Nursing Interview: What to Expect as a Psychiatric Mental Health Nurse and how to Set Yourself up for Success

Interview with Staci Priano

Q. What is your current position? How did you come to be in this position?
A. I am now working as a Clinical Resource Coordinator.

Q. What is psychiatric nursing?
A. Psychiatric nursing encompasses a fully holistic care model. A PMH nurse must assess and integrate a patient’s medical, physical, social, cultural, socioeconomic, etc. considerations with her mental health concerns. Psychiatric nursing is equal parts knowledge, compassion, and intuition leveraged by experience. Psychiatric nurses deliver care with a planned emphasis on addressing the very areas of health and the mind that other nursing and medical disciplines view as an afterthought or footnote to the priority of physical/biological care. Psychiatric nurses, by helping a client to improve and positively progress in their mental health, can impact that client’s ability to maintain healthy lifestyles, medical regimens, employability, community integration and productivity. Psychiatric nurses are essential to the real-time enhancement of their client’s quality of life.

Q. What does a PMH nurse do on an average day?
A. An average day as a PMH nurse consists of report and rounds with my fellow nurses. talking with/assessing each client’s present status, both medically (ie; vital signs, somatic/physical complaints and improvements) as well as psychosocially. Medication rounds are an integral part of inpatient psychiatric care. Multiple groups with clients, usually with specific group topic, information and goals occurred several times a day. Personal patient sessions related to concerns, goals, contracts, as well as more basic addressing of a client’s pain, fears, or successes occurred frequently. Patient’s family, friends, and loved-ones were supported, assisted, educated and guided through many areas of the mental health process. Crisis intervention, both medical and psychological crises also were emergently addressed. Close observation and priority to individualized patient’s safety needs was an ongoing, dynamic point of focus and collaboration with medical, psychiatric, nursing, and ancillary staff. Support and guidance to mental health technicians and other staff members continued throughout the day. Discharge needs, planning, and strategies for effective, long- lasting improvement in a patient’s ability to stay well outside of hospital confines were an integral part of our daily patient multi-disciplinary care plans.

As I have also worked as a psychiatric visiting nurse, I had the chance to utilize and analyze the efficacy of these very “game plans”.The visiting nurse aspect allowed me to view the continuum of psychiatric nursing care through an even wider, further-reaching arc that aided me in the vital process of planning and implementation (with our clients) of strategies to maintain and improve his/her health and well-being.

Q. What is the most fulfilling aspect of working as a psychiatric nurse?
A. The most fulfilling aspect of working as a psychiatric nurse was being able to focus on healing areas of a patient’s being that usually had been marginalized, trivialized and stigmatized. Clients many times were desperate just to be heard, accepted, and held in esteem as a worthwhile individual. Many clients were grateful just to be slightly less afraid and to be able to have a modicum of hope that their mental illness would not consume them wholly. The level of malignment and invisibility a psychiatric patient might endure in our society reduced many to further levels of illness and despair. Some of this detrimental effect could sometimes be breached by the boggling tenacity of the human spirit ignited by the skill and compassion of an exceptional psychiatric nurse. The achievement of a look, however fleeting or fragile, of hope, awareness, trust, and relief on an endangered client’s face was immeasurably gratifying and sustaining.

Q. What are some of the challenges of working as a psychiatric nurse?
A. The knowledge that this field of nursing can be less respected by nursing peers/contemporaries/ the general public. This can be reflected in lower wages as compared to acute care, medically-focused nursing venues.

The client population is challenging with successes sometimes small or outweighed by recidivism, chronicity, and the burdening effects of all the seqQ. uelae of mental illness: family strife,poverty, homelessness, drug and alcohol issues, etc.

Q. What traits make for a good PHM nurse?
A. Professionalism, optimism, patience, and tenacity! The ability to see those small successes as worthwhile and as progression to something greater. Curiosity- about the mind- body- health connections, and above all- unfailing compassion with the ability to see worth in all individuals.

Q. What advice do you have for someone who is considering going into
psychiatric nursing ?

A. Attempt to find an externship or an opportunity to shadow an experienced PMH nurse to experience this field of nursing in a reality-based setting.

Take the time to assess your real feelings about mental-illness. Address your stance on any widely-held misconceptions. Delve into your own issues and concerns to be clear in knowing what your “buttons” and fragile areas are, as these parts of your psyche will be magnified and can detrimentally ( for you and your clients) come into play during practice. Make sure you have support systems in place to allow you productive space to vent and explore your reactions as you care for your patience and learn about yourself.

Take advantage of community and educational events, seminars, rallies, etc. Stay involved in the public and political arenas that affect the mental health community. The PMH nurse’s practice will be enhanced by a knowledge base built not just academically but pragmatically and holistically with real-life experience. This sector of the population also needs support and your professional voice.

Q. What degrees or certifications do you need to work as a psychiatric nurse?
A. There are positions available to an RN at all levels of degree and experience. Managerial and educational positions will require BSN to MSN level education, with professorial positions looking toward Doctoral degree mandates. A Certification in Psychiatric and Mental Health Nursing is available to nurses actively practicing in the field with a minimum amount of experience/hours-worked stipulated by the certification board. Although this is not usually mandatory for practice, it does illustrate a certain level of expertise and commitment to the field. The certification is also valued by employers.

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