So I have a local option of a psych tech program with part time work in a hospital or a psych tech bridge to RN program about three hours away. Debating which one I should go with - the bridge program will save me money and time but the local option will give me experience in a hospital and look good on a resume.

Opinions?

I just started on an inpatient psych unit and everything feels completely foreign to me. The vast majority of my clinicals were medical units. We spent just half a semester in the state psych hospital and basically just casually hung out with the few patients that weren't a major safety risk and didn't really get to see what nurses do.

My current preceptor has a very specific idea of what 1:1 check-ins with patients should look like and much of it is in conflict with the therapeutic communication methods that were drilled in to me in school. At points it feels like it's verging into psychotherapy beyond the scope of an RN, but I actually have no idea where that line is. I don't know what to ask or how to guide the conversation. This is a voluntary unit and the majority of patients have depression (and so far almost all the patients I've seen have BPD but based on my preceptor's comments it's not always like that.) I'm also currently on night shift, so my learning opportunities are limited.

I wouldn't have expected I'd be yearning to be back on a medical unit where I felt like I had some kind of idea of how to pretend to be a nurse.

I know some of this will come to me as I get more experience, but I would be super grateful for any specific resources people recommend to help fill the above mentioned deficiencies, especially in written format. Double grateful for anything you recommend on BPD!

Anybody here do any travel psych? Can anybody give me their honest opinions on it and maybe where to start looking? I’ve been an inpatient psych RN for 3 years now.

Hello, I've been a nurse going on 2 years. I've only worked in psych. I am starting to train for the charge nurse role today. I'm trying to stay positive about it, but its hard because I only hear negative things from my colleagues. Any advice?

This thread is for non psych healthcare workers to ask questions (former patients, patient advocates, and those who stumbled upon r/psychnursing). Prospective healthcare workers and current students do not need to use this thread. Treat responding to this post as though you are making a post yourself.

If you would like only psych healthcare workers to respond to your "post," please start the "post" with CODE BLUE.

Psych healthcare workers who want to answer will participate in this thread, so please do not make your own post. If you post outside of this thread, it will be locked and you will be redirected to post here.

A new thread is scheduled to post every Monday at 0200 PST / 0500 EST. Previous threads will not be locked so you may continue to respond in them, however new "posts" should be on the current thread.

Kindness is the easiest legacy to leave behind :)

Hi guys :D

I’ve been working at a UHS facility for 3 years. Partly as a mental health tech, now as a nurse.

I’ve seen a sharp decline in my facility for the past year and a half, but I’m finally reaching my breaking point. The acuity is too high for what we can support. Crazy staffing ratios (1 nurse can have 17 patients - this used to be 1 nurse to 13 patients which to me feels comfortable). Nurses stations are fully accessible to patients, although not allowed, it’s not enclosed or raised at all. Facility stinks sometimes and has bugs. Paper charting for 90% of things. Staff are injured, knives/weapons are somehow being brought in to the units.

I’m interviewing for new psych jobs. I just finished an amazing interview at a psych unit at a bigger hospital. It’s such an eye opener to see the big, enclosed nursing station, calm milieu that has a max of around 10 patients, amazing staff ratios, seclusion/restraint room that “barely gets used”, and low acuity patients when I’m dealing with such horrible conditions at my UHS facility.

UHS will never change. I hope I get this job. I hate it because I love my coworkers and find the patients really rewarding to work with/genuinely care about helping them. It is impossible to always deliver strong patient support when I’m putting out 20 different fires a shift with a huge workload.

I may stay PRN at my current UHS job regardless because at this point I feel trauma bonded. (wish I was kidding?)

Sincerely, a really tired nurse.

Im a nurse at a psych hospital for kids 6-18yo. I never intended to be pregnant while working at this hospital as it’s dangerous. However I am pregnant and visibly pregnant now. I was attacked and threatened by a teenage pt a couple days ago, it was not highly physical they just threw water in my face and threatened to beat me up. I wasn’t their nurse I was a bystander who happened to give them water because they said they were thirsty. I don’t know what I expected from management but they quite literally did nothing. The nurse manager talked to the pt and the pt made a verbal commitment to do better and that was it. I was still expected to be on the unit where this patient was and pass through to my unit. I talked to my OB they said this is an expected workplace hazard being in psych. I can’t sleep and am riddled with anxiety to go back to work my center of gravity is changing and I am moving slower than pre pregnancy and I fear something bad will have to happen for me to be protected. I don’t want to put my notice in and quit since I hold my family health insurance but it’s looking like that is where this is heading. I guess I need to vent and get opinions. What are reasonable accommodations to ask for being pregnant on a volatile unit? I want to talk to my DON however I’m worried I will just be gaslit and told my fears are not valid and/or that this is to be expected working in psych.

