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May 18, 2005

Patience, empathy, listening,... and more

I am a psychiatric nurse who practices on a medical psychiatric unit. Patience, empathy, listening, and assessing without all the bells and whistles of medical nursing are my trademark skills.

Manheadache72x721 I have to have the patience to listen to someone scream, yell, pace, and eventually take the medicine I am offering them to fight the demons in their heads.

I have to employ empathy, while they share with me, stories of horrible abuse they've endured. I have to let these stories go through me, around me, never ever letting the horror stay inside of me. If I did, I couldn't continue to do my job.

I listen to sorrow of a mother when she has lost her child, or a child that has lost a parent. They have lost their world as they know it. I try to help them find the skills and the will to pick up the pieces and put it back together.

I help the man from under the bridge, who drank rubbing alcohol, go through our withdrawal protocol to get sober. I also try to explain to the parents of the child who doesn't recognize them, what PCP is. I comfort the wife of the man who sold their children's Christmas presents for crack.

I have to know what a fundus is and how to check it. I have to know what normal fetal heart tones sound like. How could I take care of a pregnant or postpartum patient if I didn't? Post-partum depression is deadly, and I can prepare and carryout a care plan for this patient.

I can recognize seizures, abnormal levels of consciousness, changes in mental status, and start the detective work to figure out if it is a alcohol/drug withdrawal, overdose, stroke, or other organic problem.

I can assist with a pelvic exam and do penal swabs. I know the facts to teach how to treat and prevent sexually transmitted diseases.

I can prepare a patient for surgery, dress wounds, and take out sutures/staples. I can assist with the application of a cast, apply an ace bandages, or reapply a splint.

I can take care of a diabetic bulimic and/or anorexic adolescent runaway, drug addict, schizophrenic, or 83 year old Alzheimer's patient.

I can take care of a kidney dialysis patient, and know how to prepare and carry out their treatment plan.

I can give nebulizer treatments, monitor O2 Sats (% of Oxygen Saturation in the Blood), and hook up Consentrators. My patients have COPD, lung cancer, and emphysema.

HIV, syphilis, gonorrhea, hepatitis, MRSA, lice, scabies, ringworm, and positive TB skin tests (PPDs), are all part of my daily routine. I'm with the Doctor when he gives the diagnosis. After he leaves, I have to answer all the questions of the patient and their families. Then, I have to know the routine treatment/protocols for all of these diseases.

I take care of the homeless, the middle class, and the rich and the famous. Psychiatry is not just for the faceless anymore.

Psychiatry is about having broad nursing skills, being autonomous, and a patient advocate. Most of all, you have to be willing to use your hands, eyes, ears, nursing instinct, and your heart to do your job.

Mary Baer

May 18, 2005 in What I Do | Permalink


I've been in nursing 50 years....mostly psych. but have worked in all areas except ED and ICU. I was working in one of the two huge hospitals in Winston Salem, N.C.
I was terminated becaiuse of complaining that my team workers were not meeting the needs of their pts. physical ailments.....I was working with any pts. that seeked my help and my team players, RNs and CNA/s went
to managemet and complained. They have been trying to fire me since Feb. Allowing me to work in a hostile environments with no help from supervisors to resolve problems. I am from the old school of nursing. Loving my pts and meeting their every needs. I appealed my lst termination, which they accused me of horseplay and yes I was frustrated because of no resolution to problems. I appealed and got my job back, with much anger from
the VP of Behavioral Health......Then put on probation for 3 months, with no problems.....6 days before my 3 mos. were up, I was set up by a CNA saying I used a racist remark.....which I didn't....I was suspended, there were no witnesses and so I was allowed to return to work. The evening I returned to work the same CNA accused me of embarrassing her....I was once again suspended, sent home from work.....and fired a 2nd time.
I think they were trying hard to get rid of me......
I appealed again, but the hateful VP, refused to have me return.....I am so disappointed in this huge domain in Winston Salem, N.C. I sent letters to her boss, the executive above her, and she said not to send letters to her but to go back to EEO.; It has affected my health and do not have the strength to go on any further, so I am heartbroken, spirit broken and I miss my patients so very much....I do not believe the President of the company would allow this to happen if he knew....but the BH unit in this hospital does not want to grow to their excellence of care, just psych care, they do not give medical nursing care, not the majority of them, and the new manager said she was going to straighten things out, and all she's doing is
getting rid of the nurses who care and don't look at it as just a job. Its a shame that management can pull strings and end your career the way they have done mine.

