In this article, we're going to give you some helpful advice and tips for new psych nurses.
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Mental health has a bad reputation. On one end some people think it's a taboo topic and avoid it altogether.
On the other end, some nurses think it's a place where only burned out nurses go. Or it's a place nurses go to lose their “skills.”
We're going to hit these points and more as we try to give you some advice on navigating some of the stereotypes of mental health nursing.
Plus, we're going to provide you with some tips that are going to help you be successful.
Tips for New Mental Health Nurses
1. Make Sure You Have a Good Preceptor
From our standpoint, a good preceptor can make or break your time in a given nursing area.
Honestly, if this is going to be your first job right out of nursing school, a good or bad preceptor can shape your career for many years to come.
In all likelihood, you won't have much control over who your preceptor is going to be.
Also, unless you’ve worked on that unit as a tech, you're probably not going to know which nurse would make a good preceptor and which one wouldn't.
Regardless if you're into your orientation and you don't believe your preceptor is helping you learn how to succeed at your facility, make sure to have a conversation with your nurse manager to see where the disconnect might be.
This conversation doesn’t have to be about making the preceptor look bad. Some preceptors really do care and are doing their best, but they might not be connecting with you.
The focus of the conversation should be about you succeeding after your orientation ends, not bad-mouthing your preceptor.
2. Take Command of Your Emotions
You're going to hear and see patients say and do some of the most outrageous things you're probably ever going to hear in your life.
You're going to go from wanting to laugh, to cry, to being angry. More times than not, it's going to be the wrong emotion for the situation.
Great psych nurses take command of their feelings, and they know how to display the right emotion.
3. Pay Attention to Your Facial Gestures
There's such a thing as nonverbal communication.
Many of us focus so much on verbal communication we forget how telling the nonverbal part can be.
You're going to hear things that will make you cringe, and you're going to have to be very mindful of your facial expression.
4. Master Therapeutic Communication
When I was in nursing school and taking the mental health nursing class, it was all about therapeutic communication.
I thought it was kind of silly back then but having worked mental health for as long as I have, I can tell you this statement…
“mastering therapeutic communication can make or break your experience in mental health.”
I have seen this countless times. Situations that could have been easily avoided escalates because a staff member says the wrong thing.
If you need more help on therapeutic communication, check out this handout from Mercer County Community College (source).
5. Listen and Don't Judge
Your job as a mental health nurse goes beyond just giving medications. You're going to be a sounding board for patients.
The doctors depending on the patients, will see them once a week or a couple times a week.
They might see their therapist only a couple times a week also. In both situations those visits are probably not going to be that long.
The rest of the time, you as the nurse will be the one interacting with the patients. You're going to have to learn to listen to the patient without being judgmental.
At the same time, you also have to learn to…
6. Listen and Be Careful of Giving Advice
Sure, many of them are going to do things or behave in a manner different than you.
But when it comes to giving advice, you need to be wary of that.
For advice to be good, you need to understand the whole situation and be aware of your personal feelings and biases.
On top of that, you need to consider the patient’s current condition.
The reason is that even if it's “good advice,” it might not be the best advice for the patient for their given situation.
Or it might not be the right time for them to hear it.
7. Know When to Tag-in or Tag-out
This is kind of a pro wrestling metaphor but stick with me it will make sense shortly.
For a tag team match, you have two people fighting in a ring.
Each person has a partner they can “tag” and switch them out when they start getting tired.
The goal is to do this early enough when you're able to, so you don't get pinned and lose the match.
Alright, so what the heck does a pro-wrestling tag team match have to do with working as a team in a mental health facility.
I would argue everything. Here's why. When you're dealing with psychiatric patients, especially kids, they're going to push your buttons.
They're going to do it intentionally, and most of them have been in the “system” for so long that they are really good at it.
You need to be self-aware enough to know when you need to walk away from a confrontation or interaction with a patient and tag someone else in to help with the situation.
At the same time if you see one of your coworkers struggling, whether it's a nurse or mental health worker don't just stand there.
If it looks like they're about to lose their cool intervene.
You would be amazed at the bad situations nurses, and mental health techs have gotten themselves into.
And there was a staff member who was nearby that could have intervened but didn't.
Don't let things get to a point where your coworker cusses out a patient or takes a therapeutic restraint too far, and body slams a patient.
Yes, this does happen.
8. Master Writing a Mental Health Nurse’s Note
To put it simply. Mental health nursing notes is different than other nursing specialties.
If you've come from a medical floor one of the things that will be very evident and quickly is that the notes you write as a nurse can be vastly different in mental health than when you were on a medical floor.
On the medical floor, your primary concern is physiological. Head to toe assessments.
The disease process and the whole nine yards.
For many nurses, unless there were extreme behavior cases or a patient who's a fall risk trying to climb out of bed many times, the behavior is an afterthought.
In mental health, it's the reverse. Behavior is the primary concern, and medical health concerns is an afterthought.
In mental health, your documentation would consist of things like…
- Behavior during your shifts
- Is the patient attending groups?
- Suicidal risk assessment
- Patients appearance and anxiety
- If a patient got into a restraint; what was the behavior before and after
You can kind of see the pattern. It's a bit different, and treatment plans are a point of emphasis.
Similar to how they wouldn't ignore behavioral issues in a medical setting.
Medical problems are not going to be ignored in a psych setting. Heart attacks and seizures do happen.
It's just that many times, patients are medically stable before coming to a psych floor. Or at least they should be.
There are exceptions to this.
9. Understand that Good Teamwork is a Must
In our humble opinion, we believe teamwork is more important in mental health than in any other nursing area.
That's not to say you shouldn't have good collaboration in any other nursing specialty not named psych.
It's just that in most nursing area, good teamwork makes things easier, but you're predominantly working as a solo nurse.
In psych, many times, the nurses are working as a team where the patients are not divided up among the nurses.
Even if the patients are divided up among the nurses (depends on the facility), all the patients interact in the milieu, so it’s not uncommon for nurses to be taking care of a patient that’s not technically “their” patient.
10. Understand that Losing “Your Skills” is a Myth
I’ve heard this countless times, and it amazes me how wrong this statement is.
Sure, you might not have the best IV skills or foley catheter skills in psych, but that’s not what nursing is all about.
Various nursing specialties will require different skill sets from you, and that’s ok.
You’ll develop the ones you need for psych, and if you decide to go somewhere else, you’ll develop new sets of skills.
Nobody tells other nurses…
“Don’t go into nurse management, you’ll lose your skills.”
“Don’t go into case management you’ll lose your skills.”
Yet psychiatric nurses get that all the time.
If you enjoy working in mental health as a nurse, don’t let that statement deter you from enjoying this wonderful career.
To wrap it all up, mental health nurses are needed. It's a great profession to be in, but it is one that can be mentally and emotionally draining.
Make sure to manage that so you can have a long and successful career.
Are there any tips we missed?