Hello, newish psych RN

Have had recent situations where verbal deescalations for agitated patients have not worked.

And I am finding myself battling between whether I’m letting ego take over or just over thinking when using chemical restraints.

Also having issues with behavioral/manipulative patients.

Chemical restraints recently used scenario includes conserved paranoid SCHZP pt demanding to be released and becoming verbally abusive. Pt comes into nursing station and refusing to leave until multiple attempts of telling him to step back. Pt is pacing but not actively hurting himself and taking time away from other pts due to need to redirect.

Other I made the decision to take off restraints of a patient. He was very attention seeking and not staying in the unit and going out to another area. He became a fall risk as he is walking drowsy and not wanting to stay in his room which… is hard for me to navigate. He was not listening to his 1:1 and started off verbally abusive. We kept on trying to redirect him but I made the call to request seclusion for him.

I genuinely feel so bad when I have to do this. I also don’t know if I’m looking for validation. I have this feeling of guilt like giving IMs is a punishment? The other times I’ve given them, pts have been reluctant but we are more so on the same page abt care.

Long read: sorry in advance

Maybe I’m completely out of line for even having an opinion since it’s out of my scope of practice but I just feel a certain type of way about how one of our psychiatrists chooses to treat a specific patient.

This patient is welllllllllll known to us. Every employee knows them. Every psychiatrist knows them (we have 6). This patient is admitted to us on a monthly basis or more for yeaaaaars. They stick this patient on any of our units (high acuity, low acuity, geriatric even though they not geri) just to fill a bed. This patient comes for Ativan- hard stop. They don’t attend group, they don’t socialize, fuck they usually don’t even shower. They come for Ativan and Ativan only. Every patient gets admitted with a prn Ativan order and this patient is on the clock every 4 hours for it. In addition, one of the psychiatrist treats her outside of the hospital - so if this patient happens to be assigned to him (a lot of times they are) he will also scheduled Ativan because he knows they depend on it. He also prescribes it to them on the “outside world”

This patient ended up in restraints last night over not being able to take Ativan because the prn dose was not available yet and this patient WASNT assigned to that psychiatrist. The psychiatrist they were assigned to refused to schedule Ativan for them and they ended up in restraints over that. In past admission they will cry or throw them self’s on the floor etc over the ativan.

Now I’ve been in recovery myself for 7 years. I’m no stranger to addiction- but Jesus fucking Christ we are doing NOTHING to help this patient??? Obviously the patient has to want the help but nothing we are doing is beneficial. I just feel like there has to be a better way? Why is the person still getting prescribed it? The doc should wean them off? Like it feels gross to be aiding to this. Again- I could be out of line for even having an opinion but idk

This thread is for non psych healthcare workers to ask questions (former patients, patient advocates, and those who stumbled upon r/psychnursing). Prospective healthcare workers and current students do not need to use this thread. Treat responding to this post as though you are making a post yourself.

If you would like only psych healthcare workers to respond to your "post," please start the "post" with CODE BLUE.

Psych healthcare workers who want to answer will participate in this thread, so please do not make your own post. If you post outside of this thread, it will be locked and you will be redirected to post here.

A new thread is scheduled to post every Monday at 0200 PST / 0500 EST. Previous threads will not be locked so you may continue to respond in them, however new "posts" should be on the current thread.

Kindness is the easiest legacy to leave behind :)

This thread is for non psych healthcare workers to ask questions (former patients, patient advocates, and those who stumbled upon r/psychnursing). Prospective healthcare workers and current students do not need to use this thread. Treat responding to this post as though you are making a post yourself.

If you would like only psych healthcare workers to respond to your "post," please start the "post" with CODE BLUE.

