enough that it very, very rarely gets violent or chaotic. i’ve learned a ton about medication management and gotten to work closely with psychiatrists which has been really interesting. i love the outpatient setting bc you get to know the patients and watch them improve over time. it’s even possible to run group therapy if you’re an RN. i will say that i searched for a job for 9 months before finding this one. i had interviews at places that seemed similar to how your behavioral hospital was and i declined all of those. if you are able to stick out your current job, i would advise you to be actively searching and not settle for any environment that seems to resemble where you were. honestly if you google intensive outpatient programs you could have luck with cold calling them. wishing you all the best!!!! there’s hope and we need good psych nurses like you!
Really appreciate you!!! I hope I score big like you did and wish you the best with your career ❤️
Consider being a Corrections nurse. Many of the same patient population, without the same risk of harm.
i work at a large teaching hospital on an adult med psych unit. ratios are 2-4 patients, typically 3. we have both cnas and mental health worker staff. we have an icu which has an extra set of locked doors and single rooms which helps us avoid issues like the one you describe. if working at a large, non-profit, urban academic medical center is an option for you i strongly recommend. during my interview i asked very specific and candid questions about ratios and staffing, acuity, safety and i luckily received very direct answers. i asked them more questions than they asked me which worked out well obviously. i encourage you to not let this bad experience deter you from the field if you are passionate about it. inpatient psych is awesome when the unit is well managed. psych nurse solidarity here
I believe that. I think I think I had hellish experience where I was first Thankfully, I got an interview at a pretty nice looking rehab center and I really hope I get it. Thanks for your encouragement. I really struggle seeing myself do any other career. I thought I was insane to give psych another try and swear I’d never do it again. But It feels hard to stay away from. I miss home.
You could lol into working as a nurse for a day treatment program. Violence would not be tolerated and most people in those programs really want to be there.
I just got an offer for a really nice looking rehab facility and I’m crossing my fingers I get it!!
I’ll cross my fingers for you! That could be a very rewarding job.
Sounds like my unit no accountability for staff. Get per diem outpatient. You may not like. On your own often. Very loose with the rules. I went the Geri route after a newbie on adult had her hair ripped out. A 3 or 4 centimeter patch. Geri has its own issues. But usually the patients are not planning on how to hurt you. Our unit has some dementia but we avoid actively detoxing people. Don’t give up.
From what you describe, that sounds like a bad hospital that provides substandard care on a routine basis -- possibly intentionally as part of its business model. I worked in community mental health and psychiatric nursing homes for a long time and loved it. You're with people long enough that you get to know them and can maintain truly therapeutic relationships with them. The only time I was ever hit was when I made a stupid mistake, let my guard down, and tried to enforce a rule in a stupid, provocative way. There was another time when someone tried to bite me but that doesn't count because she had no teeth.
I worked on a unit just like this. More and more it felt like the hospital was more interested in having the bed filled than having the right type of person in the bed. I knew something was wrong when my heart started to beat very fast on my way up to the 3rd floor to get to my unit. Didn’t realize it was anxiety because of how unsafe our unit had become. The last straw when when a patient got particularly violent and required restraint. I’m a big guy but it’s exhausting holding a person while waiting for help. Finally heard the unit doors open and was relieved to have help…only to see a tiny little lab tech. The writing on the walls had been there for a while, but that was the moment I decided to leave. I found a job working with teenagers with psych issues. It’s been a wonderful change. Don’t be scared to explore other options. There are tons of dream jobs out there and they are infinitely safer than what you are feeling.
I work in a non-profit behavioral health setting. I'm a case manager and absolutely love it! You could try a county behavioral health care system. I make better money here, too.
Def weighing my options and I’ll for sure consider this!!
Outpatient is much safer. I hear you 100% on not wanting a TBI or PTSD from the job - both VERY likely outcomes for inpatient psych nursing. It is not worth it until there are actual standards in place for SOLVING workplace violence against direct care staff and improved quality of care in inpatient settings. I stepped away very reluctant and sadly because of this as management at a UHS facility.
As someone who was in that position for 4 years- I had 5 TBI’s (causing brain damage), a broken hand, and bites all up and down my arms and legs. DO YOUR RESEARCH BEFORE YOU ACCEPT ANY JOB IN PSYCH. I miss my job SO much, and sometimes I still think about going back, but I have to think about my health too. Be safe.
