[Wanderlust90]

I'm an RN. I'm thinking about going & doing further study to enter mental health after a somewhat traumatic work experience that has me doubting my skills in more critical care medically/surgically acute situations. Not that I have been discouraged from staying in critical care fields, quite the opposite I've been encouraged to continue by my colleagues & bosses but it causes me so much anxiety & I dread work & have become suicidal. I don't know if it was the work situation being to overwhelming in general or if my dx's are in fact correct & were exacerbating the stress. Either way I'm defiantly interested in mental health whereas my intrest in general nursing is wavering. I'm not sure if it would be any less stressful. Thoughts?

[wildflowerchild25]

I work with mentally ill teens and it is very stressful. Of course, I am a teacher trying to get them to do work so it is different. If I were a social worker I don't know if the stress level would be different. However you don't know until you try. You have the added benefit of understanding mental illness from an insider's perspective. It may make it easier because you know how to treat mentally ill people.

Originally Posted by Wanderlust90

I'm an RN. I'm thinking about going & doing further study to enter mental health after a somewhat traumatic work experience that has me doubting my skills in more critical care medically/surgically acute situations. Not that I have been discouraged from staying in critical care fields, quite the opposite I've been encouraged to continue by my colleagues & bosses but it causes me so much anxiety & I dread work & have become suicidal. I don't know if it was the work situation being to overwhelming in general or if my dx's are in fact correct & were exacerbating the stress. Either way I'm defiantly interested in mental health whereas my intrest in general nursing is wavering. I'm not sure if it would be any less stressful. Thoughts?

I've heard that there are some people with MI who want to work with other people because they think that to help others will do both themselves and those they try to help much good. Others have other reasons ....

I don't think there is a yes-or-no answer to your thinking. It is hard to work with the mentally ill. There are many different stories that you have to listen to. Some stories will make you feel very sad, some may remind you about your own story while there also will be persons that may make you mad because to be manipulative is part of their problems and these problems you will have to help them with either you like it or not.

The questions that you perhaps might take into consideration are questions like these:

How easy is it for me to calm myself in the moment and after work when I hear about other peoples sufferings?

Can I take it when i feel rejected by the patient?

Am I able to easy find ways to relax when under stress?

What will happen if my BF is mad at me in the morning and I have to go to meet a patient right after breakfast?

These and similar questions may perhaps guide you in your choice.

Good luck!

[BastetsMuse]

Originally Posted by Wanderlust90

I'm an RN. I'm thinking about going & doing further study to enter mental health after a somewhat traumatic work experience that has me doubting my skills in more critical care medically/surgically acute situations. Not that I have been discouraged from staying in critical care fields, quite the opposite I've been encouraged to continue by my colleagues & bosses but it causes me so much anxiety & I dread work & have become suicidal. I don't know if it was the work situation being to overwhelming in general or if my dx's are in fact correct & were exacerbating the stress. Either way I'm defiantly interested in mental health whereas my intrest in general nursing is wavering. I'm not sure if it would be any less stressful. Thoughts?

I think it would be as stressful except for one thing -- where would you feel more comfortable working? Where you have a personal stake, so to speak, or where you have some emotional separation?

I used to work as a nurse's assistant and I usually felt more comfortable on the cardiac floors than on the mental health floors -- the mental health floors had too much for me to empathize about. Just saying....

[BeyondtheRainbow]

I worked as an OT in a home health agency that did psychiatric care. We had 2 psych nurses who saw a lot of patients and I came in and did OT when appropriate. I also worked in a sub-acute/long-term care facility for patients with mental illness for 3 years.

In both jobs I had times that I shone because my mental illnesses made me understand how to treat patients better than others. I had a few really impressive successes with people who had been pretty much given up on. I also had patients who seemed to sense my own symptoms and fed off them and that generally led to the patient becoming uncooperative and then quitting treatment and complaining about me for something that was generally not true or not an issue. (I remember one complained because I opened her pill box and pointed out she hadn't taken her AM meds; another refused visits for 2-3 weeks and then complained I was bossy when I told her that she needed to let me come sometime that week or I had to discharge her. (That lady it was really about smoking; I have severe allergic asthma and can't be around smokers and she couldn't go an hour without smoking. It was sad because I think I could have helped her more with a good nicotine level but not if I were dead from status asthmaticus.)

