A Day in the Life of a Psych Nurse
About Psych Nurses
Psychiatric-Mental Health (PMH) registered nurses (RN) (informally referred to as “Psych Nurses” or “Psych RNs”) and advanced practice registered nurses (APRN) represent the second largest group of behavioral health professionals in the United States. (American Psychiatric Nurses Association)
Travel psych nurses support patients’ mental health in a variety of ways, may it be through traumatic event, diseases such as Alzheimer’s or dementia, substance abuse, or individuals with a mental illness. These nurses are compassionate, communicative, and have high emotional intelligence.
Start of the shift – what happens first for a psych RN?
We were fortunate enough to learn about the life of psych nurses from Jana A., MSN, MHA, RN, a Clinical Manager at AMN Healthcare and Carla S., BSN, MS, RN-BC, Director of Clinical Operations at AMN Healthcare.
“Nurses start the shift with a report for their shift assignment. This can be a verbal handoff or bedside, which is multidisciplinary and includes physician, pharmacy, and social work,” started Carla. Jana worked as the director of a residential pediatric behavioral center, accepting kids nationwide and staying at the facility for typically six months to one year, sometimes up to five years.
Jana shared from her experience, “Twelve-hour shifts started at 6:45am for report. Next, we started making rounds on the kids who were being monitored, following up with kids who were previously restrained within the last three days, attend/monitor all holds, and escort kids to school.”
Carla continued, “Throughout the shift, nurses pass medications, discharge patients home or to other facilities, and admit patients from the E.R., clinics, and medicine. Other roles and responsibilities include providing therapeutic communication and de-escalating situations that may arise.”
What does a psych RN’s workload and team look like?
“When I was in residential, we had two to three med nurses, usually LPNs, and two charge RNs for 90 residents. I had 25 nurses and LPNs who reported directly to me,” said Jana. “The team consisted of RNs, LPNs, psych techs, psychologist, therapist, kitchen staff, and environmental services.
Each person in our facility built a special bond with the children and played an important role in their healing. Each kid have a team of six to eight people just for them and our building had a school just for our kids, which was supported by the district. It was important that the kids were able to earn a high school diploma and were able to create school activities for them.”
Carla shared her experience, which had similar team roles but was organized differently. “Psych RNs typically have six to eight patients, but this can vary based on patient acuity. The team consists of seven to ten staff members, and this will vary, again, depending on acuity and the need for additional staff to provide safe and quality care. The team consisted of unit clerks, psychiatric nursing assistants, social work, physicians, pharmacy, occupational therapy, recreational therapy, nurse counselors, music therapy, and safety and security.”
Shift wrap up and wind down
At the end of the shift, there is a handoff report to the oncoming nurse. The shift length can vary, from six hours to as long as twelve.
Winding down and self-care is important. “Psychiatric nursing is extremely rewarding, but also emotionally draining. It is important to find what [self-care strategy] works for you. I was fortunate enough to manage a unit where staff participated in yoga and music therapy while at work. Other self-care tips include outings with peers, unit potlucks, and exercise,” said Carla.
Jana found laughter to be the best medicine. “We giggled and we giggled a lot. We would meet outside of work for dinner or to exercise. We would take breaks outside to walk around the block. Most importantly, we would build each other up!”
For more self-care ideas, read “The Top 8 Self-Care Tips from Nurses”.
Impactful patients and inspiring RNs
“All of my patient encounters touched me in some way,” said Carla. “Sometimes it is the little things in life that we take for granted, such as providing someone a safe, warm shelter and food. This brings us happiness and is why we love this profession. The patient impact and my memories has made me a better person and a strong advocate for mental health”. Carla sent us a meaningful quote from author Brene Brown, “One day you will tell your story of how you overcame what you went through and it will be someone else’s survival guide.”
Jana shared, “You could not walk through the door without making an impact on at least one child. Many of the children went from facility to facility and often ours was the last chance before jail. The ages were 7-20, boys and girls. I implemented RN led education groups. A nurse would go around to each unit to teach about sex education, flu, COVID-19, hand washing, and CPR - literally anything that could be relevant to them.
I remember one patient who faced a multitude of challenges: Type 1 DM, borderline personality disorder, and an eating disorder. She would self-harm, among other things. I spent countless hours coaching and educating her. Currently, she is in nursing school and doing very well. She wants to make the same difference in other’s lives as we did for her.”
Could there be a more inspiring and touching story for a psych nurse? If you’re interested in making a difference in the lives of patients, check out the psych RN positions with Onward Healthcare or apply today online or on our app, AMN Passport.