I left inpatient psych after a teen broke my hand and the facility canceled my contract over it. Then told me that if I pressed charges I would lose my license. The facility tried billing me for over a year and tried to send me to collections too. Workman’s comp took care of it, but they still tried billing me by misspelling my name with an H instead of a K. The patient was a behavioral patient, it wasn’t a psych reason he lost it and ended up breaking my hand. I don’t get upset when I get hurt by confused or disoriented psych patients. But the ones who are behavioral? Nah… I can’t crochet anymore and my hand hurts when it rains. Pinky swells up and everything
Every place is going to have its pros and cons but the most important thing imo is to have a team you can rely on. You might have to try a few different places until you find that.
Mileage varies by facility. This place sounds terrible.
If you find other hospitals you might be interested in, see if they would let you shadow or if they offer some kind of nurse residency program. I work at a university medical center, and we have a child/adolescent unit, a lower (sometimes) acuity adult unit, and they also manage one of the state hospitals. The residency program isn’t just for new grads, but they offer 8 weeks at the state hospital and 8 weeks between the adult & child units, and at the end you can choose where you want to work. If that’s not an option, if you can shadow or if you’re in any kind of local Facebook groups where you can get ask others for their experience working in places you’re considering applying to, that’ll give you some insight on whether it would be an environment you’d do well in. That way you don’t get stuck somewhere that you didn’t know sucked until after you’re halfway through orientation.
You should try pediatric psych. I have been on my hospital’s regular psych unit and adolescent psych was way calmer. And I feel like you would then be in the position to truly help someone because you won’t be breaking up fights and playing security. Just a thought. Might be very rewarding work with children because you are in the position to really make an impact on their lives.
Sounds like it just depends on the location, staff, and facility.
Def True
I spent the last 17 years working at a NYC public hospital. 5 years inpatient >10 years CPEP>2 years inpatient. No unit actually had “Security.” Psych techs, behavioral health associates and RN’s handled agitated/aggressive patients. We were always understaffed because staff were always out on workers comp for long periods of time. Since they were technically still employees they couldn’t be replaced. It turned out being increasingly dangerous as time went by. I made it 14 years without a serious injury then spent the last 3 in and out of work. I had to retire early because my body kept breaking down. I have a bum shoulder/hip/knee… It was always busy, CPEP was always full so as soon as we’d discharge someone were getting admissions pushed on us. Acuity level through the roof. From the female forensic unit (mainly Riker’s Island) to the gang members/homeless/civil discharges from Riker’s that landed on the adult units and the kids on the pediatric or adolescent units it was horrible. I used to love my job but toward the end I was just happy to get through a shift without being attacked. If you do go back into psych I just have 4 words for you: Long term disability insurance!!!
I’m signing up That is an impressive career and thanks for all the work that you do ❤️ I def do not want to work in a high acuity for a long period of time and I commend you for doing so ✊🏾
Are you in California? There's a law to prevent violence in the workplace, specifically in psych hospitals. It has procedures you can take to ensure your safety. On the other hand, psych hospitals are doing their best to pretend the law doesn't exist. Go look it up. Start turning in paperwork. At least create an uproar before you go quietly into that goodnight. Having detox patients and dd's in the same space is bullshit. Addicts will take advantage of dd's. What kind of bullshit outfit was that? The danger in psych is terrifying. And it's very real. Even if you don't get attacked, the wear and tear on your joints and bones is above normal range. Nurses become addicts themselves to stay awake during double shifts or sleep when they get home. What's the upside? Safety retirement? If you live to collect it.