The things I was generally good at were things like noticing depression before anyone else did. Especially in home health where I was allowed to give a depression inventory I got a lot of people some help that they really needed. Once in the long-term place I had a patient who got violent in the halls; I finally realized she was very light-sensitive and that was why she was beating people up when she was out with the skylights. I then realized I'd had the same issue on Geodon and surprise! she was on Geodon. I went through a very goofy thing to get her help; I told a nurse who knew about my bipolar and had her claim that she looked it up and saw the side effect and maybe it was worth trying sunglasses or something else. The med was changed and that was the end of the violence.

So you kind of constantly draw from your own experiences and it's both good and bad. I had a hard time with people who weren't motivated because I know that motivation is the only thing that has kept me going. So when people wanted to give up I had a hard time sometimes being patient. It was my job to find some reason to not want to give up but that can be very hard to do sometimes.

Other times it is so easy. One person had become completely overwhelmed by her mail, especially those freebie name/address labels from charities. The more depressed she got the less she could sort through it and the more it was taking over her living room. So that's what we did, we worked on sorting and motivation to do a certain amount per day and having an I don't know pile to get help with and just talked a lot about how to care with the depression she'd had for a long time. Psych RN did a lot more counseling about handling the depression. Overall that was a really positive outcome after about 3 months of work from the psych RN and I. I think of her often b/c I see her home often.

I guess I'm saying that it is a good area to work in and your experiences will help you. In my experience my experiences also hurt me sometimes. It was hard to keep a boundary between what I wanted to tell patients and what I could; I know sometimes it would have helped to know about my illness and that I was doing ok but it wasn't the right thing to do either. Sometimes they kind of guessed. I loved the work but it was exhausting, the home health much less the long-term care. (But I only did psych probably 3-5 hours per week in that job). It was hard to teach skills I didn't always have myself.

But it is very rewarding, often very positive, very often quite funny and I'm so glad that I had the experiences I did. When I started in psych it was a fast transfer due to staffing issues and nobody thought to tell me it was psych. I figured it out the first hallway I walked down and panicked because I didn't know how to do this. But I learned and loved it. I left the long-term only bc the drive was too far. Home health I left b/c that's what I was doing when I became unable to work at all.

[Wanderlust90]

Originally Posted by BeyondtheRainbow

I worked as an OT in a home health agency that did psychiatric care. We had 2 psych nurses who saw a lot of patients and I came in and did OT when appropriate. I also worked in a sub-acute/long-term care facility for patients with mental illness for 3 years.

In both jobs I had times that I shone because my mental illnesses made me understand how to treat patients better than others. I had a few really impressive successes with people who had been pretty much given up on. I also had patients who seemed to sense my own symptoms and fed off them and that generally led to the patient becoming uncooperative and then quitting treatment and complaining about me for something that was generally not true or not an issue. (I remember one complained because I opened her pill box and pointed out she hadn't taken her AM meds; another refused visits for 2-3 weeks and then complained I was bossy when I told her that she needed to let me come sometime that week or I had to discharge her. (That lady it was really about smoking; I have severe allergic asthma and can't be around smokers and she couldn't go an hour without smoking. It was sad because I think I could have helped her more with a good nicotine level but not if I were dead from status asthmaticus.)

The things I was generally good at were things like noticing depression before anyone else did. Especially in home health where I was allowed to give a depression inventory I got a lot of people some help that they really needed. Once in the long-term place I had a patient who got violent in the halls; I finally realized she was very light-sensitive and that was why she was beating people up when she was out with the skylights. I then realized I'd had the same issue on Geodon and surprise! she was on Geodon. I went through a very goofy thing to get her help; I told a nurse who knew about my bipolar and had her claim that she looked it up and saw the side effect and maybe it was worth trying sunglasses or something else. The med was changed and that was the end of the violence.

So you kind of constantly draw from your own experiences and it's both good and bad. I had a hard time with people who weren't motivated because I know that motivation is the only thing that has kept me going. So when people wanted to give up I had a hard time sometimes being patient. It was my job to find some reason to not want to give up but that can be very hard to do sometimes.

