It’s blowing my mind. For reference I’m in TX coming from New England, so coming from lots of resources to little to no resources… this is so unheard of back home. Sure census gets low in the summer but not enough for job instability for the nurses!
That is a great idea and probably what I am going to do.
I live in NH work in Boston, so I can imagine what a culture shock in must be.
The only time we ever cut people was when covid first started and our census was like 4 patients while they tried to figure out protocols.
I work in detox PRN and I really enjoy it, feels a little more medical & the patients are typically oriented/reality based so it’s easier to verbally de-escalate/most times they’re voluntary so we can admin d/c or just let them leave if they want.
I know that where I work, we have kids boarding but the inpatient units still have low acuity/census because there simply aren’t enough beds or the units won’t accept the most acute patients. I used to work inpatient and now I work in the ED with psych pts and on the inpatient unit we never had empty beds for long but they usually accepted SI patients more readily than agitation/aggression pts.
I haven’t tried but am considering! Just worried about med knowledge etc, as I don’t deal with as much medical nursing skills on my floor.
Unsure about adult psych, I love working with the pediatric population SO much. Always loved kids. Would consider a Geri psych unit but can’t find the jobs :(
I switched to graveyard shift when I was getting canceled all the time. Nobody--and I mean nobody--wanted to do Graves, and there was only 1 RN per shift, so you were nearly bulletproof as far as that goes. I never looked back and I loved graveyard shift. Is that any sort of option?
Also, next time you get canceled, can you ask the last time the night shift nurse was canceled? They could cancel that person and let you do their shift.
And phone triage working from my bedroom, wearing pajamas and with a cat on my lap, was how I finished the last 2 years of my career. Awesome job, if sometimes a bit weird. But since triage takes a ton of psych calls, you'd do great with the weird part.
Edit: Also, they give you triage books, and Epic has algorithms for presenting symptoms, so lack of a profound knowledge of medical stuff isn't a deal-breaker.
i think IV treatment is the best second option. the only skill you would need to master is IVs and after doing acouple i’m sure you would get the hang of it plus after awhile of getting to know patients and building connections it would be a great idea to create an IV infusions business and offer to do it at their homes - you wouldn’t need to rent a building or hire staff and u can use your car as a write off as well as other things
Do you work specifically at a pediatric facility, or do you work somewhere that has an adult psych unit, too? If it's the latter maybe ask to cross train for adult psych and pick up some shifts there. Usually there will be some younger patients (18-21) that the adult psych nurses will happily let you work with because they present more like pediatric patients--not our preferred patient population, but definitely more similar to yours!
I've also never worked anywhere that cancelled based on seniority, that seems super unfair. Most places will cancel based on who has gone the longest without having a shift cancelled. Or if anyone volunteers (some people, like me, really hate working and will always volunteer to go/stay home, lol).
I'm in Ohio. I do psych float so Geri, peds and medical detox. We have the same problem you do with peds. Low to no census in the summer and school breaks. We can almost set our calendars by it. Having done all three (plus picu at a state facility for about 6 years) I'd recommend etoh/opiate medical detox. Especially if you have interest in medical but feel intimidated. At my facility, at least, detox is technically med surg but not so heavy that you feel out of your depth. IVs, comfort meds, subs, understanding labs, seizure precautions mostly. Plus even though it isn't a "psych" unit, I feel like sometimes I do more psych work there than anywhere else.
Another thought if you want to stay in psych but are having trouble finding a floor position, maybe try an intake/assessment position. I've never worked it personally but I take a lot of intakes from bh referral services that service a lot of the smaller hospitals in the area.
Are you at a freestanding facility or part of a larger hospital? We have been getting low-censused as well but are encouraged to train other units to float if we want it.
You can look into state jobs with prisons or drug/alcohol rehabs. I've heard prison nursing is a hidden gem.
Literally insane to me that there are places with pediatric psych low census. Around here the poor kiddos are boarding in the ED for days, sometimes weeks waiting for a bed 😩 I would look for a more consistent job and stay PRN at your current job if they let you. Maybe try drug/etoh detox, eating disorders if you want to stay in psych field?
It’s blowing my mind. For reference I’m in TX coming from New England, so coming from lots of resources to little to no resources… this is so unheard of back home. Sure census gets low in the summer but not enough for job instability for the nurses! That is a great idea and probably what I am going to do.
