Was offered a RN position today at a brand new behavioral health facility today. I have no experience in this field of nursing and would like some insight if anyone here has any.

The pay is excellent a d I'm sure there is a reason for that . . .


Well, I accepted the position this morning. Waiting for the written offer before I submit my resignation.

Thanks to those that commented and for the PMs and emails

Nothing like being locked innside with the lunatics.

edit: not a RN...more like one of the lunatics.

I don't think we are supposed to say "Psych" any more, so "Behavior health" has replaced it.

George Carlin would love it.

@ 03RN

Not me, but a buddy of mine did pysch for a few years before switching to ICU.

He said it's a fucking zoo.  

Luckily, your techs are responsible for most of your takedowns.  But you're gonna get in there some too.

My mom was for a while. She used to say some of the crazy people get to go home at night.

I have fucked more than my fair share of mental health rn's does that count?

They were all seriously batshit extra crazy..

Red head nurse, extra crazy,  has kinda become my type.

OP is gonna get stabbed at work.

A lady who worked in  private mental hospital once told me that you really couldn't tell the patients from the aides until you saw which ones had keys.

Not a RN or clinical in any way, I but observe them frequently in my administrative role. Passion for BH patients = good to go. The other half can’t hack it anywhere else in a hospital.

I went to nursing school with this guy. He worked at a "behavioral health" facility right up until this happened:

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It's not a hard job unless you have a problem with old people throwing their dirty diapers at you every now and then.

Literally one of the easiest nursing jobs out there.

You sit in the nurse station and only get up when someone starts acting out (rare, especially if they are on the right meds) and you hand out meds a few times per shift.

Mostly you'll deal with older people who have dementia and aren't violent or aggressive (mostly), but may have clarity issues, forget where they are, or try to sex up other patients.

As hospital security, I can tell you most of our issues don't come from the BHU patients despite the majority of them being dopers.

I’ve had plenty of experience in public and private psych hospitals and adolescent residential treatment. (Austin, Tampa, San Antonio, Houston)

As you go through orientation learn what staff members are clear and assertive, and kind, in their communications with others, particularly patients. If they play therapist by “just knowing what this patient needs” better than anyone else and they let down their overall vigilance and concern for other patients and staff, watch them. Along with too aggressive techs. There’s a lot of your staff problems on the line out on the unit.

I have worked with dozens of psychiatrists- and other doctors, too. The poor psychiatrists will stand out because most of them are hacks and incompetents. No capacity for critical thinking, stuck with limiting or discredited treatment models, poor communication skills, over invested in
one patient.  I’ll put it this way, if they were cardiothoracic surgeons they wouldn’t be able to keep a license.

Quite a few redhead nurses, you know what I mean. Med surg burn outs that don’t really want to learn the job.

If you are expected to manage the unit, rather than just pour meds, heads up.

Let me help.

@03RN

Last wife was a night shift psych nurse.  She was also a left-handed horse chick on two SSRI's.

One morning, she didn't come home.  She found her soul mate/wallet at work.

Happy feet.

I rather enjoyed the Psych Patients.   You just can’t make this stuff up.

I have close friend who has been 1. A Social Worker then a 2. Mental Health Specialist and is now a 3. Behavioral Health Specialist.

He’s been doing this for almost 15 years now. Over the last 4 years or so, most mental health facilities (and emergency rooms that have to treat and medically clear walk-in psych patients before they are transferred) have been changing the way psych patients are treated.  The hospitals and facilities are becoming more and more hands off.  They are letting violent and aggressive patients destroy rooms and equipment as long as they are not harming themselves or staff.

Isolation/quiet rooms are being phased out because they are... abusive, barbaric, remnants of the past.  Straitjacket’s? I don’t think they’re used anymore.
 These kinder gentler policies with violent and aggressive patients are causing lots of clinical staff injuries.  PTSD is common among health care workers in these environments.  Hospitals are not concerned with the property damage costs.  When you have a psychotic 300 lb psych patient who decides he wants to leave, various staff members are going to be collateral damage. And most institutions won’t give a fuck.

 You are going to be one of the Crisis team members that are going to have to control this psycho.  Your Dept will more than likely be understaffed. And if you don’t follow the hospital’s kinder gentler polices, the hospital will not support your actions. You are expected to verbally de-escalate these people. I’ve seen some mental health policies that are basically saying to protect yourself, you can roll in to a ball until additional help arrives.

 All behavioral health facilities are moving in this direction.  My friend tells me he deals with psychopaths that are beyond help. They shouldn’t be released back in to society.  But they are treated and released back in to society.  If you’re LEO you know about the system.  They are the first ones who are called to transport them to emergency rooms with 72 hour hold requests.  A week later they are back, wrestling with these psychs again and taking them back to the hospital.  Rinse and repeat.

 With all that being said, some clinical staff get off on this kind of everyday dangerous work day after day.  Me?  You couldn’t pay me enough.

Ill come back and write more.

Three good scars from bites. Went to the ER once. Restraints everyday, dealing with units rioting, patient suicide attempts that were pretty close.