Other times it is so easy. One person had become completely overwhelmed by her mail, especially those freebie name/address labels from charities. The more depressed she got the less she could sort through it and the more it was taking over her living room. So that's what we did, we worked on sorting and motivation to do a certain amount per day and having an I don't know pile to get help with and just talked a lot about how to care with the depression she'd had for a long time. Psych RN did a lot more counseling about handling the depression. Overall that was a really positive outcome after about 3 months of work from the psych RN and I. I think of her often b/c I see her home often.

I guess I'm saying that it is a good area to work in and your experiences will help you. In my experience my experiences also hurt me sometimes. It was hard to keep a boundary between what I wanted to tell patients and what I could; I know sometimes it would have helped to know about my illness and that I was doing ok but it wasn't the right thing to do either. Sometimes they kind of guessed. I loved the work but it was exhausting, the home health much less the long-term care. (But I only did psych probably 3-5 hours per week in that job). It was hard to teach skills I didn't always have myself.

But it is very rewarding, often very positive, very often quite funny and I'm so glad that I had the experiences I did. When I started in psych it was a fast transfer due to staffing issues and nobody thought to tell me it was psych. I figured it out the first hallway I walked down and panicked because I didn't know how to do this. But I learned and loved it. I left the long-term only bc the drive was too far. Home health I left b/c that's what I was doing when I became unable to work at all.

Im wondering if my age will work against me? I'm 25 & can be quite shy when I feel overwhelmed or in over my head. I fear that the patients might sense this fear & feed off of it. Also I'm abit of a people pleaser & fear I may be manipulated too easily. Essentially I just want to be there & care & hopefully make someone's horrific night in psych a slightly better experience because they have someone there's who's goal is to comfort them by just being a kind person in their time of need. I do not have the judgement many nurses have towards psych patients. I have patience. I am particular drawn to adolescent mental health & feel like I have really connected with & achieved my goal with the young psych patients I have encountered within general nursing. I have with older patients too but I feel like I've got an edge being that but closer in age to them. I don't play a mum role but an older role model that's still quite young. Not sure if I'm really a very good role model build you don't include any substance abuse history I look good on paper!

[BeyondtheRainbow]

I was 27 when I started in psych and looked about 20. There were a few times it was an issue when a patient thought my age made me more manipulatable (my new word I created) and would test boundaries but I worked with a 23 year old speech therapist who looked 15 and she managed just fine although she had the same things happen at times. Mostly we both sometimes had patients not willing to accept that we were actually in charge. But honestly that happened the most to me in a normal but more dementia centered nursing home where I started out at 25. One lady on a dementia when I was 25 once told me "You are 12 and you may NOT tell me what to do!". I had to get my assistant to sit there and tell him what I needed her to do, then he'd have her do it, I'd make notes and move on to the next thing, over and over while he barely held off laughing. She was on of my favorite patients ever.

You definitely have the right goal and I think working with kids is great. I think they need more people who really want to work adolescent psych. Whenever I go for my appointments every month I get off the elevator and see into the peds waiting room and some of those kids look so miserable. In the adult waiting room people tend to try to pretend nothing is wrong and we aren't crammed into a tiny, cold room due to circumstances we don't like, but that child/adolescent room can seem sad. I hear the kids come into our waiting room to get weighed sometimes and again sometimes they just sound too sad. I remember being that age and wishing someone, anyone could help. I loved the bits of kindness that I received from some special adults.

I think you have a great idea. And you're a nurse so if you try it and hate it it's not like jobs are few and far between. (I always loved that about OT although when I was fired when unemployment in my state was well over 10% I did feel guilty knowing that I would have an easy time getting a job when so many others wouldn't.)

[jacky8807]

So ya I agree with rainbow
Rewarding and you will GET it and that will be really cool
Just still have to keep the medical profession boundaries up and in that population it would be hard for me
I'd end up being like "oh I went through that too and blah blah

[BeyondtheRainbow]

I had 2 times that it was really hard not to tell and one time I told and still think it was the right thing to do even though I know by all standards it was wrong. The time I told I can't explain b/c it is too specific to the very rare circumstances.

