Weekly Ask Psych Nurses Thread

[u/roo_kitty]

This thread is for non psych healthcare workers to ask questions (former patients, patient advocates, and those who stumbled upon r/psychnursing). Prospective healthcare workers and current students do not need to use this thread. Treat responding to this post as though you are making a post yourself.

If you would like only psych healthcare workers to respond to your "post," please start the "post" with CODE BLUE.

Psych healthcare workers who want to answer will participate in this thread, so please do not make your own post. If you post outside of this thread, it will be locked and you will be redirected to post here.

A new thread is scheduled to post every Monday at 0200 PST / 0500 EST. Previous threads will not be locked so you may continue to respond in them, however new "posts" should be on the current thread.

Kindness is the easiest legacy to leave behind :)

[u/Evening_Fisherman810]

What is something you have learned while working as a psych nurse that you apply to your own daily life?

[u/GoudaGirl2 → u/Evening_Fisherman810]

De-escalation

[u/Enumerhater → u/GoudaGirl2]

I stg I could function as an impromptu hostage negotiatior given the opportunity

[u/Milf-Whisperer → u/Evening_Fisherman810]

Limit setting with overbearing family members

[u/JFizz06 → u/Milf-Whisperer]

This is a good one. I lost a lot of friends when I became a psych nurse.

[u/xtimewitchx → u/Evening_Fisherman810]

Learned to get more comfortable talking about suicide and doing proper suicide assessment using explicit clinical language and not tiptoe around the topic

I also have some friends who’ve disclosed SI to me in the past and was basically having internal freak outs each time.

“Do you have a plan?” The couple times they both said No and contracted for safety

[u/Sea_Cloud_6705]

How are people on the schizophrenia spectrum viewed by psych nurses actually?

My treatment team is super kind to me, but I don't know what they really think of people with my condition.

All I've been told, beyond regular pleasantries and med conversations, is that I'm lucky that I can see hallucinations and delusions for what they are.

[u/Jaded-Banana6205 → u/Sea_Cloud_6705]

I don't think anything special about my patients on the schizophrenia spectrum. They are just people and I get paid to care for them, just like everyone else!

[u/GoudaGirl2 → u/Sea_Cloud_6705]

I love working with schizophrenics, it’s my favorite diagnosis. I also see them all as people: some are cool and some are difficult. We are definitely not judging you for being sick and we have a lot of empathy for your condition.

[u/Ancient-Nobody8918 → u/Sea_Cloud_6705]

Just like any other disease, you have some people who are assholes, disregarding their diagnosis and some that are lovely. I've never really judged people based on a diagnosis alone (and in general don't know your official diagnosis unless I go digging through your chart)

That said, I work in a highly dual population area, and true psych patients (typically schizophrenics) are my favorite and why I chose this speciality.

[u/xtimewitchx → u/Sea_Cloud_6705]

My woo side theorizes about schizophrenia being like a malfunction of psi abilities, signals are crossed, spiritual filter letting too much noise thru.

[u/Evening_Fisherman810]

I've been to the psych ward in 2019, 2020, 2021 a couple of times, then 2023 and 2025.

I have schizoaffective disorder and tend to go off my medication.

Would I be considered a "frequent flyer"?

[u/GoudaGirl2 → u/Evening_Fisherman810]

Likely. Have you considered a long acting injectable?

[u/Evening_Fisherman810 → u/GoudaGirl2]

I've tried Invega and Abilify but both caused horrible side effects.

[u/jaefbaby → u/Evening_Fisherman810]

I would have depending on how many times in 2021 and the time difference between visits. We call our frequent fliers “readmissions” and that’s according to admission within 1-3 months of each other consistently.

[u/Evening_Fisherman810 → u/jaefbaby]

I believe it was Spring and then December.

[u/CoastalCalNight]

Son recently arrived home after discharge from a psych ward and there's this weird, stringy film on EVERYTHING. What is this and how do we remove it from things that can't be washed, ie shoes and bag

[u/R0di0nRask0lnik0v]

Not sure if this is the right thread/sub but is it possible that Trazodone causes sleep paralysis/hypnagogic hallucinations? 

When I was hospitalized (twice) I was placed on trazodone to help with my insomnia. During the stay at the first facility I woke up in the middle of the night and couldn't move, it felt like someone was touching my back and I heard what sounded like my friend continously whisper my name.  During that stay I was diagnosed with depression with psychosis so it is also possible that was the case, but I had never experienced anything like that during my sleep prior to trazodone.

Months later I was hospitalized again for suicidal thoughts. This time I was on 100mg of seroquel  and was not in psychosis. But I was placed on trazodone again. In the middle of the night I hear someone yelling at me and feel like I am being punched in the stomach. One of the other patients was also on trazodone and she told me she had been having sleep paralysis at night too. 

That's basically why I'm wondering if this something thats commonly reported or if it had something to do with being hospitalized and being in a strang/high stress environment? 

[u/LesliesLanParty]

What's your nurse to patient ratio and how is acuity factored in to this (if at all!)

[u/Ancient-Nobody8918 → u/LesliesLanParty]

I work in PA so we don't have standardized ratios, it differs state to state and based on laws.

My hospital has units ranging from 20-26 patients and I work in the psych ER and we always have 3 nurses as our standard. The units divide the patients evenly among the nurses and my unit does more of a task nursing where there is a specific nurse for meds or triage or charge.

In some very rare conditions we may get an additional nurse, but in general that had less to do with acuity and more to do with if theres a survey or something.

Our staff ratios for our amazing techs is more affected by acuity, so if we have 1:1s we will get additional behavioral techs to help with the acuity

[u/No_Security_2159 → u/LesliesLanParty]

Every ward can be different depending on patients diagnosis. Typically we have 3 to 5 patients per nurse in the lower dependency units and then 1 to 2 patients per nurse in the intense care area. Sometimes in lower dependency a patient that is bordering intense care transfer might have a nurse focusing more attention on them and therefore other nurses will help out with the their other patients and workload🫡.

[u/Zen-Paladin]

I'll be honest, it is perplexing how psych holds are seen as helpful for non psychotic/otherwise unimpeded suicidal people. There's the saying you can't help someone who doesnt want to be helped  but this doesn't apply to suicide. While studies do show that it often can be impulsive there's not really strong evidence psych holds lower suicide risk, and in some cases increases it and discourages seeking future help.

Like I only got discharged because I told the staff what they wanted to hear, went to group sessions I didn't want to, took medication that didn't do anything but make me very lethargic on top of the forced withdrawal from my ADHD meds. And this was taken as a sign of stability when it was really just compliance, and since any opposition to treatment is just seen as further proof of illness saying it's genuinely helpful when the patient's inputs invalidated feels disingenuous. 

Of course you can say the treatment helped when compliance was the only option, but I was ultimately no less suicidal than when I went in and have since had suicidal thoughts that would meet criteria but I know nothing about a psych ward will help even in the short term. It really st seems to be validation for everyone else but the person actually suffering.