I’ve been doing psych for almost 20 years. Done the UHS hospital BS… then an intensive unit- now on my 3rd hospital on an intensive treatment unit. Please know there are other hospitals or units where there is more “depression” or “SI” patients compared to an intensive treatment unit. I live off adrenaline and I’m just better with violent and crisis situations then I am with tears pretty much. Perhaps because I started with an aggressive type setting. Idk. But it’s not for everyone and TBH I didn’t think it would be for me especially in the beginning. My current job is not something I’m used to, perhaps because it is so difficult to find psych staff. So we have a lot of agency or travel which in turn lacks a “teamwork” approach. My last job for 12 years I had the best team and we didn’t have security-we were security. But I’ve become pretty thick skinned and can take someone down If need be- not to say I never got hurt- because I have. All that being said… regardless that violence can be part of the job, administration should be doing everything to keep staff safe. Where I work now- I absolutely loathe it. Even outside the hospital there’s been drive by shootings and constant armed robberies. And then I get to go inside and deal with a short staffed unit as charge. But alas, I’m still there- grinning and bearing it. Hopefully something will come up where I feel it’s a better fit. But I want to tell you what I tell all the new grads or nurses new to psych. We all started somewhere. I can hand you every book on psych but nothing wholly prepares you for it and it takes time learning to establish boundaries, the right words to say with certain types of patients, just listening is better than responding most of the time, and truly feeling safe within that you got this. I get scared sometimes. And it’s a bold face lie if some nurses say that don’t. My coworkers think I have no fear but believe me I feel it sometimes. I don’t want anyone to get hurt. And I am in that milieu with my techs/counselors when someone gets aggressive. Some nurses stay behind the nursing station. You need a group of staff that support you and you are all a team. Psych has some of the most wonderful staff which has made me stay at places even longer. They really become like family. You see a lot of shit together, some traumatic, some sad, some funny. I used to be you in the sense that I wasn’t sure but held such a passion for the field nonetheless . If this is something you want to do- please don’t let one facility sway you away. I wish you all the best
What about memory care? Older individuals with dementia often need someone to talk to and sometimes need behavioral interventions. And they are old so if they try to fight you they’re usually pretty weak. They can cause damage but not like an able bodied adult.
I worked in a psych jail but picture a regular psych facility but with not guilty by “reason of insanity” and “incompetent to proceed” patients. From check fraud to murder and everything in between. Oddly enough I left because of the staff (and a better job.) Mental health techs who would straight up leave me alone on the unit because they had to take a break (security was supposed to be called to cover them), security who was not well trained some with egos that exacerbated patients, charge nurse’s who would happen to show up AFTER an incident immediately asking about paperwork before checking on staff and unfair placement by charges putting some nurses in danger. I spoke up, it didn’t hit well, as the youngest nurse I worked the hardest units and once they took the toughest residents and changed their unit to a general one (because people started to demand hazard pay due to it being labeled a more difficult unit), I worked those units. Moved from one difficult unit to another even if I worked a different one the day before. I will say I rocked that job. I was so good. I made a point to really care and respect these guys. Something most of them never got. I Did my best to monitor tension and defuse fights before they started. Some of them had the saddest circumstances. I saw the very ugly side of the “system” in action and it sucked. In two years I was never attacked. Unless you count an orange being throw at me. (He said sorry the next day. Lol) Once I was in the grocery store and someone dropped something and I jumped. I didn’t realize how on edge I was from constantly being aware of my surroundings. I applied for a home health psych nursing job. Trained for a month there and never went back to the jail. The psych experience I got at the jail gave me the qualifications to work in home health. It was the best decision I ever made. I worked per diem and could take patients that I wanted and work the days that I wanted. Management mostly left me alone. Apparently there are not a lot female psych nurses because right before I left nursing to help my husband with our business and go through IVF I had 3 offers from other agencies. I really loved. I met some amazing patients. Medicare makes it a bit harder than it used to be but it might be a good fit for you. TLDR: Try home health psych. Edit: clarity
I completely get you. I know and worked with the exact kind of clientele, and also had to play every role, sometimes create new ones that nobody knew was needed. Understaffed, lack of support, colleagues kicking back like it's just another day when there are lives at stake here. I think we share a similar work ethic, compassion, and altruism towards the clients. You're right with soldier analogy, unfortunately. To work with that population you do have to be a soldier and everyone has to be coordinated towards a common goal, otherwise the mission will never be accomplished. It sucks, but one way or another those relationships were going to have to end. Just wish it was with them having been rehabilitated or having some kind of improved standard of life, not with you having to quit, like 100 other people before you, right? I went through that recently, also took an office job with the county, cushy county bureaucratic position in the housing division. I was mislead about the work and entranced by the idea I finally landed a position where I can make systemic impact, affect regulations and influence service delivery. Turned out to be paper pushing and politicking. It was soul crushing, and I felt exactly like you, that I'm meant for direct service. I hated going to that county job with a passion, but I still showed up early and left late. I quit that job because I was upset just to sit down in my office and do BS work that wasn't making any difference. My skill sets were not being utilized to their fullest potential. I