Im a new graduate, ADN, and I just got offered a job in behavioral health at the local hospital. I am pumped that I actually got a position in this economy.  Does anyone have any advice for a person fresh out of school, on what a typical day is like in psych nursing? and anything that will help me adjust and become confident?  I have psych experience as an LPN at a detox facility that deals alot with homeless people and behavior issues, but it was a sub-acute facility. Also, I'm going to get bumped from time to time to other units, and that's what scares me the most! Please help!

Also watch out CLOSELY if you think a patient may be faking symptoms. Since SSI (social security income) physically is hard to obtain some people are there just to get it. I caught a few myself. Good Luck.

I've worked Psych in patient for 10 years. CaptinEricRN, has covered many of the important points, which I fully agree to.  So I won't be redundant.

Be careful with the borderline patients. They can drive you crazy..."I'm hiding a razor in my room" You have to move their rooms and have the rooms searched. Despite the frustration, you must take them seriously, as the day you do not is the day you'll regret it. Many borderlines wind up killing themselves after hospitalization accidently. They seek attention continuously. They can act in a very seductive manner: do not become enmeshed with them.

There are times that a patient will say to you, "You do not like me." Be sure to tell the patient that you are there for them and it is not that you do not like him, but that you disapprove of his behavior. Reject the behavior not the person.

This sounds crazy, but you guys who've been there for a while may laugh, but find it true. A few psychotic patients have been cured with ducolax. Cleaning out the bowl, sometimes cleans out the mind. I don't know why, but I've seen it time and time again.

The sociopaths can be wonderful liars, how you will find this out. But in time, even the best can't fool you: you will gain the knack of it, the feel of it that only comes from experience. You'll also be dealing with duel diagnosis patients who have substance abuse problems. They will be med seekers. Watch your PRNs and document carefully.

Those on q15' checks know that they are. Check on them occasionally more than q15, I've found in less than 15 minutes a person can be in a tub underwater with a plastic bag over her head.

Psych can be very rewarding, but for many patients it's a revolving door. Some you will help, and others you can not. You never forget the ones you've put much of your energy into helping only to find that they've been discharged and killed themselves. And as the years go by, those who are in the revolving door, you may see them go from young and fit to older and completely disheveled. And you have to deal with it emotionally yourself. You'll always care, a Nurse always does. But you must have an invisible button that you turn on and off. You are one person at work and one person at home and never the twain shall mix.

You must not only protect yourself physically, you must protect yourself emotionally. Don't bring the trouble of work home with you. Just do the best you can. Confidence comes with experience. Just as a baby needs to struggle to walk, you will struggle at first. But with time and a strong belief in your self, your confidence will grow with each new challenge that you over come.

In the work place watch what you say about your coworkers. Everything gets back to everyone. There are no secrets. You're not at work to make friends or enemies. If you have something to say to a coworker, say it directly to him/her and not behind his back. Don't be a back stabber, work your problems out with your coworker. If you can not then tell your coworker, we need to sit down with the supervisor and talk this through. You'll find the staff can sometimes be as crazy as some of the patients. You have to deal with it and have a good sense of humor.

So go in humble, experience will grow confidence, better be able to laugh about things after work. As you work hard, make sure you play hard. Hit the gym, don't neglect yourself. Discuss your difficulties with your supervisor. There will be good days and bad days, such is life. But never let the bad times bring you down. You must find time every day to laugh and the rest will fall into place.

I will first say that you have to love it in order to do it. many nurses working in medical/Surgical, critical care, look down on psychiatry because we aren't washing, turning, changing dressings, hanging bloods or IVs, running codes, etc. We don't do that routinely but we are working with people , who on any given day think they're God, you're the devil, are having auditory and/or visual hallucinations. they could be flooding their rooms, causing the toilet to over flow, smearing feces on the walls of their room, screaming, calling you everything but a child of God, t.hreatening to hit you or another patient, refusing to bathe or getting in the shower but the water isn't running, or they can make you laugh with some of the things they say in the midst of their crisis. What's important to remember is that they are people who have lives. They are doctors, lawyers, professors, actors, princes of foreign countries (on my unit we've had all of that), nurses, doctors, artists, writers.We treat them like human beings and remember that there but for the grace of God, go you or I. there is no other field of nursing i'd want to work in. I love my patients and my staff who've chosen to work in this field.

I just started in a state psych hospital about a month ago.  Good Luck!  I agree with all of the advise and I'm heading it myself.  Become good friends with those who have been there a long time and allow them to teach and guide you!  I have complete admiration for the nurses on my unit!

I am a PMHNP student and this is great info !