I don’t particularly enjoy writing about what I do for a living but since it’s nurse’s appreciation week from May 5-11, I figured, I might as well share some insight into my job as an acute psychiatric nurse! Also, in case you didn’t know, nurses week is a nurse’s favorite week in the year because hello, potlucks!
When I tell people that I work as an acute psych RN, I always get the reply – “oh you must be saving so many lives!” or, I get endless questions about medical stuff – which I’m always happy to answer! But to be honest, as a psych nurse, things are done differently. I don’t necessarily deal with crazy medical emergencies – I deal with code greys (highly combative / agitated patients, hence the title) but I also like to think I help brighten someone days when I prevent them from harming themselves or just being there to talk or listen to them.
What’s in my work bag?
I usually bring a backpack with me to work which includes my markers and pens (and let me tell you – nurses love their pens so don’t steal them**), report sheets (I made my own report sheet that fits well with my thinking process), protein shakes, some medications for personal use (usually ibuprofen and antacids) and did I mention markers and pens?!
** I’ve literally stopped charting just to hunt down for my pen at one time. I use a 0.38mm Uniball Signo RT which I purchase via Amazon so I know I’m the only one at work with that pen ;D
What’s a normal day for me?
Honestly? There is no typical day for me. But if we lived in a perfect world… A typical day for me kinda looks a lot like this:
- 0553 – Clocking in for work and going to the report room.
- 0600 – Getting my assignment (we have a 1:6 ratio for nurses:patients) and getting report from the previous shift.
- 0630 – Out of report. I do my daily assignment of either checking the emergency cart, checking the fridge temp and/or checking the scissor log. After which, I get started on making sure my patients’ holds** are legal and they they have consent for their psychotropic medications. Around this time, I also like writing down what time my patient’s medications are due as well as checking to see if they need anything done (collecting urinalysis samples, doing EKGs, giving out flu shots, etc).
- 0700 – I start doing my vitals + passing medications.
- 0800 – If assigned to breakfast, I walk with patients to the dining hall. Every patient has their own diet so a licensed staff has to be present during meals, also in case of emergencies.
- 0930 – Treatment team. During this time, social workers, doctors, and nurses huddle in the dining hall and collectively talk about patients up for discharge and talking about IMs/seclusions/restraints the previous shift.
- 1000 – I try to finish all my charting. My rule of thumb is – get this out of the way because emergencies can happen throughout the day.
- 1100 – Gym time. Patients are given 30 minutes to spend time in the gym.
- 1200 – Lunch time. Same as breakfast – if assigned, to the dining hall I go! If not, I pass out trays on the unit.
- 1300 – Outside group. Nursing staff usually assist recreation therapy group when it comes to taking patients outside to enjoy some sunshine.
- 1400-1600 – I take this time to make sure I’ve done everything I needed to do for the day. Charting? Done. Patient education? Done. Care plans? Hopefully done.
- 1700 – Dinner time!
- 1800 – Change of shift. Back to the report room to give report on the day to the night shifters.
Holds need to be checked because psychiatric patients involuntarily place and are on either 5150, 5250 or 5270 which determines the length of their stay at the hospital. If you want to learn more, read this! Also, working in a psychiatric hospital means everything is pretty much on lockdown, which explains why when patients are off the unit, they always need to be escorted by staff.
Sometimes, my day doesn’t go as I would’ve wanted it to – I could be giving emergency medications via IM (intramuscular injection) at 0900 instead of charting. Or I could have a patient or two in seclusion that need to one-to-one supervision and we’re short-staffed so I have to do that while getting everything else done. Or I could have three discharges with two admissions already on their way, and end up being over-ratio. Will I get a bathroom break? Will I get a lunch break today? Who knows?
Being a psychiatric nurse is a wild experience but I wouldn’t trade it for the world. I may not have code blues (emergency situation involving cardiopulmonary arrest) at work like other nurses do but you got a code grey going on? Well, I’m ya girl for that. And, to all my nurses out there, happy nurses week! Enjoy the endless potlucks! If you have any burning questions, let me know – I might do another work-related post someday.