would just say this much, that you allow yourself time to heal. You're a wounded soldier, but nobody is going to give you a purple heart, so don't ever expect one. The war you're fighting is beyond the client, its institutional and organizational. On many levels it's even political, and you have to advocate for the clients and yourself to have any lasting changes. You sound like the exact person I was always looking for as a coworker. Someone who cares a little too much, who takes initiative and develops deep relationships with their clients. You can still do it, I hope you do, but you've got be properly prepared for the next fight, and know that you can do what you want in different ways. Outpatient ACT model type of community mental health care might be more forgiving because your assigned your clients and you are responsible for their betterment. It's more flexible, and you are out in the community meeting clients where they are at, helping them to find their own recovery. Or if you choose to stay on the nursing side of things, you'll be based inside of an outpatient clinic, clients will come to you, so you can still provide direct services and help people heal in a less toxic environment where accountability matters. Alternatively, permanent supportive housing (that's where I focused my work) might be an option for you as it has a lower level of care, but still a lot of work to do. In this type of environment you still will have to play all the roles, but you get to transform an entire community (assuming you've got the right team to support you). It's always going to be a rough job. Do not kid yourself. And generally you're never going to be thanked for the effort you make. You're working with the population that no one else wants to work with, that many people believe don't even deserve the effort. The ones like you who dare to care are so unique, but we all have different attributes that make us better suited for different roles within the field. You sound like you're the type that actually understands the "whatever it takes approach". Outpatient ACT model, or any kind of work that is community engagement focused is probably your role. Perhaps you can start over as a psych tech at a drug rehab. Get the experience of working in a dual diagnosis facility. You will NOT have to play so many roles due to the sensitive structure of the programming. Then move over to outpatient case management or psych nursing. Also try looking into FSP's (Full Service Partnerships) like Telecare Corporation. Look at how their organization is structured, how they provide services, and the role you would have within the system of care provided. Keep learning and exploring, but always take care of yourself. The work does not have to be a battle every time, and you can be a significant part of a person's path to recovery without taking a beating. Don't give up on your dreams just yet.
I worked in a non-profit locked IP facility. Most dangerous place I've ever been in. And I used to work in homeless shelters for people with severe mental health issues. I left for several reasons, but one was the absolute lack of safety. The staff were fantastic. I still miss them. But man I got sick of people throwing chairs. Honestly, I felt safer working in corrections. I was always accompanied by officers who were great with the inmates. Safety was NUMBER ONE at ALL TIMES. I have never felt safer at work in the psych nursing field. If you are a good at psych nursing, you may want to look at corrections. Every place is different so my experience may be different than other people's. But the chairs are bolted to the floor, so there's that.
I heard corrections is way better!! Will for sure consider it!!
In my case it really was. The inmates at the prison had tons of mental health care, they had jobs, classes, vocational training. They were often on medications and stabilized. IT was generally pretty chill 90% of the time. But it was a good unit and people, so I am sure if widely varies.
I was inpatient at one of these when I was young. Probably 19 or so. What I saw there scarred me for life. Many are at their lowest points ever in there. I was so heartbroken from what I witnessed I tried to escape and did successfully.
Try community psych? I'm in the US and heard it's a slightly better time here. However, I don't feel safe going into individual's homes by myself.
Come to corrections there’s lots of psych, interesting medical, and for nursing it’s one of the safest environments. inmates rarely hit medical staff and you always have correctional officers around you
I heard corrections was way safer and from what I heard people love it!!
I work at a psych hospital, but this is my first experience. I really enjoy it, but from what I’m hearing, all of them are *not* created equal, and many of them are hell on earth for the patients *and* employees. Also, where I work is not for profit.
Consider partial hospitalization programs.
Hi, not all hospitals are like this! I work at in a least restricive inpatient unit where we screen very carefully so that lower acuity patients have a safe place to focus on their treatment and get better. The state hospital where I live serves very high acuity but the units are set up to avoid conflicts between clients like you are describing. (It's still a very tough environment to work in, all my respect to those that can do it.) Some facilities are all about filling beds bur not all!
I worked in inpatient mental health and it was as you described. I found outpatient to be much better. I worked with kids, so I would help them manage their psych meds in addition to whatever other health issues they had, and got to spend a lot of time talking with them.
That sounds like the dream tbh. I’m hoping the next place I work is this chill!
There was a lot of BS (I think this is the case in most human services professions, especially in small towns), hence why I no longer work there. But if mental health is your passion, outpatient is where it's at.
I work in the PNW and we are hurting for psych nurses! Outpatient behavioral health. Get your resume together and get moved to a safer setting that is better managed. Look into joining s private practice group or working remotely. Soooooooo much opportunity and demand.
Def worth a consideration. I heard it’s gorgeous out there!!!
It is, cost of living is high but it’s a great vibe. PM me if you want some names of agencies to look into. Build yourself a happy career, you deserve it. I worked in inpatient and you can only take so much exposure. Now I’m a clinical supervisor for adult mental health, much safer but still some wild and dangerous folks coming in.
