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More than almost any kind of nursing, working in behavioral health requires nurses to exercise the“therapeutic use of self.” The following are qualities nurses working in the field say are the most crucial to have or develop in order to be able to use the self therapeutically:
Sense of Humor
“If you can laugh things off instead of taking things personally, each shift will go easier,” said Betty Gerzon, who has worked in psych mental health nursing for almost two decades, “patients will sometimes call you names and you have to realize it is not about you, it’s one of the few areas patients actually have control over, they’re just frustrated and emotionally fragile and need to have some outlet.”
“You need to have personal insight into what pushes your own buttons, because if you’ve got a weakness, patients will go for it,” explained Angela Best-Boss, a nurse at a large behavioral health facility in Indiana.
Another nurse described this as “remembering every day is bring your baggage to work day. You can’t expect to come to the floor without any prejudices or issues that are brought up by patients. But you have to be aware of them and be willing and able to talk them through with staff or your supervisor and not take them out on patients.”
Willingness To Learn Something About Everything
Nurses on behavioral health units have to address all the co-occurring medical problems that patients bring with them to the floor. While psych mental health nurses may have specialized skills in working with people with mental illness, they also have to be generalists in a sense to address the myriad of other types of medical problems patients will have.
“One shift you might be managing a brittle diabetic, another day you might be helping a patient with a new colostomy” said a recent grad from Ohio who works in the psych unit in a general hospital, “so you have to have confidence in your ability to learn fast and look things up if necessary.”
Able To Avoid Power Struggles
When things get tense on the unit, nurses have to be able to de-escalate conflict situations. Sometimes this requires holding a boundary and sometimes it requires backing down, and a good psych mental health nurse needs to be able to determine which choice is more safe and ultimately productive.
Donna Luongo, a charge nurse explains, “You can’t say things like ‘because they are the rules’ you have to be willing to put things in terms that the patient can relate to. For example, ‘Our job is to keep all our patients safe while they are here. I understand that you don’t feel it’s fair that I can’t give you that rubber band, but all our patients are at different stages in their recovery and we can’t give you the rubber band because if I give you a rubber band I have to be willing to give everyone a rubber band and some of your peers will use that rubber band to harm themselves’.”
Active Listening Skills
In situations where patients are not always able to easily express their own feelings in words, active listening helps keep the patients and the unit safe.
“It takes a certain amount of patience to help someone who is reacting to all sorts of internal stimuli to tell you why they’re upset” explained Gerzon, “but if—with your help– they can talk it out instead of act it out, then you’ve created a real therapeutic environment and the patient has learned they can trust someone.”