Psych healthcare workers who want to answer will participate in this thread, so please do not make your own post. If you post outside of this thread, it will be locked and you will be redirected to post here.

A new thread is scheduled to post every Monday at 0200 PST / 0500 EST. Previous threads will not be locked so you may continue to respond in them, however new "posts" should be on the current thread.

Kindness is the easiest legacy to leave behind :)

I work adolescent Psych as an RN, yesterday the cordless phone stopped working and I was trying to fix it. After about 5 minutes of no luck I made the stupid mistake of trying to call my own phone with it. Sure enough, late last night I get 2 calls from the facility, the person on the other line doesn't say anything and just hangs up both times. Then it clicks, a patient was using the cordless phone going through the call logs calling the numbers. I reported the incident to my nurse manager and DON, how much hot water am I an? What do I do now?

Currently work as a BHT at an SUD detox and inpatient facility. I am also a nursing student who has longterm sobriety.

I was wondering if any psych nurses here know of any coworkers in a psych inpatient facility who have a felony on their record.

I am NOT asking for legal advice, advice on licensing, judgement, BON contacts, or state specific rules.

Just a simple YES or NO. Have you met any RNs employed at an inpatient behavioral health or psych facility with a non-violent felony in their record?

*Mod approved post*

Are you a *Canadian\* inpatient child and youth mental health nurse (ICYMHN) who experiences boredom in their day-to-day work? I am conducting a study to find how ICYMHNs experience, understand, and respond to boredom over the course of their duties. Studies of occupational boredom have shown that boredom may have negative effects for individual employees and the organization. More needs to be known about how boredom affects ICYMHNs and their ability to provide safe and therapeutic care.

I will be conducting 1 hour interviews with ICYMHNs to better understand this topic. If you are interested and would like to find out more, please e-mail me (Davey Hamada, PhD student) at [[email protected]](mailto:[email protected]). This study has been approved by the University of Calgary Conjoint Health Research Ethics Board (REB26-0696) and is supervised by the principal investigator, Dr. Graham McCaffrey (University of Calgary, Faculty of Nursing).

I have worked at my long term inpatient psych hospital for 8 years. I worked 5 as an aide and 3 as an RN.

I’ve lived through so much in my time there and truly am passionate about my job as a psych nurse.

Something that my hospital is failing miserably at is debriefing significant events. We have had horrible, terrible things happen, and we are told to never speak of it. It’s almost the opposite of debriefing.

I am interested in learning about a successful debriefing program and finding a way to get our management to adopt something useful. My coworkers and I are burnt out. We have less staffing than ever before and higher acuity patients. I feel like some of this could be relieved significantly with some guided debriefing to help people process that emotion together. Does anyone have any recommendations?

I worked on a schizophrenia unit and loved it, however the few "very dangerous", extremely aggressive patients made me feel its not worth it. Otherwise I loved everything about the unit as well as the majority of the patients.

This is sorta long so pls find tldr at the bottom if ur not tryna read all this lol

hiii so I passed my NCLEX in November 2025 and started working on an adult/geriatric inpatient psych unit in December. I had about 2/3ish months of orientation but honestly it never felt like a real orientation especially in that last month. Like one day it was just… over no one asked if I felt ready to be on my own and definitely no competency check. The very next week that I made 3 months working there I was given 12 patients on day shift. When I told my DON that I didn’t feel comfortable taking that many patients yet she pretty much gave me a vague response (non uncommon with her) & proceeded to pass meds for two of my patients and ofc then went on to disappear for the rest of the shift. Since then I’ve been averaging around 13 patients, and that’s just become the norm at this point.
The lack of support has been the hardest part though honestly cos when I ask questions or ask for much needed help, I usually get half assed answers or I’m made to feel like I should already know. Nevermind, scratch that lmao the worst part is that we’re chronically understaffed. Thats the main thing making me want to leave. I was recently sick and was basically told I had to come in when I was calling out because they needed me. Yesterday my manager accidentally left me off the schedule but still expected me to come in even though I had no idea I was supposed to work because it wasn’t on the schedule I was given.
Another thing that surprised me is that they’ve already had me precepting new hires twice without ever asking if I was comfortable doing it. I’ve only been off orientation for a few months myself.
I genuinely love psychiatric nursing. Like seriously the whole reason I even decided to go to nursing school was because I was a psych major and wanted to be more hands on. I don’t regret choosing psych because I enjoy working with this population. The problem is that I don’t feel like I’m developing as a nurse much here. Most days it feels like I’m passing meds, charting, going to meetings, de-escalating situations, and supervising patients. I rarely get to do RN lead groups because we dont have time and thats a part of the job I enjoy. Since we have a lot of geriatric patients, we also deal with plenty of medical issues but when emergencies happen I usually feel unprepared because I don’t think I was trained adequately. Sometimes even the more experienced nurses seem like they don't know what to do so patients end up getting sent out.
Lately I’ve been thinking about applying for a different position perhaps med surg or idk there's hospice and mother baby positions available near me. I want to build a stronger medical foundation and become more confident with all the skills I feel like I’m missing that a nurse should have. There’s actually a hospital closer to my house than my current job, so it would work out well if I got hired. My plan is to hopefully stay PRN at my psych job for extra income if possible but I worry about working here.
My biggest question though is would a medical unit still train me like a newer nurse even though I’ve already been working as an RN for about 6-7 months? I honestly still feel like a new grad because I don’t think I’ve had the support or training I needed. I’m worried managers will see my 7 months RN experience and assume I don’t need much orientation when in reality I feel like I have a lottttt to learn.