The other two were heart-breaking. One was a regular nursing home patient who always said I reminded her of her daughter. She had the same dark curly hair and green eyes that I do, was the same height and build, etc. Nobody else even knew she HAD a daughter so it was a little confusing. Finally I asked and she told me her daughter has spent her adult life in and out of the state hospital until she killed herself. She was, of course, bipolar, and her mother saw it in my eyes. When I dug around in her chart enough I found that she never mentioned the daughter in her history but when her son had visited he'd told the social worker that there had been a daughter who died so there was a brief note but otherwise nothing b/c the patient couldn't stand to talk about it. It must have hurt her terribly to see me but she also got something from it. I always wondered exactly how much she could tell because without ever telling me she made it pretty clear she KNEW.

The other time was one of my long-term care psych patients. We had gotten very close because she had a severe injury and we spent probably more hours together than I spent with any other patient in my whole career. She had schizophrenia but was paranoid about talking about it so one day when she admitted she was hearing voices in the moment I was surprised. I reassured her that she was safe and tried to help her not feel so isolated by it by saying that lots of people hear voices. I really meant 99% of the people where she lived did but she asked me if I did. At the time I had not had auditory hallucinations but I'd had visual ones and definite paranoia and it was really hard to not be more honest than was healthy for her.

I had some big words of advice that were actually good and then I forgot completely while I was typing this for the 2nd time after accidentally deleting. So maybe I'll remember and be back.

[Aurelius710]

The guy that I go to see for my mental illness is actually a psychiatric nurse practitioner. For me, he fills the role of both psychiatrist and psychologist. I have regular therapy sessions with him and he prescribes my medications as well. He works out of a local clinic in my town, but he essentially runs his own business.

Obviously, you would looking at a master's degree and some licensing requirements if you did go that route, but you would be in more of a General Practice atmosphere rather than critical care.

Hope that helps!

[Wanderlust90]

Beyondtherainbow I defiantly get the "you are 12 & may not tell me what to do" scenario lol.

Another fear is that the inpatient ward I would be gaining my experience on is public & currently treats a lot of "forensic" patients. Mainly due to merhamphetamines & psychosis.

Regardless I completed the course application today

[BeyondtheRainbow]

Congratulations!!!

The public thing......that's what I was thinking about.

First, what you were talking about. The place I worked had a sub-acute stepdown unit thing and we had a number of forensic patients through it. Then we had a number of long-time forensic patients, a good number of whom were murderers. We also had court-ordered sex offenders and they could get scary at times. (One of the times looking young could be scary). A number of our men got DepoProvera shots to kill the urges. Many of our patients had been homeless until found and brought in to the facility through the courts so there was all kinds of substance abuse too. Eventually you get used to it and honestly I came to LOVE this man, my favorite patient I ever had, who had killed his mother and spent half his life in jail. He had nobody and so I make sure to honor his memory evey April 28, which is the day he died. He was the funniest person I've ever met and the one most in need of love.

Sometimes when substance abuse is the problem you can make such a difference just by providing a distaction. One man I remember who was there while waiting for a bed at the substance abuse place his parents wanted him to go to loved to just play Yahtzee with me. We worked on a lot of coping skills and stuff but always while playing Yahtzee. As we'd play he'd noticeably relax and seem to forget how bad he felt. Like all things there are challenges but I could tell stories from just my forensic guys for hours.

My big advice was to be sure your family or whoever would help you if you needed to go IP knows where to send you that you're privacy would be respected. My shaky plan for admission during that time was to go to another state (which I leave 90 minutes from) so that I wouldn't be IP with my patients. Obviously you wouldn't have that with adolescents but you could have staff rotate through and it could be awkward. I had a list of all the places that our facility sent people and made sure my mom and pdoc knew those places were off limits.

I'm glad you applied. I think you'll like it. It is really a fun area to work in and one that nearly every you feel like you made a difference, even if it was just unlocking a door to give out art supplies when people were anxious in the evening. Good luck!

[Wanderlust90]

Beyondtherainbow, by public I meant government run hosiptal. I live in Australia so the system might be set up abit different. The forensic patients I've come across are mainly substance abuse related psychosis that have been accused of crimes like aggravated assault (lots of domestic violence), theft &, drug charges, that kinda stuff, so nothing too bad really just your fair share of patients who can be very opportunistic & sometimes aggressively psychotic.

