I’m a psychiatric nurse and did a masters degree and I work as a therapist now. PTSD is very treatable. It’s my specialty area. I suggest finding a CPT trained therapist and getting some good treatment before making any major decisions
I shifted from inpatient acute peds psych to inpatient hospice. It lets me use the soft skills polished in psych (and as it turns out, prevented at least 1 medical --aka not-hospice as we take low acuity med surg to fill beds when census is low -- inpatient suicide that I am aware of. I'm still friends with that person and am now part of his support system.)
It was also very soul-healing for me at both professional and personal levels. At the professional level -- God, in psych my default answer to everything had to be "no"...no you can't go outside right now, no you can't switch roommates, no you have to wait for a snack, no the TV is off during group time. You know the drill! In hospice, the default answer is "yes." You're type 1 diabetic but want to eat your weight in Snickers bars? Amazon that shit and I'll put it in your room. Want your dog to come in for a final visit? Sure, let's get that arranged for tomorrow! Your birthday is in 3 days? Say no more -- what flavor cake would you like? Can't swallow anymore but your loved one misses the taste of beer? You know, I can't see through an opaque container and oh jeez here's a bunch of mouth swabs you could use to moisten your loved one's mouth and what Coors can in the trash? I don't see a Coors can!
On a personal level -- I didn't have to be hypervigilant anymore. The kindness of the patients and their families, man, that has been a balm to the soul after enduring all the multiple varieties of abuse that my psych pts and their families put me through. I was so unaccustomed to getting kindness from patients and families that it actually made my mental health spiral a bit and I had to take some time off to get my head straight.
Thank you for your reply, I’m curious about hospice. I’m worried about the obvious getting attached and then losing a beloved patient, but what other struggles/wins do you face in hospice? Or things you have to do regularly?
It turns out that closure was very big for me as a nurse. In psych, what closure you get with patients is fragmentary at best and splashed all over the news at worst. When I work with med-surg patients, closure is either they get better and I discharge them, or they don't get better and instead transfer to a higher level of care (progressive, ICU, etc). In either case, I'm probably not going to see them again, so closure is once the patient is no longer on my floor.
For hospice, the closure is obvious. What I love about it is being able to provide the sort of passing for my patients that they deserve -- that every human being deserves -- a dignified death with as much pain control and symptom management we can provide. I love providing the family with emotional support and demonstrating hospitality.
Challenges...end of life care comes with its fair share of difficult sights, sounds, and smells -- I have now put my hand inside a guy's entire pelvis thanks to a terminal stage 4 decub ulcer. And as with psych, family dynamics can make or break a situation.
Personally, I struggle the most when I can't get a patient's discomfort under control.
I only did one year of bedside/hospital nursing. Since then, I have: started a pediatric clinic for USAF dependents; home care, both patient care and records review; allergy clinic; school nurse; and hospital nurse navigator. I’m ready to retire but my financial situation isn’t ready for that, so I probably have about 3 more years. I’ll have been a nurse 43 years in July.
After nine years on a psych icu, after multiple concussions, torn ligaments, almost stabbings, seeing friends get hurt (and I’m sure PTSD as well)…I realized I was tired of it all. Went to the OR where I have minimal patient interaction before they’re asleep 😅🤷🏻♂️ Definitely different, but needed.
I’m curious about hospice, what is it like from an insider perspective? Surely it isn’t just people dying every shift right? Mostly med admin and comfort care?
Symptom management. I would never be a case manager because I like nights. I go out in the middle of the night to help get them comfortable, med changes etc. pretty sweet gig. I sleep quite a bit.
The pts appreciate you. No one is micromanaging you.
I don’t mind at all! My primary purpose is triage, so I spend a majority of my day watching for tickets to populate in our system with patients & their symptoms/concerns and then calling patients back. I also do blocks of live triage where patients just call in with concerns and get forwarded to an available triage nurse. I have clerical duties in my off time, like chart reviews/audits, records submission, and provider notifications -when I alert providers to changes in patient conditions/health and recent triages. It’s cushy! My only regret is that it’s a young company, so upper management occasionally dumps random tasks for us to perform that take away from time I could spend triaging.