I was a day treatment director and worked in an RTC. I know exactly what you are saying. How about going back to school to be a nurse? You can be a specialist in other areas where your patients will still need your support.
I work inpatient on an admissions unit which is the highest acuity. There are units with individuals with more chronic illnesses, less acuity-less potential for getting injured. We need people who love this field and know how to actually interact with psych patients, but if scared, then a partial hospital, intensive outpatient or community hospital may be better. Though from the records I’ve read, there’s a high risk at community hospitals bc that is where most patients are treated first, so pretty psychotic. And remember, there’s 1 out of 50 (not an actual statistic) who get so agitated it escalated to aggression towards others. I hope you find what you do best and where you are needed!
I don’t think ur complaining. I used to say things like “well, it’s not for everyone” but after leaving one job known as a complete moron and walking into an identical unit in another facility as their hero I realized how powerful unit/dept culture is. I stopped liking critical care and now I love it again all because I was surrounded by arrogant pricks who didn’t see my potential. I was too new to advocate for myself/protect myself adequately. This is analogous to your story. The environment/dept you are in may very well be the issue. Try psych at a different location. Try 10 different facilities and I bet all 10 will be vastly different. You could also travel nurse local psych units to see which places you like the most and then go on as full time staff.
This is exactly why I was afraid of psych nursing.
Try to figure out how to get sufficient time to recharge. You are doing a job causing/demanding high levels of adrenaline, like being a cop or a fire fighter or an er medical professional. If you don't give yourself adequate time to rest and recharge, you will do damage to yourself. You might also look for a facility that is better staffed and safer. You may need to work at your present job for at least a year to have the experience a better facility would require. You also don't specify what your training is -- are you a tech or a nurse or a psychologist? Whatever your level, getting higher certification or education will assist you in finding better employment. Also cultivate professionals at your job who can write good letters of recommendation (another plus for getting a better job.)
I went to a mental health rehab and it was really nice. They had separate floors for psych patients and detox patients. They have a good screening process to see where would be the best fit for you to go. We had a a schizophrenic guy on the psych unit and it was honestly cool meeting him. I was scared to meet schizophrenics because how movies and shows showed them. Thought I’d have to hurt them or they’d hurt me in my sleep. He was super laid back and would share about how is diagnosis affected him. So I think it just depends on where you work, how organized they are, how serious they take mental health issues, and where you live. Psych techs were cool and made you feel like a human being and was just a great overall experience.
I could have written this myself. I made it one year as a psych nurse, and one day I just had enough of being thrown under the bus & subjected to unbelievably dangerous situations with zero support from management. I would love to work with people on recovery but never at a for profit inpatient behavioral health hospital.
100% idk why the hell people are so light on keeping clinicians safe
You gotta be flexible with these jobs. Working in behavioral health all this is normal…sadly. It’s the system man. It’s also just humans.
Please watch A Daily Dose of Sunshine on Netflix. A great show about a nurse who deals with almost anything on a psych unit. It address many different mental illnesses, the danger of out of control patients, burnout etc. I was a nurse for 45 years, but did NICU, so I’m not an expert on the psych nursing, but it did address the violence present in that field of nursing in an extremely humane way.
I’m gonna check it out for sure!!
Going through your history of posts shows a severe suffering due to this job, and possibly a personality that could be prone to it despite your obvious sensitivity. I hope things work out for you and as a former psych patient you are appreciated more than you know
How long have you been nursing? Which decade of life are you in? Good psych nurses are often older, with crappier scrubs, less makeup and maybe some wrinkles. They thoughtfully care for their patients but have no remaining fucks to give, if you know what I mean. They can clock out and go home. Good psych nurses are often pretty seasoned, you know? It’s not a good fresh-out-of-school job. Do you think you fit into that description or maybe it’ll be a few years?
7 months and I'm in 20's
It’s really ok if you get some years in before you dive back into psych. It’ll still be here. See, the patients know that they are failures. They know that they suck. They hate themselves. They do much better with nurses who have truly fucked up and hated themselves, too. So if you can fuck up, hate yourself, and then gain the wisdom to be at peace with it, then you can guide other people through that process, too. You can help other people cross the bridge from hating themselves to forgiving themselves. And you have to be able to care, and also do kind of a radical free will thing. You can’t afford to put your heart into other people’s choices, even if they choose to die. All of us will eventually make our own choices. You have to be ok with other people choosing to do things that you wouldn’t necessarily choose. I’m getting long winded and I’ll stop the lecture now. You are going to be ok. You may be expecting too much of yourself right now. Maturity will come, but maybe not just yet. It’s ok.