Good advice on getting a plan B set out regarding IP. My treating team are all aware that I work in the ED & so wouldn't present to there in crisis anyway. & they are also aware I was considering moving into the mental health unit & have been accomodating in organising another "crisis" contact if I needed to be assessed for IP care. There's another public hospital 4 hours away I could go to.

Thanks for all the encouragement & information, it's really great being able to talk to someone in the field! I'm feeling really positive about it all at the moment.

[Wanderlust90]

Originally Posted by Aurelius710

The guy that I go to see for my mental illness is actually a psychiatric nurse practitioner. For me, he fills the role of both psychiatrist and psychologist. I have regular therapy sessions with him and he prescribes my medications as well. He works out of a local clinic in my town, but he essentially runs his own business.

Obviously, you would looking at a master's degree and some licensing requirements if you did go that route, but you would be in more of a General Practice atmosphere rather than critical care.

Hope that helps!

I don't think I have the capacity to complete a masters degree at the moment, a graduate diploma is about all I can muster I think, don't want to increase stress to a point I can't cope. But it sounds like a wonderful career path.

Originally Posted by Wanderlust90

Im wondering if my age will work against me? I'm 25 & can be quite shy when I feel overwhelmed or in over my head. I fear that the patients might sense this fear & feed off of it. Also I'm abit of a people pleaser & fear I may be manipulated too easily. Essentially I just want to be there & care & hopefully make someone's horrific night in psych a slightly better experience because they have someone there's who's goal is to comfort them by just being a kind person in their time of need. I do not have the judgement many nurses have towards psych patients. I have patience. I am particular drawn to adolescent mental health & feel like I have really connected with & achieved my goal with the young psych patients I have encountered within general nursing. I have with older patients too but I feel like I've got an edge being that but closer in age to them. I don't play a mum role but an older role model that's still quite young. Not sure if I'm really a very good role model build you don't include any substance abuse history I look good on paper!

Hi again, Wanderlust,

Now you have had helpful answers from people who have wanted to share their experience working with people while they themselves have had to cope with MI. I don't think age matter, but your posts in the "Not depression, dysphoria" thread still stays as a little red lamp for putting yourself into an education where the job afterward will put you into a lot of stress. You said among other: "The whole dysphoria feeling I seem to have little to no control over, like I can't just divert my attention or whatever, the feeling sticks for a while & evolves into self harm & suicidal thoughts at worst. Especially if I can't remove or avoid the agitating stimulus if there is one. Avoidance behaviour has become my go to." You also talked about "borderline symptoms" that you were afraid to talk about (if I understood you right).

If I were you I would have talked about these problems to your treatment team, and then let them try to see if you can be helped for these problems or not. If not, it would probably not be fun for you to work at a hospital and loose control. Even if you are able to keep the control at work and only slips into this condition when you come home in the evening, it can be hard to live with. I know people who have been admitted to their "own hospital" to be cured because they met the wall. They regret their choice about working with Mental health.

I think that the best we always can do is to be honest about the ++ and -- when we are going to make choices in our lives that are really, really important.

Good luck with your decision process!

Good on you!
__________________

[Wanderlust90]

Singer47 I'm not nesesarily afraid of possible borderline traits just trying to figure out if my problem truely is chemical or if it's more of a personality thing that's best treated with psychotherapy. I don't want to take meds unnecessarily. I have a lot of emotional dysregulation, impulsivity, irritability, anxiety, somewhat disordered eating, self harm & suicidal thoughts. Not at this very moment obviously but since noticing a problem.

I am very concerned about stress but it's unavoidable & I want to reduce avoidance behaviours & face my fears. As an RN it's stressful regardless but I value it as a job with so much reward. My concerns about the stress in my current role are more to do with careless mistakes & being unconfident, overworked & overwhelmed easily. I think mental health will be a different kind of stress. Also my plan is to enter community so less acute again. My treating team is aware of my plans. Half are for it, the other have reservations. So i feel like maybe just take the plunge?

In regards to tackling the issues affecting my work I feel like the team has focused only on suicidal thoughts & manic symptoms. We haven't had time to delve into everyday functional coping mechanisms.