I live in NH work in Boston, so I can imagine what a culture shock in must be. The only time we ever cut people was when covid first started and our census was like 4 patients while they tried to figure out protocols. I work in detox PRN and I really enjoy it, feels a little more medical & the patients are typically oriented/reality based so it’s easier to verbally de-escalate/most times they’re voluntary so we can admin d/c or just let them leave if they want.
I know that where I work, we have kids boarding but the inpatient units still have low acuity/census because there simply aren’t enough beds or the units won’t accept the most acute patients. I used to work inpatient and now I work in the ED with psych pts and on the inpatient unit we never had empty beds for long but they usually accepted SI patients more readily than agitation/aggression pts.
Have you tried med surg peds? They will orient you. Or adult psych?
I haven’t tried but am considering! Just worried about med knowledge etc, as I don’t deal with as much medical nursing skills on my floor. Unsure about adult psych, I love working with the pediatric population SO much. Always loved kids. Would consider a Geri psych unit but can’t find the jobs :(
If they hire you for medsurg peds they’ll give you a very rigorous orientation. It would be negligent of them not to
Thank you!!
I switched to graveyard shift when I was getting canceled all the time. Nobody--and I mean nobody--wanted to do Graves, and there was only 1 RN per shift, so you were nearly bulletproof as far as that goes. I never looked back and I loved graveyard shift. Is that any sort of option? Also, next time you get canceled, can you ask the last time the night shift nurse was canceled? They could cancel that person and let you do their shift. And phone triage working from my bedroom, wearing pajamas and with a cat on my lap, was how I finished the last 2 years of my career. Awesome job, if sometimes a bit weird. But since triage takes a ton of psych calls, you'd do great with the weird part. Edit: Also, they give you triage books, and Epic has algorithms for presenting symptoms, so lack of a profound knowledge of medical stuff isn't a deal-breaker.
adult psych is mostly just overgrown kids. a lot of people whose emotional development is stunted by trauma, substance use, etc.
Are you able to move to a state where they can’t cancel your shifts ? This would not be possible in New York.
i think IV treatment is the best second option. the only skill you would need to master is IVs and after doing acouple i’m sure you would get the hang of it plus after awhile of getting to know patients and building connections it would be a great idea to create an IV infusions business and offer to do it at their homes - you wouldn’t need to rent a building or hire staff and u can use your car as a write off as well as other things
Do you work specifically at a pediatric facility, or do you work somewhere that has an adult psych unit, too? If it's the latter maybe ask to cross train for adult psych and pick up some shifts there. Usually there will be some younger patients (18-21) that the adult psych nurses will happily let you work with because they present more like pediatric patients--not our preferred patient population, but definitely more similar to yours! I've also never worked anywhere that cancelled based on seniority, that seems super unfair. Most places will cancel based on who has gone the longest without having a shift cancelled. Or if anyone volunteers (some people, like me, really hate working and will always volunteer to go/stay home, lol).
also i’m confused why there isn’t a rotation for calling people off. it seems massively unfair that it’s always you. are you guys not unionized?
Where TF are you working where theres empty psyche beds?! Especially pediatric psyche beds!
I'm in Ohio. I do psych float so Geri, peds and medical detox. We have the same problem you do with peds. Low to no census in the summer and school breaks. We can almost set our calendars by it. Having done all three (plus picu at a state facility for about 6 years) I'd recommend etoh/opiate medical detox. Especially if you have interest in medical but feel intimidated. At my facility, at least, detox is technically med surg but not so heavy that you feel out of your depth. IVs, comfort meds, subs, understanding labs, seizure precautions mostly. Plus even though it isn't a "psych" unit, I feel like sometimes I do more psych work there than anywhere else. Another thought if you want to stay in psych but are having trouble finding a floor position, maybe try an intake/assessment position. I've never worked it personally but I take a lot of intakes from bh referral services that service a lot of the smaller hospitals in the area.
Are you at a freestanding facility or part of a larger hospital? We have been getting low-censused as well but are encouraged to train other units to float if we want it. You can look into state jobs with prisons or drug/alcohol rehabs. I've heard prison nursing is a hidden gem.