Labor Market and Career Information

Psychiatric Nurse
Margaret Anderson

	Introduction Nurses have lots of options. Some work in medical hospitals, others in doctors' offices. Some travel for their job, others stay at people's homes. Margaret Anderson works in a psychiatric facility. Margaret is a registered nurse at a psychiatric hospital in Texas. Every day she works with people who have mental conditions that make them unhappy and sometimes even unable to deal with reality. As their nurse, Margaret has to do more than just care for their medical needs. She also has to ensure that her patients feel safe, respected and understood. It sounds like a tall order but Margaret is up for the job! She left behind a career in computer programming so that she could connect more with people and that's exactly what she does as a nurse. Her ability to get along with and communicate with others--patients, nurses and doctors--is the key to her success. So is her compassion. If you thought nurses were just doctors' assistants, read Margaret's story. You'll see that nursing is a whole more!

	What exactly do you do? I am a Registered Nurse. I provide patient care to adult patients on a Psychiatric Unit in a hospital. The patient care includes assessing the mental and emotional status of my patients each day, administering medications, assessing for effectiveness and possible side-effects of medications, and providing patients support and information regarding their particular diagnosis, medications, and treatment.

	Describe a typical day. I work the 7am to 3pm shift. The charge nurse gives me a list of the patients that I am assigned to provide care for that shift. First I read the report sheet from the previous evening and night shifts regarding the kind of evening and night my patients had. I then get started on my busy day. Duties of the shift include checking vital signs on each patient (blood pressure, temperature, pulse, respiration), "doing the Rounds" which means checking on each patient at specific time intervals to see where they are and how they are doing (the patients have a full schedule of groups to attend), and administering medications. I also spend one-on-one time with each of my patients in order to assess their mental and emotional status, assess for effectiveness and possible side-effects of medications and provide support and information regarding their particular diagnosis, medications and treatment. I document my assessment findings and the activities of each of my patients in each of my patients' charts each day. And I fill out the report sheet for each of my patients to pass along information to the next shift. In addition, I do admissions of new patients to the unit and discharges for the patients who are ready to go home.

	What's the coolest part of your job? The coolest part of my job is the flexibility. The hospital is open 24 hours a day, every day of the year. When I was first hired, I worked as a PRN ("as needed") nurse. I had the flexibility of setting my own schedule. It really worked out well for me because I was able to work the 7am - 3pm shift. I could work as many or as few shifts a week as I wanted, depending on the needs of the hospital. Now my status has moved up from PRN to Part-time. I still get to work the 7am - 3pm shift. I am guaranteed at least 2 shifts a week, but again, I am able to work as many shifts as I want and now since I am part-time I also get benefits, such as Paid Time Off!!!!

	What's your favorite part? Spending time with my patients. I like sitting and listening and talking with them and providing support, encouragement and information as they work their treatment plan for their particular diagnosis. I enjoy seeing the progress that each patient makes as they work their treatment plan.

	How do people react when they learn what you do? When I tell people that I am a Psych nurse, they usually react with a surprised, wide-eyed, raised eyebrows look. Then they usually say that they have a lot of respect and admiration for me because they don't think they could do it. But I think they could and I think they would enjoy it as much as I do.

	Describe a funny or unusual incident that happened at work. I was working on the unit on September 11, 2001. I went into the dayroom where patients were watching television. That's where I learned about the World Trade Center tragedy. As I looked around the room while the television reporters told of the tragedy, I witnessed patients, nurses and doctors talking about it. For a moment, we weren't patients, nurses, doctors... we were all Americans...we were all human beings who felt the same about the tragedy. I was glad I was at work that day for my patients and was able to help them.

	What's the part you like least about your job and how do you handle it? Sometimes when people are hurting mentally and/or emotionally they can be grouchy and not very kind. I handle it by knowing that I am here to help them work through their pain. I smile at them and try to be empathetic, kind and gentle.

	How did you become a nurse? I had worked as a computer programmer for many years. I liked the job okay but missed having more contact with people. A family member was terminally ill and during that time, I spent a lot of time at the hospital. During my visits, I was impressed with the nurses and the work they did. I became very interested in becoming a nurse. The company I worked for at the time offered a buy-out [essentially paying people to quit] in order to downsize the number of its employees. I accepted the buy-out and went back to school and earned a Bachelor of Science (BS) Degree with a concentration in Nursing. After graduating, I passed the state board exam to become a registered nurse.

	Why did you become a psychiatric nurse? Did it require special training? In nursing school an entire class and clinical was devoted to Psych nursing. (A clinical meant we would go to hospitals or other health care facilities and actually do patient care under the guidance of the nurses there.) My favorite class was Psychiatric nursing and my favorite clinical was the Psychiatric clinical. When I was there I had a good, warm, comfortable feeling as I worked with the patients. With Psych nursing, though, most of the training comes from on-the-job training. My work experiences have been invaluable training. Also, every year I am required to attend an eight hour training class that pertains to Psych nursing at the hospital where I work.