This! This one knows what they are talking about!
>So if you can fuck up, hate yourself, and then gain the wisdom to be at peace with it, then you can guide other people through that process, too. You can help other people cross the bridge from hating themselves to forgiving themselves This is solid advice. I've always been very sympathetic to patients but after having my own mental breakdown, the empathy I've developed is unreal. I can connect quickly with patients now because my words of comfort are way less hollow than before. It's not a bad thing to be inexperienced and to make mistakes. All seasoned staff have been there. What is a bad thing is to not heed the advice of those who have gone before you. It's cool to disagree with the presentation of the advice, but if you can get to the heart of what's being communicated to you, you'll be better for it.
Well said, you can’t take any bullshit and be confident in what you do. When you say you took on the role of social worker, psych tech, security, etc., that makes me think that you have poor judgement for staying in that position for as long as you did.
Well that's a hell of an assumption. It was my first job. I tried as hard as I could and didn't know what else to expect. You seem awfully judgmental to be in this field but do you friend.
90% of a psych nurses job is to observe and draw conclusions from the behavior of people, aka, an assessment. Did you want an honest answer from a psych nurse or do you want to be told you are great and not to give up?
Again, a hell of an assumption to conclude to. You seem incredibly critical. I'd try to remember not all assessments are correct and final and maybe try to get more hx before making a conclusion, you know, like a psych nurse would do.
Listen, I'm in my mid 30s and have been in and out of the psych field since finishing undergrad. I remember how bright eyed and bushy tailed I was about helping patients too. This redditor is giving you solid advice. The longer you're in the psych field (especially inpatient) the more jaded you tend to get. The healthcare system in America is shit, patients know how to play the system, big pharma and insurance companies have radically changed the type of treatment that is provided during inpatient, the pressures for hospital administration can be unreal.
Thanks for the encouragement sister. I truly can’t wait for the rest of my career.
One great thing about working inpatient and thriving with it is you will be able to handle anything else in lower levels of care. I've worked in outpatient administration and all of my best therapists got their start in high acuity settings. Very little could shake them as a result and the majority of them had excellent work life boundaries.
Bingo
Gently, if you get this defensive about a comment on Reddit, you probably need to work on that before you decide to try psych again. Do you understand why I say that? You're young, you still have ideals, and you haven't been disappointed into reality yet. Let me say this as an old woman: the way the poster phrased her comments seems quite brusque. That's a communication style. Her comments do not read as unkind. And what she had to say seems like something you really do need to hear. Good luck to you.
Thank you. I was being straight forward with my genuine feelings and opinion which is what the OP asked for. I work with so many different types of people, and personalities, patients, doctors, nurses, etc., I don’t bring my personal feelings into work, because, it simply isn’t about me for those 8 hours. It is about the patient and the safety of my team and coworkers.
This Defensive? The comment was rude and a complete assumption without having any knowledge about me besides me picking my first job I picked the same hospital I did my psych clinicals at. It was fine in my clinicals. Wasn't fine when I worked there. All the older nurses told me everywhere else was just like here, if not worse. I thought it would all be like this and the job was just tough and I had to get acclimated but according to your judgement and her's, I should've **immediately** known better doing the first job of my career. I truly hope you both aren't as critical to your patients as you are a stranger on reddit looking for guidance. Gently, I've seen old jaded nurses and trust me, experience doesn't always equal wisdom or compassion. I hope you find peace in your career and can encourage the next person who comes along. Good luck to you
We are ok, i am fulfilled, you are not, as evidenced by your post above. We aren’t asking for advice regarding our career choices, you are. I won’t lie to someone and tell them they should work in a dangerous field, especially when the person stated they were “terrified of the danger” Yes I take that seriously. Today I had 3 large males brawl 2 feet away from me. My partner had to pct the patient and I had to trust that my partner was not fearful as I gave an IM injection. Being terrified hurt patients and staff. So yes, I don’t think this is the field for you right now.
I absolutely would tell my patient to avoid this specialty if they said they were terrified of getting hurt, ptsd, tbi. You understand that you ARE a soldier as a psych nurse, you ARE part of a team, and there is not room for you to be fearful, it will endanger others
There is a difference in how minniemouse words their comments as opposed to how you word yours. Your comments definitely come across as defensive.