Originally Posted by Wanderlust90

Singer47 I'm not nesesarily afraid of possible borderline traits just trying to figure out if my problem truely is chemical or if it's more of a personality thing that's best treated with psychotherapy. I don't want to take meds unnecessarily. I have a lot of emotional dysregulation, impulsivity, irritability, anxiety, somewhat disordered eating, self harm & suicidal thoughts. Not at this very moment obviously but since noticing a problem.

I am very concerned about stress but it's unavoidable & I want to reduce avoidance behaviours & face my fears. As an RN it's stressful regardless but I value it as a job with so much reward. My concerns about the stress in my current role are more to do with careless mistakes & being unconfident, overworked & overwhelmed easily. I think mental health will be a different kind of stress. Also my plan is to enter community so less acute again. My treating team is aware of my plans. Half are for it, the other have reservations. So i feel like maybe just take the plunge?

In regards to tackling the issues affecting my work I feel like the team has focused only on suicidal thoughts & manic symptoms. We haven't had time to delve into everyday functional coping mechanisms.

Thank you for the clarification, Wanderlust. I only wanted to help. There is not a diagnose for everything, but thinking of a borderliner (not cured) working with mental health was a thought that made me wish to give you a tiny help in thinking on the possible consequences of your choices. I meant no harm. Only wanted to help. I understand that there is much stress with ordinary nursing too. So you really have some choices to make ...

With regard to traits and/or brain chemistry I think it goes both ways. A serious trauma or a long standing not so good child-hood environment will put stress on the brain and may change it's way of functioning. Medication or change in behavior might change those patterns. It is not always easy to know what is chicken and what is hen. I'm sure you already know that and are working on finding out what suits you best.

I hope you have not seen my posts regarding this topic as offensive. They were meant as friendly reminders (in case you needed friendly reminders).

Good wishes for you!

[Wanderlust90]

Singer47, I took no offense, I really appreciate your advice!

Glad to hear, Wanderlust! :-)

[Wanderlust90]

So after finding out the course is about $13 000 more expensive than I thought I've gone from happy as larry to a sobbing ball of tears, basically didn't get out of bed for 36 hours & now I'm exhausted, low & feel like the worlds against me.

I feel like we're are doomed to be trapped in our social & economic classes. Any attempt to better yourself results in being even further in debt. A debt I've collected in order to simply get a job & be allowed to work. & our old prime minister decided he would cut university funding when his own university education was government funded. Get ****ed. Enjoy your $300 000 pension a year for having done nothing but embarass us.

Sorry to hear that, Wanderlust! 13 000 is an amount of money if you don't have them. Is it possible for you to take a break in your education and work for a couple of years and then continue your education afterward?

I find mental health nursing very triggering. I have grown up with mental illness issues in my family and was always afraid of ending up like my mother. I find being around psych just makes me feel out of control. I too cannot work in acute care either. There are plenty of areas that are rewarding. If you can handle psych, go for it. I am glad to see you considering it carefully.

[Wanderlust90]

Originally Posted by Singer47

Sorry to hear that, Wanderlust! 13 000 is an amount of money if you don't have them. Is it possible for you to take a break in your education and work for a couple of years and then continue your education afterward?

Yeh that's pretty much what I'm doing, & taking casual shifts in the mental health unit at the hospital I work at also. So I can do a transition program but it won't give me any qualifications. Will have to reasses when I have the financial capacity. Very disappointed still but thinking more clearly about it now & far less catastrophically haha

I'm still sorry for you when it comes to economical problems. Your ability to think clearly, however, impresses me. Of course you felt down after finding out about the costs. That you see it more positively now, tells a bit about your strength. What do they say? Isn't it something about if you find a block at your road, either jump over it if possible or walk around it.

Good wishes for your success! May be this «block in the road» will turn out to strengthen your belief in what you might be able to manage, strengthen your self confidence and by so also strengthen your ability to cope in the future.

Future ?

[tradika]

I can appreciate this question. I am in nursing school and want to do psych. I think a lot of it is going depend on why your really wanting to do this. If you have ever been IP then you know it can be a very stressful area of nursing to go into. Not to mention that having MI yourself may hit a little to close to home. I have also met some folks who think it's a good idea because they want to help themselves too! That is a poor *** reason to do it. You still have to keep your boundaries and not be buddies with them even when you share their condition. It would be a struggle, but a lot of it depends on soul searching and realizing the good and bad.