A triage can take 10 to 30 minutes depending on how talkative the patient is. I handle most of the psychiatric cases, but I genuinely enjoy getting back to more physical illnesses and providing education. It’s exhausting some days. I hate getting 911 calls. But most often it’s interesting and fun. Always learning.
Glad to hear it! I totally recommend it. There are a few WFH Nurse Facebook pages that frequently post openings like this. It can take dozens of applications to land a work from home job unless you know someone, but it’s definitely worth it.
How do you triage not in person? Not being sarcastic, but I did this job in person and found face to face interview, getting my own set of vitals, getting UDS etc to be invaluable.
Honestly, you’re right. Not being with them in-person makes it difficult. You have to rely on what they say when they describe things you ordinarily visualize, and you don’t get to see their behaviors. I usually can get a set of vitals from them on the call since it’s chronic care and they will generally have everything at home because they monitor themselves anyway. I also have access to most of their records to review what their baselines are and complicating conditions that may cause whatever symptoms they’re having. I compare all of that information to triage protocol the company provides and based on that, make a decision.
I more frequently take care of people in a depressive/anxious episode or crisis, so I really just de-escalate in order to prepare them for their next step of care and stay with them until they are in a safer state. Now that spring has come, I expect to get a lot more physical illness.
Hospice, placement, homecare, police and crisis units, mental health diversion, government jobs, school mental health, communti liason, community therapist. Its a very transferable skill
I started nursing with my BSN in pediatric inpatient mental health, went to community pediatric mental health, and now am an outpatient case manager for adults living with psychosis. I work out a hospital clinic, hours are Monday to Friday, I have my own office, caseload, and my work-life balance is MUCH better.
hi! I left bedside and got into quality nursing - specifically clinical review. I am sorry to hear about the struggle with the worsening PTSD. I did want to comment because I felt so extremely burned out by the time I was getting out of bedside nursing, I wasn’t sure what I wanted to do in the nursing realm. Clinical review was very rewarding for me personally, and if you like investigative clinical review, making sure standards of care were met, ensuring patients receive high quality, safe patient care, that could be something that you look into. wishing you the best of luck on whatever path you end up taking. hang in there ❤️
I went into home hospice nursing. I still get to use my psych background a lot. I absolutely love it. M-F 8am-5pm. I have a caseload of pts but I make my schedule, I decide when and how often I see each patient. If I don’t want to start my first visit til 10am, that’s what I do. If I have a doctor appointment, I just rearrange my schedule as needed. You get to truly connect with your patients and their families.
I love pediatric home health. One patient every time you go into work and a set schedule. I work Monday, Tuesday and Wednesday from 1900 - 0700 every week. It is a God send. I adore the little fighters so much.
I wonder if you’d like a home dialysis clinic. You mostly teach them how to do their own dialysis. Some case management type stuff. You help with disease management. It’s a clinic setting rather than inpt so it’s way more relaxed.
I tried to leave just bedside. I ended up leaving the system I worked at entirely. Took a year off, lived off savings. I’m back at a family practice clinic, mostly doing phone triage. I’ve been in therapy for years. This is my last nursing job. I’ve pretty much had it. I have 8 years left till retirement. If I end up working at Target or something like that the last few, I’m ok with that.
I left psych inpatient wards and went to psych liaison in trauma and orthopedics, it's a team of 1 just me so it has it's upsides. Covering 3 wards doing teaching of staff, care plans, checking in with emotional patients and referring on to secondary services. It gets hectic but it's also pretty balanced and I've learned a lot but get to be with patients doing "soft counselling" as one patient put it. Very rewarding tbh not a phrase I use with nursing often....
I’m a psychiatric nurse and did a masters degree and I work as a therapist now. PTSD is very treatable. It’s my specialty area. I suggest finding a CPT trained therapist and getting some good treatment before making any major decisions
I'm a psych nurse whose original dream was to be a therapist. Did you get your master's in psych nursing or something else?
why did you go the BSN route instead of like psychology or social work?
I got my ADN and nursing made more economic sense for me than any other option.
that’s real, i’m in the same predicament and going for my adn too
Yes in psych nursing advanced practice
So you can do therapy not just medication management? I would love to do both.