Posted by: Angel Mercy | Aug 29, 2008 9:28:06 PM

I, too, Mary have been a nurse for 30+ years and have many certifications. My heart is in geriatrics and I broke down in tears this week when I realized that though I no longer have my parents, God has blessed me with thousands of parents to care for. I am saddened that there are so few young nurses who truley have their heart and soul in the profession. I work with so many that see it as just a job.

Posted by: sandy | Nov 16, 2007 12:19:49 PM

Hi Mary
I concur with all the comments you have had. Your article displays a wide nursing area plus skills in which psychiatric or mental health nursing as it is called for the moment in Australia.
I have been nursing since 1966, trained in Scotland now an Australian nurse in mental health nursing and loving every minute. I have many nursing and tertiary certificates. I use them all in my daily practice with patients, relatives and many colleagues. My heart and soul are in nursing and I am very hopeful for the future and essence of nursing.

Posted by: teresa | Jul 23, 2005 2:18:55 AM

hi mary!
that was awesome!if its okei w/ you,i am presently conducting a research regarding the experiences of nurses working in the psychiatric units and i would like to ask if you can tell us some more about your experiences during your work in the psychiatric unit...

Posted by: Melagin | Jul 3, 2005 5:29:47 AM

God bless your sweet soul!

Posted by: Marie | Jun 2, 2005 9:04:51 AM

I have always had a heart for the voiceless psych pts and especially the geri patients with psych needs. Your story really had me nodding my head. It is only within the last two years that I have been working as a nurse-therapist on a geropsych team for the county. And I love what I do! Every day I look forward to going to work, to being "there" for my patients, to being the advocate they would not otherwise have. And I am so blessed to work with a team who loves our patients as much as I do, and geriatric psychiatrists who encourage us to think, to care, to be the wholistic nurses/therapists we need to be in order to help our pts maintain their mental health.

Posted by: Deb Bonne' | May 19, 2005 11:11:50 AM

I am approaching my 25th year as a psychiatric nurse and love my job as much today as I did 24 years ago. How eloquent you explain that we really are "real
nurses". In psychiatry we have to have a wide range of skills, because often times consults are not readily available and medical issues are not the focus, leaving many lives in the hands of nurses open to the possibility that anything can happen. Reading between the lines is imperative. Yes psychiatric patients have medical issues too, issues all to often overlooked because they have difficulty expressing themselves effectively. Opportunities to advocate for our patients
abound. What a wonderful way to spend a career. Caring for the walking wounded, the forgotten, the discarded, the lost. I wouldn't change a thing in my
last 24 years of nursing. How wonderful it will be to look back and say I really loved my job and never dreaded going to work one day.

Posted by: Julie Schreckengost | May 18, 2005 10:02:04 PM

Hi Mary!

I admire your courage and strength in handling psychiatric patients. I just graduated from BSN this summer, and all my classmates know that my favorite area of specialty is the National Center for Mental Health, mostly due to my jolly and kind-hearted client. Her case was quite simple...there were no signs of violence or abuse...she was just simply childish in her ways even though she was in her mid-30's. Our bonding was unique... somehow, I've always felt that if I encountered a really big problem and I was alone, I might end up in a mental institution myself. That is why I have a special place in my heart for our psychiatric clients. Most of the time, something terrible had gone wrong in their lives, and I believe that they deserve all the help and understanding we can give, because the lack thereof during their most trying of times actually led to their present condition. I have yet to take my board exams, and I still haven't decided on an area of specialty, but psychiatric nursing is one of my options. Thank you for sharing your experience. I wish you luck and may God bless your good heart. :)

Posted by: ally mc1 | May 18, 2005 8:33:53 PM

hear, hear Ms. Mary

Last week I found myself at the end of a fit from administration and an RN peer.
I had challenged (using the appropriate change of command!)a supervisor's handling of a situation with a peer.
Before I was the peers advocate, I talked with several different individuals. Only my sister said up front, if you go ahead, be aware there will be/could be retaliation.
Well, a few weeks down the road... I was fired.
All were shocked.
I am humiliated and sad. Not ot mention scared because I do not have an income.
what a way to treat staff.
No wonder young woman and men are not interested in the job. Career? not really.


Posted by: kytobond | May 18, 2005 3:44:12 PM

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