Hopefully going to be a psychiatric aide this summer, tips?

[loveoforganic]

Couldn't think of a better place to stick this thread. At any rate, I've taken basic abnormal psych, read the job description, etc. I was looking to see if any of you might have some tidbits of advice you'd be willing to pass along.

Thanks

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[whopper]

Abnormal psychology was one of the classes that made my mind that I wanted to be a psychiatrist. (You didn't happen to take it at Rutgers did you with Dr. Atwood did you?)

It'd depend on what type of psychiatry? inpatient, outpatient?

 

[kugel]

That was the job that convinced me to give up on my plan for a career in experimental psych and go to medical school.

From my own experience:
- Be decent, respectful and professional with EVERY pt, no matter how difficult. It's not your job to teach them manners. "Sticks and stones may break my bones, but names will never hurt me." I've been told to do many things that are probably not anatomically possible, but it never ruined my day. The strongest response that ever did me any good was, "I haven't cursed or yelled at you, so there's no reason to do that to me. I'll do my best to make sure you get good care whether you yell or not." Verbal attacks generally have nothing to do with you personally. You just happen to be the one in front of them. They're generally angry, agitated, abusive because of their own suffering. It's just NOT about you.
- Remember, it's a treatment "team" and much of your job will be to support the nursing staff and to execute the "treatment plan" developed for each patient. Think about how you can help others do their jobs, and how you can help promote the treatment plan.
- Avoid the strong temptation to start thinking, "all (s)he needs is...." There's a very good chance you don't know as much about the pt and his/her background as you think you do and that your life experience does not apply to the pt's situation as much as you think it does.
- Physical intervention (hands-on) is the LAST resort. Learn all you can about different techniques to de-escalate patients and everything about how to avoid getting yourself into a situation that requires physical intervention to get you out.
- Avoid the temptation to think, "This is stupid. We just need to MAKE him go." As long as no one is getting hurt, you have TIME to find a way out of having this situation become physical.
- During any sort of crisis, only ONE person at a time talks with the pt. Avoid the temptation to chime in and "convince" the pt. with your two cents. More than one person talking only confuses the situation, diverts the pt's attention from what the team leader wants, and increases the pt's stimulation (a bad thing during a crisis).
- Find a mentor who can show you the ropes, help you understand the policies and procedures, can help you learn from situations that don't go as well as they could have, and who can help you vent and understand your own frustrations and irritations when they come up. Look for someone who's been doing this for a long time, seems to enjoy the job, is respected by others, and does NOT complain about everyone/everything.

Hope some of that helps.

 

[loveoforganic]

Whopper -

1) Primarily inpatient, but there is an intensive outpatient unit. There's an adult unit and a youth (7-17) unit, which are both for general severe mental illness, as well as an adolescent (13-17) unit that deals only with co-occurring developmental/learning disorder and serious psychiatric disorder.

2) No, I don't attend Rutgers, but I did have a very interesting abnormal professor whose research focuses on antisocial/CD adolescents, which happens to be a major area of my interest also.


Kugel - Awesome reply, EXACTLY the advice I was looking for! Thanks a mil, I hope to have a similar experience to yours.

 

[EFesta77]

Abnormal psychology was one of the classes that made my mind that I wanted to be a psychiatrist. (You didn't happen to take it at Rutgers did you with Dr. Atwood did you?)

It'd depend on what type of psychiatry? inpatient, outpatient?

Ha, I took it at RU with Dr. Atwood. Amazing course.

 

[whopper]

Funny because Atwood had an anti-psychiatry slant. In fact made all of us read Toxic Psychiatry. However he was still a great teacher. When I was Chief at UMDNJ, I tried to get him to give a grand rounds, and he never responded to my calls or emails.

If you are doing inpatient-the only thing I can suggest that Kugel didn't mention is make sure you are safe. Inpatients-usually more so in an involuntary unit can get violent. Make sure you have some gist of the regulations the staff do should a violent episode occur.

Don't take my statement in a bad way. Violence is rare, and when they did happen, usually no one got hurt.

 

[lastcall]

That was the job that convinced me to give up on my plan for a career in experimental psych and go to medical school.

From my own experience:
- Be decent, respectful and professional with EVERY pt, no matter how difficult. It's not your job to teach them manners. "Sticks and stones may break my bones, but names will never hurt me." I've been told to do many things that are probably not anatomically possible, but it never ruined my day. The strongest response that ever did me any good was, "I haven't cursed or yelled at you, so there's no reason to do that to me. I'll do my best to make sure you get good care whether you yell or not." Verbal attacks generally have nothing to do with you personally. You just happen to be the one in front of them. They're generally angry, agitated, abusive because of their own suffering. It's just NOT about you.
- Remember, it's a treatment "team" and much of your job will be to support the nursing staff and to execute the "treatment plan" developed for each patient. Think about how you can help others do their jobs, and how you can help promote the treatment plan.
- Avoid the strong temptation to start thinking, "all (s)he needs is...." There's a very good chance you don't know as much about the pt and his/her background as you think you do and that your life experience does not apply to the pt's situation as much as you think it does.
- Physical intervention (hands-on) is the LAST resort. Learn all you can about different techniques to de-escalate patients and everything about how to avoid getting yourself into a situation that requires physical intervention to get you out.
- Avoid the temptation to think, "This is stupid. We just need to MAKE him go." As long as no one is getting hurt, you have TIME to find a way out of having this situation become physical.
- During any sort of crisis, only ONE person at a time talks with the pt. Avoid the temptation to chime in and "convince" the pt. with your two cents. More than one person talking only confuses the situation, diverts the pt's attention from what the team leader wants, and increases the pt's stimulation (a bad thing during a crisis).
- Find a mentor who can show you the ropes, help you understand the policies and procedures, can help you learn from situations that don't go as well as they could have, and who can help you vent and understand your own frustrations and irritations when they come up. Look for someone who's been doing this for a long time, seems to enjoy the job, is respected by others, and does NOT complain about everyone/everything.

Hope some of that helps.

Excellent advice. I wish someone had told me all of the above and more a few years ago.

 

[silas2642]

Couldn't think of a better place to stick this thread. At any rate, I've taken basic abnormal psych, read the job description, etc. I was looking to see if any of you might have some tidbits of advice you'd be willing to pass along.

Thanks

As a prior psych tech, I would tell you to be very careful with the axis II pts and the axis II staff (psychiatry tends to draw a crowd). Boundaries, boundaries, boundaries. These are people who can illicit extremely strong feelings in you for reasons you can't even really explain-- they are your best friend one moment and then your worst enemy the next.

But understand that people with cluster B personality diagnoses, particularly borderline personality disorder, which you will encounter a ton on the wards, have a lot of pain in their lives and struggle with this on a daily basis-- you kind of have to empathize with this. They are just very frustrating to work with and difficult to understand sometimes.

 

[loveoforganic]

Thanks for the advice guys - all noted and helpful. Sorry for the delayed reply - finals week.