Has anyone made the switch from psych to Med-Surg early in their career? if so please let me know if it was worth it, and did your new hospital give you a proper orientation?

TL;DR: New grad psych nurse with about 7 months of experience. I love psych, but my orientation was minimal, I don’t feel supported, we’re constantly understaffed, and I don’t feel like I’m building enough medical skills. Thinking about switching to med surg (or another medical specialty) but wondering if hospitals will still give me a proper newgrad style orientation, or if they’ll expect me to already know everything because I have 7 months of RN experience. Anyone made this switch?

Hi,
2nd post in 24 hrs… Any of my fellow nurses worked for Sierra Health & Wellness in CA? They’re currently hiring for a Nurse Manager position in my area. It’s a Sunday-Thursday 9-5pm… what gives me pause is I’ve seen this exact position posted 3 times in the year and a half I’ve been a nurse. The facility I’d be at is Voluntary admission only, so there’s that.

Hello to all my fellow psych nurses,
Does anyone else who works NOCs feel like they’re micro dosing psychosis by working night shift? 🤣 I work M-Th 2300-0730. While I typically manage these hours well, and do sleep on my work days I find my sleep to be subpar. My sleep is usually from 0900-1630. Even with blackout curtains, sleep aides, etc. My first day off (Friday) I usually sleep til 1200-1300, and wake up without an alarm and when I try to fall back asleep I can’t because I’m amped to be off work… then I usually gravitate towards bed around 0030 and sleep until 0900 the next day. I’ve tried everything to keep a consistent schedule on my days off, it just doesn’t happen I think it’s as much psychological as it is physiological. My spouse is a day walker, as is everyone else in my inner circle. I really love my job, and I’m good at it. I’m in NorCal, positions for nurses are hard to come by here and highly competitive as is most of the case in CA. I’ve only worked in psych as a nurse, and have been a nurse for 1.5 years. Seeking some commiseration, reassurance, and guidance I guess.

What in the actual f***. I have never seen our high acuity unit so bad. Three different issues popped off in less than 2 hours. Is this a typical experience for you guys? I've been at psych for about 6 months and this was the most unsafe I've ever felt

Hey. So I started my first RN job at an inpatient behavioral health facility two weeks ago. I received a total of 6 training shifts with a “preceptor” who did not know she would be training me and almost immediately had me doing tasks independently (med passes, COWS/CIWA, charting, getting & giving report, and admissions). The facility has both electronic and paper charting which has been a nightmare to learn and keep straight. Our ratios are 12 patients to 1 RN and 1 BHT. Leadership is a joke and the culture at this place is not very welcoming. I will have my first solo shift as an RN this coming week and I’m feeling extremely nervous and anxious about not getting proper support, being rushed to do things and just overall lack of guidance as a new grad. I just want to ask for perspective. Is this normal? Is this typical psych new grad nursing training? Are these ratios reasonable? What should I focus on as a new nurse beginning in psych? Thanks for the input.