The worst was having 2 young girls who started prostituting at 11 or 13.

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8 hour shifts and getting hit on by bipolar chicks. Spending all shift at the nurse station was not my experience - spent a lot of time getting to know patients and their stories.

RN with brief psych experience. I hated it, the patients are obviously difficult, you dont feel like you are helping (revolving door) and at many places the RN is there to just pass meds and listen to bitching.

If you've ever been around a person with borderline personality disorder you kinda get the picture, except imagine several on the same unit together.

To me, it isn't worth the physical side of having to physically fight patients frequently either.

Buddy of mine just quit as an RN at one, after 9 months.

If you have questions about the facility. I might know. You can PM me.

My girlfriend is a psych RN at a state facility. She absolutely  loves it. I get to hear some good (and bad stories) of what happens at her work. She’s been attacked several times once dragged down the corridor by her hair. I was talking to her on the phone the other day as she was walking in to work. One of the patients told her that he was going to kill her. She laughed at him and asked him why. Security is always close by. She used to be a surgical RN but prefers psych.

A former girlfriend is a psychiatric RN.  She told me "The first thing you learn is how to duck a punch."

@Shootindave

I sent you a PM

I hired in at a behavioral health hospital at the end of September. Second week of October, stabbed twice in the neck by a psychotic TBI patient.

Still less stressful than a regular med surg hospital.

As an RN, often you’ll be the only nurse on the unit. There might be two or three techs and if you’re lucky, a LPN to pass meds. I wirk night shift, I basically pass evening meds to 25 or so patients, chart a nursing assessment, a suicide/safety assessment, and perform some inventory and safety checklists. Pull meds for the morning shift, give report to the incoming day shift. Wash rinse repeat.

I’ve gotten to know my patients pretty well, I’m charge nurse at an adult male forensic unit (prisoners adjucated to a mental facility).  Stable for the most part, minor issues but  I have to say it’s easier and less stressful than a 6:1 med-surg floor.

Pay is better, at nights I’m making over $30/hr with the shift differential, and if I’m the only nurse I get an additional $10/hr. If I pick up a shift I get another $15 an hour so I can be getting $55 an hour some nights. Smaller staff than a med-surg hospital, I’m on a first name basis with the Director of Nursing and the CEO. After three months of quarantine and covid PPE protocols our faculty is now 100% covid free, we test all staff and patients once a week. We had app 40 patents and 15 staff come up positive since October, only one death. Aggressive quarantine and PPE finally resulted in a covid free facility. I can’t say it enough, WAY less stressful than my time at a regular hospital.

Thanks for the info. This is helping me make up my mind. I have to let them know tomorrow.

@RevolverRO

The facility I'm looking at is owned by UHS. Do you have any knowledge of them?

I might have knowledge (wink). Not saying on a public forum.  PM if you have questions.

@RevolverRO

PM sent

Did OP take the job?

Not yet. I have to let them know something tomorrow. Waiting to hear about benefits, etc.

Please let us know, we are all in a low hover here waiting.

Are you a decently fit man who knows how to fight and can take a punch?

What kind of psychiatrists are you working with?  I'm sure like all docs, there is a spectrum, but I've only run across a very very few that would be described as you mention above.  Psych docs are some of the least appreciated until they are needed, then they are the most loved.  Other specialties appreciate you most of the time, although sometimes they except us to be able to fix stuff that is not fixable.   We run a unit and manage lots more besides psych, also see consults on the medical floor, ER, ICU, help with supportive care (or close to needing hospice), and also outpatient stuff.  We can take sicker patients than some psych places b/c I have a medical hospital attached, and I have nurses that are familiar with other medical stuff and not just psych.  We are comfortable with a good bit of medical stuff, you have to know what your limitations are and when to consult medicine or a specialty.  We also take geri patients that often have LOTS of meds and LOTS of medical problems, and for the most part, we manage these.

As far as nursing, it seems to be low key 95% of the time, but that other 5% is much more intense than on other floors.  
OP, if you have any specific questions, shoot me an IM.  We need good nurses in our field. I've had and have mostly excellent nurses on my service.  They are very valuable.  

Lol yes. Was a police officer for 10 years before becoming an RN

Thanks for the offer!

It probably depends on what you will be doing. If it’s mostly just handing out meds, then go for it. If it’s something where you are in fear of being attacked by patients... maybe not. At least where I am there is a big demand for RNs so you could take the job and if it doesn’t work out the job you left will take you back, or another dozen jobs will.

Not a RN but married to one.  She was floated to the floor a few times and I knew the chair of the dept pretty well.  Mostly Baker Acts and biters.  Could be great depending if they specialize in certain sub-diagnosis' but with the mass exodus of quality people it's a shit show right now.  I'd ask about the major 3 diagnosis for admit's and see what they say.  

Wife said:  "Think of working in a jail ward but hands on.  "

Don't I wish!

Recovering from my third work surgery in 10 years right now.

Double Tap

Update in OP