But I Didn't Go To School For Psychiatric Nursing?

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Psychiatric Mental Health Nursing: You’re going to do it no matter what.

Hey everyone! It's David from ADPIE. This week I wanted to talk to you about mental health. This is one of my favorite nursing specialties! While I don't work in psych, it is such an important part of my nursing practice. Mental health has many connotations for people. Some associate it with taking care of yourself. Tea, warm baths, meditation, wine…

For others, it is a branch of medicine that is often thought of as last resort if you are trying to find a job in nursing. “The psych hospital is always hiring…”

This is so unfortunate because it is the most underutilized, but much needed branch of nursing. Nurses are so well equipped to be a valued part of mental health services.

Mental health and psychiatric nursing is its own nuanced branch of nursing with its own skills and challenges. Having said that, nurses always handle mental health in some way and students really need to understand the importance of that. Psychiatric nursing is usually covered after the first semester. If you have taken any psychology courses beforehand, they will really help you out.

One topic that is discussed and often dreaded is “therapeutic communication”. It is such a hard thing to teach someone if you don’t have a knack for it. A part of it is natural ability in reading someone’s body language, reading between the lines, asking the right questions, and no small amount of intuition. Many nurses dread having to really talk to their patient; preferring to just make them better and get out of the room.

You may not have wanted to go into mental health nursing, but no matter what specialty you choose, you WILL have to talk to patients. During this time, you have an opportunity to really make an impact on someone’s situation. If you are still nervous, here are some ways to get through a therapeutic conversation:

• Listen
• Truly listen. Some may call this actively listening. What is the quality of their voice? Do they have a tremor despite saying they are fine?
• Don’t try to offer advice right off the bat
• I’ve seen some nurses get the first little bit of information and fire off some advice. Wait for the patient to finish speaking. While we are trained to intervene in many ways, do not tell them what to do. It comes off as dismissive and you sound like a know it all.
• Keep the patient on track
• Patients like to wander; both in conversation and off the unit sometimes. Keep them focused on what is bothering them. If you need to, bring them back to the point.
• “Tell me more...” does actually work
• This is such a cliche statement that we learn in school, but it really does work. It makes you open to more information and tells the patient you have the time and attention to give them. Some of the greatest stories from patients or most insightful information came from me using this very phrase.
• Get on their level
• Sit with them. I got this from a physician and it works most of the time to make an angry patient much more amicable to conversation. 
• Keep your nurse face on
• No matter what they say, keep your “nurse face” on and remain professional. You are not there to judge them or make fun of their situation. Be open to any and all information. Most of the time, patients are scared and looking for help or information. They might say some weird ****, but we need to take it all in and help them process it.

If you are interested in mental health nursing check out the American Psychiatric Nurses Association. Most nursing specialties have an association and they are great resources for certifications or information on their specific specialty.

We’re looking forward to seeing you guys next week, but if you have any questions, please contact us.

As always, we’ll continue to monitor...

- David RN, BSN