	You have a Bachelor's degree in nursing rather than an Associate's degree? Has it made a difference?? Since I already had a Bachelor's degree, I was able to attend a University that did not require me to repeat any needed courses that I had taken with my previous degree. I was able to complete the Bachelor's degree program at this University in the same amount of time that it would have taken to complete an Associate's degree (approximately 2 years). However, even if I hadn't already had a degree I would have still gotten a Bachelor's degree instead of an Associate's degree. With a Bachelor's degree, the possibilities for advancement are greater and some health care facilities pay higher salaries to people with one.

	What pleasantly surprised you about your job when you first started? How much I LOVED it and how much FUN it was! Before I was a nurse, I worked at many jobs (I had had another career). I liked those jobs okay, but being a nurse just came more naturally to me and I thought to myself, "You mean I get to have this much fun and get paid for it?!!!!!"

	What disappointed you? When I would be canceled for a shift. I was a PRN ("as needed") nurse, so if there were already enough regular staff nurses scheduled for the number of patients, they didn't need me to come in and so I was canceled.

	How has your job changed over time? I have worked as an RN for 3 1/2 years. I started out as PRN ("as needed") nurse and worked 2 to 4 shifts a week. Now I am a part-time staff RN and am guaranteed at least 2 shifts a week. (I usually can work all the shifts I want). I also get benefits that I didn't get as a PRN nurse. And I get to help train/orient new nurses when they begin work on our unit.

	What will nurses be doing ten years from now? I think more of the paperwork will be computerized and that there will continue to be advances in treatments and medications that will help in treating patients. I also believe that nurses will continue to be in demand, so nurses will have no trouble finding jobs and will be able to pick and choose the area of nursing that they want to work in. I think the future for nurses will continue to be bright for many years to come.

	What are some of the most important skills and abilities needed for this job? Being able to get along well with people is important. Also, patience, caring, understanding, and being empathetic, nonjudgmental and a good listener are important. You need to have a genuine concern and love for people. Nursing Assessment Skills and Knowledge about the patient's diagnosis and medications are also important. Nursing Assessment Skills means collecting data that reflects how a patient is functioning. This data includes a patient's mood, expression of mood, thoughts, perceptions, and understanding of their illness. Knowledge about a patient's diagnosis and medications would include knowing about illnesses such as Depression, Anxiety, Bipolar Disorder, Schizophrenia and Chemical Dependency and the medications used to treat these.

	How much of that is learned and how much has to be natural aptitude? The Nursing Assessment Skills and Knowledge about patients' diagnoses and medications are learned. I think being able to get along with people, patience, caring, understanding, empathy, being nonjudgmental, and good listening skills start with a natural aptitude but are skills and abilities that improve through experience and learning.

	What information do you need to keep up in your field and where do you get it? To keep up in my field I need information on the latest treatments and latest medications. I get this information from nurse magazines, the Internet, books, and continuing education courses. Every two years I need to renew my nursing license. To do this I need 20 hours of continuing education. Continuing education classes are offered through the hospital I work at, in nurse magazines that I subscribe to, and seminars that are offered in my area.

	What advice do you have for people who want to enter this field? I think nursing is a very good career choice. There are so many different areas of nursing to choose from. Nursing pays a good salary. There continues to be a nursing shortage, so it isn't hard to find a job.

	What do you wish someone had told you before you left high school that would've helped you with your career? To think about what YOU want to do. Be true to yourself. Don't pick a career because of the salary it pays or because you think it's what someone else wants you to do. It's YOU who has to do the job and go to the job every day. Be sure it is something YOU will be happy with. When YOU are happy with your career choice, you will find that your friends and family are happy for you.

	Quick Facts
	The Job in Brief
	Title:	Staff RN
	Description:	Taking care of patients (including administering medication), communicating patient progress with others, and admitting/discharging patients, among other duties.
	Education level required:	Minimum for an RN: Associate's degree Margaret's Education: Bachelor of Science Degree (BS) with a concentration in Nursing and Bachelor of Business Administration Degree (BBA) with a concentration in Management
	Equipment used:	Frequently used: Stethoscope, blood pressure equipment, thermometer, Blood Glucose Testing Meter, EKG (electrocardiogram) machine, Sure-med machine (computerized device used for storing and dispensing medications)
	Workload steady or fluctuating:	Steady.
	Dress code:	Business casual. Where I work we get to wear blue jeans on Friday!!
	Work environment:	Psychiatric Hospital

	Demands on Worker
	Works hours (time and duration):	I work 8 hour shifts (6:45 am to 3:15 pm with a 30-minute lunch break).
	Travel involved:	Score: 0 (1=never; 5=very often)
	Average stress level:	Score: 3-4 (1=none; 5=a lot)
	Amount of teamwork needed:	Score: 5 (1=none; 5=a lot)
	Level of self-motivation required:	Score: 4-5 (1=none; 5=a lot)

	Labor Market Information
	Employment outlook:	Employment of registered nurses is expected to grow faster than the average for all occupations through 2008 (at least).
	Typical Texas salary:	$37,215 - $45,485 a year