r/psychnursing

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.

Most of the patients are mellow, overmedicated and are just trying to get through their day, following orders and routines. Yes, they Are suffering and it can be heavy and difficult. But I can differentiate between their suffering and the person. Meanwhile, some of my co-workers take up alot of Space, constantly talking non-stop, not reading the room, not being capable to deal with silence, not understanding how draining it is or how they affect others around them. Literally sucking the energy out of the room. And they also gossip and talk down on the patients. Being overly critical. Sometimes I have a hard time differentiating between who are patients and who is working there because some of them seem so hysterical and worked-up that I feel like Im back in high school. And I notice they are already trying the old high school bullying tacticts of exlusion and invisibility and I couldn’t care less to partake in their power plays and I just ignore them. Sometimes they chatter so loud I feel like I’m in a chicken den and I have to leave because my nervous system can’t take the abrasive loudness of it all. Is this how it is working in the health care or in women dominating fields everywhere? 🙉 Not sure how to go about this as I’m afraid to rock the boat as I’m new in the job. Any advice or support would be helpful. I’m not so good at setting boundaries but I’m want to become more assertive. I apologize as English is my second language.

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 :)

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

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.

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.

This is just a 100% rant but I work in psychiatric emergency and I hate it. I have no idea why I thought I’d enjoy this job and regret accepting the position. I’ve worked inpatient psych before and did enjoy it, but nothing like this. The city I live in has some pretty pronounced issues with substance use and homelessness and the healthcare system just does not empower us in actually helping anyone in this setting, and I just feel like I’m a part of perpetuating a terrible cycle of trauma and dehumanization half the time. It is so deeply demoralizing and frustrating and upsetting. The culture of the unit I’m on is also incredibly toxic and adversarial toward the patients.

I’m also afraid every day. I was nearly assaulted today and was assaulted last week. Every shift, there is a situation that arises that puts us at imminent risk of assault, if not multiple situations. The patient who threatened me today is on our unit all the time, and this person is a powder keg waiting to explode every time. This person also hates women and especially dislikes me, for no logical reason of course. I don’t want to ever deal with this person again because I do not feel safe at all, but it’s my job. I actively want to quit and don’t know how to go on. I’ve cried after work every day this week.

No point I guess but screaming into the void. Stay safe out there comrades.

Hi there! My hospital is adding an interventional psychiatry department for ECT. I’m curious about the workflow, if you work or have worked in this kind of department, can you let me know your experience?

Thanks!

I searched the sub and I didn’t see anything related to this question, so apologies if I missed something.

I’m a new psych RN, coming from an ICU background. I’ve never really had to worry about keeping my badge safe while I’m wearing it, other than basic common sense.

I will be working on an adolescent acute unit and I’m preparing for a decent amount of shenanigans. At my new facility, I have a ring of keys, a badge, and a RFID fob (small round) that opens doors.

Experienced psych RNs and techs, what products do you use to keep your keys etc. safe?

TLDR: RN interviewing at a UHS facility. Looking for interview tips and how to negotiate pay.

I have read some of the horror stories here. I am trying to hope for the best but prepare for the worst. I have been an RN-BSN for 4 years, mostly have Medsurg and tele experience plus a few stints in the OR and Medical Detox. After a few months of applying to a few places, this is the first one to invite me in for an interview. It’s a psych hospital with 5 units with populations ranging from adolescents to geriatrics. Any tips or words of advice would be great. Also, has anyone ever had any success negotiating the pay with a UHS facility? I am new to the specialty, but if they offer to start me at the beginning of the pay range, I will be losing 14$ an hour compared to my current job. I appreciate any comments! Thank you all!

UPDATE

Guys, I went to the interview! Some thoughts:

1. You guys were right. They have no security and no restraints. When I asked that, they said they heavily rely on BERT for escalating patients and I was like oh…

2. The interview itself was pretty simple. They asked some pretty basic questions. It threw me off a little becuase I was preparing for scenarios involving de escalation or someone refusing meds or something. The unit I applied for is Detox and 5150 holds so I thought they would ask.

3. When asked for what I’m looking for in salary, I asked to be toward the higher end of the pay scale since I have been a nurse for over 4 years and already have some psych experience. They were like “Well, we can see if we can work with you on that.” My state recently passed a law requiring psych hospitals to have mandated ratios last month so it sounds like they might be scrambling to get staff to be in compliance.

4. Also, ALL PAPER CHARTING

They said to allow them around 48 hours to get back to me, so we will see what happens. If I don’t get selected then maybe it’s the universe protecting me. If they DO select me then im gonna really pray on it 🙏😅. Thank you guys!

I'm looking for some advice from psych nurses or hiring managers.

I recently got invited to interview for an inpatient psych RN position. The only catch is that the posting is for full-time, and I'm really looking for part-time or per diem.