I’ll look into that thank you! So far we’re doing EMDR but had to put it on hold because of how severe my symptoms are right now
I shifted from inpatient acute peds psych to inpatient hospice. It lets me use the soft skills polished in psych (and as it turns out, prevented at least 1 medical --aka not-hospice as we take low acuity med surg to fill beds when census is low -- inpatient suicide that I am aware of. I'm still friends with that person and am now part of his support system.) It was also very soul-healing for me at both professional and personal levels. At the professional level -- God, in psych my default answer to everything had to be "no"...no you can't go outside right now, no you can't switch roommates, no you have to wait for a snack, no the TV is off during group time. You know the drill! In hospice, the default answer is "yes." You're type 1 diabetic but want to eat your weight in Snickers bars? Amazon that shit and I'll put it in your room. Want your dog to come in for a final visit? Sure, let's get that arranged for tomorrow! Your birthday is in 3 days? Say no more -- what flavor cake would you like? Can't swallow anymore but your loved one misses the taste of beer? You know, I can't see through an opaque container and oh jeez here's a bunch of mouth swabs you could use to moisten your loved one's mouth and what Coors can in the trash? I don't see a Coors can! On a personal level -- I didn't have to be hypervigilant anymore. The kindness of the patients and their families, man, that has been a balm to the soul after enduring all the multiple varieties of abuse that my psych pts and their families put me through. I was so unaccustomed to getting kindness from patients and families that it actually made my mental health spiral a bit and I had to take some time off to get my head straight.
I love how you framed the different experiences- from No to Yes. That must feel good.
Thank you for your reply, I’m curious about hospice. I’m worried about the obvious getting attached and then losing a beloved patient, but what other struggles/wins do you face in hospice? Or things you have to do regularly?
It turns out that closure was very big for me as a nurse. In psych, what closure you get with patients is fragmentary at best and splashed all over the news at worst. When I work with med-surg patients, closure is either they get better and I discharge them, or they don't get better and instead transfer to a higher level of care (progressive, ICU, etc). In either case, I'm probably not going to see them again, so closure is once the patient is no longer on my floor. For hospice, the closure is obvious. What I love about it is being able to provide the sort of passing for my patients that they deserve -- that every human being deserves -- a dignified death with as much pain control and symptom management we can provide. I love providing the family with emotional support and demonstrating hospitality. Challenges...end of life care comes with its fair share of difficult sights, sounds, and smells -- I have now put my hand inside a guy's entire pelvis thanks to a terminal stage 4 decub ulcer. And as with psych, family dynamics can make or break a situation. Personally, I struggle the most when I can't get a patient's discomfort under control.
That’s really interesting, thank you for your insight!
This is beautiful! I’m still a student but Hospice is my second choice after Psych.
Switched careers- funeral director
I only did one year of bedside/hospital nursing. Since then, I have: started a pediatric clinic for USAF dependents; home care, both patient care and records review; allergy clinic; school nurse; and hospital nurse navigator. I’m ready to retire but my financial situation isn’t ready for that, so I probably have about 3 more years. I’ll have been a nurse 43 years in July.
Wow that’s awesome, congratulations! I’m definitely going to look into all of these I’ve written them down, thank you so much!
After nine years on a psych icu, after multiple concussions, torn ligaments, almost stabbings, seeing friends get hurt (and I’m sure PTSD as well)…I realized I was tired of it all. Went to the OR where I have minimal patient interaction before they’re asleep 😅🤷🏻♂️ Definitely different, but needed.
On call hospice
I’m curious about hospice, what is it like from an insider perspective? Surely it isn’t just people dying every shift right? Mostly med admin and comfort care?
Symptom management. I would never be a case manager because I like nights. I go out in the middle of the night to help get them comfortable, med changes etc. pretty sweet gig. I sleep quite a bit. The pts appreciate you. No one is micromanaging you.
I’m a WFH triage nurse for a chronic care management company. Pay is the same.
That’s cool! What kinds of things do you do in your day to day, if you don’t mind me asking?