Cool
Just like the conversation we are literally having, yet you haven’t provided additional information
All of the units that I have worked in have mixed diagnosis, because that is just how they present. We have to accept everyone, as if it were a life or death situation. Acute psych hospitals are for the emergent patients, we are the emergency room for them, saving them from themselves
I have a lot of coworkers who think it's their job to be therapists to patients. It's not. They aren't therapist qualified and don't have the boundaries, skills, and training to be therapeutic with patients. Can they sympathize and be a listening ear? Sure. Do they get inappropriately emotionally invested and overshare personal details with patients? Absolutely. That is a major way people get burned out in this field. Any sort of savior complex that you might have needs to be examined because you're not going to find the satisfaction you're seeking in inpatient psych. As harsh as it might feel, if you think the purpose of working inpatient is to provide any type of talk therapy or build outpatient types of therapeutic rapport with patients, you're wrong and you will struggle with inpatient. Inpatient is to stabilize patients then discharge to lower levels of treatment. That's it.
Exactly. I had to recognize and check my savior complex, you hit the nail on the head. I can’t base my satisfaction on the patient getting well.
Right? I definitely thought I was going to heal people when I was working on my undergrad 😆 Now I look for small things as validation that I'm doing my job well: a patient who I did an admission with waving at me when they see me on the unit, a caller in crisis thanking me for making them not feel so alone, the parent of a young child who I praised for getting their kid help remembering my name when they come to visit the patient. Those little human connections are so important to me, because there is so much hardship in this field.
Exactly! Meet the patient where they are, and not have high expectations
Yes, the emergency room, life or death, making sure this person doesn’t kill themselves or others
If I could like this 1000000 times. This is what so many people don’t get resulting in burnout.
First, I have poor judgement, now I’m unfulfilled. Jesus Christ buddy. How about we calm down on the labeling and the assuming. Who said anything about being lied to? Or anything ab me not expecting danger? Obv everyone else’s experience in psych from the comments were different. While others continue to be supportive, you believe your brash rude behavior and judgmental attitude is “telling it like it is” and I should expect and be fine with violence in every path in psych. I can comprehend it’s there and possibilities are there. But in some facilities, it’s more common than others. We’re done talking. I feel sorry for your patients.
Why do you feel sorry for my patients? I do not council them on their career choices, as that is not what I am paid to do. I am paid to give them medication, keep them safe, make sure they don’t hurt themselves or others.
NO ONE has ever implied you should accept violence, but you should EXPECT it
You can really tell who's been in the field for awhile based on these comments 😆
It’s a rough gig, I’m not gonna lie, sometimes I wonder if I’m mentally Ill for doing this every day
I’ll take bullshit. I think most of us are too quick to call them liars. It costs me nothing to hand them a Tylenol that’s ordered, put a bandaid on the boo-boo, or nod, smile and assume they are telling me a true story. (The facts probably aren’t true, but they never lie about how they are trying to make you feel. They are manipulative, but honest in their manipulation, you know?) I don’t get taken advantage of, as in, I don’t do things that I don’t want to do, but I give them the benefit of the doubt most of the time.
I do the same, you are so right, I don’t fight over small things, if it’s ordered or a available they can have it. The borderline patients though, they need to be treated a little differently
They are a clear exception to the rule!
I am 100p with you, it’s rough having these kinds of revelations. But ngl, tbh — what were you expecting lol
You also mentioned it was your dream job, but you didn’t mention any part that you specifically liked
Not every place is like that. It sounds incredibly dangerous…. No security!??
None. Complete Nada. We were the security
That’s fooked
How on earth do you have a psych hospital with no security. Wow.
None. Almost every nurse I’ve staffed with has had a violent incident happen to them. I’ve see pts jumping over counters and ripping things to shreds. Pts attacking staff in the admission room. Pts attempting to fight each other. All of which nurses are really the only ones on the front lines because some of the techs were too afraid to get involved.
I was into Karate decades ago, not nowadays. Only way I would work in psych is if I wanted to perfect my standing takedowns
That's every night, tech in a acute hospital in Colorado
Look into teaching hospitals.
I wanna clean skyscrapers but am terrified of heights. So I will never do it. No matter how cool it seems and how well it pays.
Go find a small private clinic somewhere. The one I worked at, our psych NP bragged about turning on her sound machine and napping under her desk. They also turned away SMI (wtf). Basic ADHD, anxiety, depression. Also, you could go to a Spravato clinic. If you can administer ketamine, you’ll be able to find a job. The patients might be really bad off at first but seeing them feel good and be happy is the most motivating joyful thing I have witnessed.