Here's my dilemma: I currently have a full-time remote RN job with excellent pay, benefits, and work-life balance, so I'm not really in a position where it makes sense to leave it. At the same time, I'm genuinely interested in transitioning into psych nursing because it's a specialty I've wanted to explore for a long time. My thought was to get my foot in the door by working psych part-time while keeping my current full-time position.

I also noticed that the hospital's website mentions they offer full-time, part-time, and per diem nursing positions, even though the specific job I interviewed for is listed as full-time.

Would it be inappropriate to ask during the interview if they'd consider hiring me part-time instead? Or would that make them lose interest since they clearly posted a full-time opening?

Has anyone had a hospital make an exception or hire them into a different schedule because they liked the candidate? Or am I better off interviewing for the full-time role and waiting to see if a part-time opening comes up later?

I'd love to hear from anyone who's been on either side of this situation.

Hello all. I’m new to behavioral health nursing and wanted some input on a position I recently accepted. For background, I’ve been an ICU RN for 6 years. I’m very much used to a 1:2 ratio, although I have floated A LOT in the last couple of years as a travel nurse so have taken up to 1:6 ratio on medsurg floors. However I’m not very familiar with the flow of inpatient psych and understand it’s very different than medical units. The unit(s) I’ve accepted a position on are 30 beds each (one is an eating disorder recovery floor and one is a mood and anxiety disorder floor). This is not a psych hospital but a residential program, therefore (from what I’ve been told in my interview) they do not accept patients with acute psychosis. It sounds more like a step down from inpatient psych before a patient goes home. Everyone is independent with ADLs. Each floor has 2 RNs on each shift, and also I think 1 or 2 techs working each shift (so essentially 1:15 ratio?). Does this sound appropriate?

Hi all! I’m an RN-BSN with a background in Hospice, Home Health, and Outpatient Clinics. I want to transition to Psych nursing. I have applied to some psych inpatient and residential facilities.
What advice would you give a nurse transitioning to this specialty? What is the best place to start in psych? Are places willing to hire nurses from other specialties?

I am an emergency ward/critical care nurse from a non-US/non-commonwealth country. I recently joined my hospitals behavioral emergency team. We respond to behavioral crises on the medical wards, psych, really everywhere. We’ve gone through some milieu management training, verbal intervention training revolving around MI/DBT/SFBT, additional restraint training, we have a training night 1-2x per month…

I’ve gotten ahold of the flow for single patient crises on medical units. We show up, single provider leads verbal intervention, physical or pharmacologic intervention if it comes to that, treat or transport any resultant injuries, get called off by the patient’s assigned nurse, and we all leave simultaneously. Quite straightforward in my opinion, usually fairly short activations.

Responding to our inpatient psych units can be a little more complicated. It is not always clear who is the primary patient, sometimes there are multiple… there often are chain reaction type events & cascading disruptions. It also is less explicit how long we’re needed, and the common practice is for behavioral emergency team members to slowly leave, scaling down as things feel calmer. This has led to repeat behavior emergency codes though. Does anyone have advice for managing these milieu-wide crises/tense milieus from a nurse responder perspective?

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’ve been in IT support for about 5years, and I’ve been searching for a new role for the last two. In that time I’ve seen postings for Psychiatric Care Technician at a state mental health facility come up a few times, and I’ve wondered if that’s a job I should consider in this market. The posting advertises an employer paid cna training over 8weeks. This seems like a reasonable way to get to the health care field where there seems to be a lot more demand. I’m thinking that if I like the role could get the necessary degrees to pivot into psychiatric nursing.

From what I can tell, I should expect hours to vary (expected overtime, nights, weekends, and holidays). I get that this depends on where you work and the staff to patient ratios. The posting warns that you can’t use vacation time for 6 months after hire, which is pretty common for a lot of places, not just in healthcare. I also know that I should expect there to be emergencies. I don’t know how frequently emergencies happen or what kind of emergencies to expect, but I have a sense that there will be more emergencies (or at least more human emergencies) than in IT Support. I also expect that the sense of helping people might change, because I won’t be directly helping someone with their problem(s), but instead I would be doing maintenance work (rounds).

Can folks who are currently or have recently been in a psychiatric care technician position please share a little about your experience? I’d especially like to hear from career changers.

* What’s an average, boring day look like?
* what’s a really stressful day with a big emergency or a few look like?
* Do you have a pretty standard schedule that rotates or is your schedule always changing and only published biweekly/monthly?
* Do you have a hard time getting time off approved?
* How often do you deal with violent patients?
* Do you have sufficient training to deal with violent patients?
* Did you have energy for hobbies when you were not working?

I have c-ptsd and Ive been feeling really dysregulated from all of the codes on my unit lately. It wasn’t ever as bad as it’s been lately. How is everyone dealing with their anxiety from their job? Any grounding techniques that work better than others?