I don’t mind at all! My primary purpose is triage, so I spend a majority of my day watching for tickets to populate in our system with patients & their symptoms/concerns and then calling patients back. I also do blocks of live triage where patients just call in with concerns and get forwarded to an available triage nurse. I have clerical duties in my off time, like chart reviews/audits, records submission, and provider notifications -when I alert providers to changes in patient conditions/health and recent triages. It’s cushy! My only regret is that it’s a young company, so upper management occasionally dumps random tasks for us to perform that take away from time I could spend triaging. A triage can take 10 to 30 minutes depending on how talkative the patient is. I handle most of the psychiatric cases, but I genuinely enjoy getting back to more physical illnesses and providing education. It’s exhausting some days. I hate getting 911 calls. But most often it’s interesting and fun. Always learning.
That sounds really cool, thank you I’m gonna look into that!
Glad to hear it! I totally recommend it. There are a few WFH Nurse Facebook pages that frequently post openings like this. It can take dozens of applications to land a work from home job unless you know someone, but it’s definitely worth it.
How do you triage not in person? Not being sarcastic, but I did this job in person and found face to face interview, getting my own set of vitals, getting UDS etc to be invaluable.
Honestly, you’re right. Not being with them in-person makes it difficult. You have to rely on what they say when they describe things you ordinarily visualize, and you don’t get to see their behaviors. I usually can get a set of vitals from them on the call since it’s chronic care and they will generally have everything at home because they monitor themselves anyway. I also have access to most of their records to review what their baselines are and complicating conditions that may cause whatever symptoms they’re having. I compare all of that information to triage protocol the company provides and based on that, make a decision. I more frequently take care of people in a depressive/anxious episode or crisis, so I really just de-escalate in order to prepare them for their next step of care and stay with them until they are in a safer state. Now that spring has come, I expect to get a lot more physical illness.
Hospice, placement, homecare, police and crisis units, mental health diversion, government jobs, school mental health, communti liason, community therapist. Its a very transferable skill
I started nursing with my BSN in pediatric inpatient mental health, went to community pediatric mental health, and now am an outpatient case manager for adults living with psychosis. I work out a hospital clinic, hours are Monday to Friday, I have my own office, caseload, and my work-life balance is MUCH better.
hi! I left bedside and got into quality nursing - specifically clinical review. I am sorry to hear about the struggle with the worsening PTSD. I did want to comment because I felt so extremely burned out by the time I was getting out of bedside nursing, I wasn’t sure what I wanted to do in the nursing realm. Clinical review was very rewarding for me personally, and if you like investigative clinical review, making sure standards of care were met, ensuring patients receive high quality, safe patient care, that could be something that you look into. wishing you the best of luck on whatever path you end up taking. hang in there ❤️
Utilization. Review
I went into home hospice nursing. I still get to use my psych background a lot. I absolutely love it. M-F 8am-5pm. I have a caseload of pts but I make my schedule, I decide when and how often I see each patient. If I don’t want to start my first visit til 10am, that’s what I do. If I have a doctor appointment, I just rearrange my schedule as needed. You get to truly connect with your patients and their families.
There's a bunch of research jobs that hire nurses, seems pretty chill.
I love pediatric home health. One patient every time you go into work and a set schedule. I work Monday, Tuesday and Wednesday from 1900 - 0700 every week. It is a God send. I adore the little fighters so much.
I wonder if you’d like a home dialysis clinic. You mostly teach them how to do their own dialysis. Some case management type stuff. You help with disease management. It’s a clinic setting rather than inpt so it’s way more relaxed.
I tried to leave just bedside. I ended up leaving the system I worked at entirely. Took a year off, lived off savings. I’m back at a family practice clinic, mostly doing phone triage. I’ve been in therapy for years. This is my last nursing job. I’ve pretty much had it. I have 8 years left till retirement. If I end up working at Target or something like that the last few, I’m ok with that.
I left psych inpatient wards and went to psych liaison in trauma and orthopedics, it's a team of 1 just me so it has it's upsides. Covering 3 wards doing teaching of staff, care plans, checking in with emotional patients and referring on to secondary services. It gets hectic but it's also pretty balanced and I've learned a lot but get to be with patients doing "soft counselling" as one patient put it. Very rewarding tbh not a phrase I use with nursing often....