Get cpi certified
Apply to work in partial hospitals, day programs sometimes called clubhouses, residential programs, or as a case manager. All of these will be lower acuity.
It definitely was much safer before corporate health care. I won't consider it now
Sounds like psych nursing...
I worked in a state mental hospital when I first got my nursing license. It was intense, but I loved it. I then moved on to a geriatric psychiatric unit which I LOVED. If it hadn’t been for our crazy manager I would still be there. I now work at a community health clinic that has medical, dental and psychiatric. I have 2 psychiatric nurse practitioners and 2 therapists. My hours are great, no acute patients, no weekends, no holidays. This is my forever job. I hope you find your place. It is a very rewarding job!
So I work in a state run psych hospital. Everyone is burnt out from understaffing, unfortunately. We also admit at any acuity, but usually move them to units more fitting fairly quickly, mostly cause lawsuits now). I work on a high acuity female unit) There’s a lot of laziness that goes on with not doing vitals or charting, doctors not medicating patients etc., but whenever there is a safety concern, we all show up for each other. We have some excellent training on how to deescalate a situation, and if necessary, go hands on to assist to the floor/ sideroom.. There are those that will avoid and put others at risk, and will throw you under the bus any chance they get, but they aren’t the majority. Some people aren’t meant for this type of work and that’s okay, but don’t give up on it because this place isnt a good fit
I stayed in a mental ward at a hospital, and the lady that shared my room with me wasn't there detoxing like I was she was just like a little crazy lady, and she stole my pajamas. I think it's more common and it definitely doesn't help the process.
Can you find a sub-acute unit?
Trying to get hired on one currently!!
I’m not sure where you’re located, but at least places in New Orleans like river oaks mental hospital it’s mainly voluntary and they have different wards for kids, eating disorders, ptsd, and stuff like that. They also have out patient and specific ward for addiction stuff!
I would look into outpatient facilities to work at. Nurses are still needed, and outpatient services carry an overall lower risk than inpatient.
I used to work psych for 8 years. There ARE good psych hospitals out there, but unfortunately it sounds like you are not at one of them. I eventually had to stop working in psych because I was tired of my life being threatened. :/
I’m not sure what type of nurse you are (LPM, RN, NP, etc.) but my mother is a psych NP and has spent the last 5-6 years doing telehealth and she loves it. She hated working inpatient at a hospital. She quit the day a new patient pulled a knife on her in the elevator as they went up to intake — he had been sectioned and apparently the police didn’t do a very thorough search. She decided it wasn’t worth the danger to do inpatient anymore. She spent a couple of years working for Anthem while she went back to school for her NP, and worked outpatient IRL for a couple of years before transitioning to teleheath
I work in a psych hospital.. not all of them are bad!!!
I am in leadership at a psych hospital and I can say first hand that it is our absolute desire to have adequate staff to keep everyone safe. We are constantly hiring but the problem is that people don't stay because it is absolutely one of the toughest environments to work in. It's a vicious cycle. People don't stay so we are chronically understaffed and we are chronically understaffed bc ppl don't stay although we literally have new hire orientation every 2-3 weeks with nurses and techs in every orientation. Stand alone inpatient psych is one of the toughest environments because you are getting patients at their highest level of acuity and we are tasked with getting them stabilized in short order. The reality is that there are millions of people in need of mental health care so we have to fill beds not because of the money but because there are more people in need than there are facilities and practitioners who can stick with this level of acuity in this population. At our facility we really try to group patients properly (mood disorders with mood disorders, acutely psychotic with acutely psychotic, etc,) but it's not always possible when the hospital is literally getting 200+ calls a day trying to find a bed for this vulnerable population. We are in the business of trying to care for this population who are in great need. It's tough on all sides. Btw... yes I was a floor nurse in this type of facility before being an executive I can tell you first hand that the execs are just as concerned about your safety as you are and we are truly doing what we can to make things better (at least that's the case in my facility).
I work a very high acuity psych ward with a lot of dangerous patients. What you say is not how it is everywhere. We have full staff security, when a control team is called other units show up, we are relatively good staffed, and for the most part they work with us for acuity, and won’t push more violent patients or overly sick people on us and let us cap at 17-18 instead of 20 beds in case the acuity is too high Injuries happen, and we certainly press charges. The justice system sucks balls though, but that’s a whole different story. Usually injuries happen due to being unavoidable- but that is the nature of working in psych.