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Traveling psych nurses | |||
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For psychiatric nurses with a subspecialty in adult care, travel opportunities exist throughout the country. Yet, those who broaden their sights and work closely with recruiters will realize more options. Over the past 125 years, psychiatric nursing in the U.S. has progressed vastly. Until the 1880s, formal training in this area of expertise wasn't even an option. But today, nurses who specialize in psychiatric care may choose to become certified in a number of subspecialties, from substance abuse to consult/liaison. Highly focused, the adult mental health subspecialty offers diverse opportunities. For example, geropsychiatry is on the rise because the Baby Boomer generation is aging, and crisis stabilization is an area in which nurses provide brief mental health intervention to needy individuals in licensed, state-run facilities. Here, two mobile psych nurses and a company representative share their expertise and discuss how you may expand your alternatives when accepting assignments in adult mental health. No challenge too big, no patient too sick Gwen Beyer, BSN, RN, has spent nearly 6 years caring for adults on crisis stabilization units (CSUs). A psych nurse traveler for slightly over a year, she has fulfilled contracts in Juneau, Alaska; the Triangle area of North Carolina; and Gross Pointe Farms, Michigan. At the moment, she is on assignment at the 411-bed Foote Hospital in Jackson, Michigan, through MedStaff Healthcare Solutions, based in Newtown Square, Pennsylvania. "I am fortunate enough to have been raised in a family that encouraged global curiosity," she says. "Each time I travel to a different location, I think it's wonderful that I enter a whole new cultural zone." Gwen selected her current locale because she grew up in the Ann Arbor area and wanted to spend time with her mom and stepfather who continue to live there. When Gwen was a nursing student performing psych rotations, her mentor was a medical director with an intense enthusiasm for his practice. "His passion for psychiatric care was palpable," she states. "His influence prompted me to specialize in psychiatric nursing." Today, Gwen achieves the greatest job satisfaction from treating patients who suffer the most severe states of psychosis. "I feel rewarded when someone admitted in a full-blown crisis becomes stabilized and is able to make it on his or her own." Gwen encountered one of her most memorable patients, a woman diagnosed with generalized anxiety disorder, early in her career. The patient underwent benzodiazepine detoxification. "Benzo detox is unpredictable and takes a long time to clear from the body," she explains. "Week after week, I was amazed by how differently she behaved from hour to hour." Unlike most patients in CSUs, whose length of stay is about 4 days, the woman remained for over 3 weeks. More recently, Gwen treated a patient who hallucinated that each night her home was invaded and she was given injections of insulin all over her body. "She was extremely paranoid and slept in her shower stall, wrapped in a shower curtain." For Gwen, it's these desperately ill patients who make psychiatric nursing an interesting career. "They're admitted at their most dysfunctional level," she says. "I enjoy helping them reach a point where their paranoid delusions become further apart." Teaching patients to recognize their condition and manage it on their own with medication and self-awareness is a primary function of Gwen's job. "Being nonjudgmental and able to appreciate the creativeness of the human mind are important elements of your practice. It is truly amazing to see where the human mind can go." How does Gwen believe adult mental health care will progress within the next 5 years? "Geropsych will grow by leaps and bounds," she predicts. A Baby Boomer herself, Gwen is already providing care to geriatric patients born at the start of the Baby Boom Era who are beginning to develop dementia. One challenge she has noticed during her time on the road is a lack of nationwide funding for mental health. Many facilities are moving away from subspecialties and generalizing adult mental health. For instance, rather than designating a unit for chemical dependency, a hospital may merge this type of care into its general adult care units. To overcome such challenges, Gwen recommends psych nurse travelers be flexible. "Balance your life in a new working environment with your life in a new neighborhood." Always active in her assignment locales, Gwen explores her temporary communities and gets involved. Applying psychiatric skills each day Kathy Csonka-Lewis, RN, fell in love with psychiatric nursing her first day on the job. Currently fulfilling a contract for Jacksonville Beach, Florida-based PPR Healthcare Staffing, she has 13 years of nursing experience and has subspecialized in geropsych for 2 years. "The first nursing opportunity I accepted was in psych," she recalls. "I immediately loved it." She understands that anybody at anytime can have a situational crisis. Kathy also understands that psych patients often lack the coping skills to deal with difficult circumstances. "I have empathy for my patients and the structure required to help them," she says. "So, I do my best to deliver quality care." Kathy truly shines when she is given the freedom to develop her own therapeutic practices. A traveling psych nurse for a total of 7 years, she fondly recounts when she was on assignment at the 371-bed Euclid Hospital in Cleveland, Ohio. "Every night, we had a ritual to calm down the geriatric patients before bedtime," she recalls. "I brought in a CD by The Mills Brothers and made peanut butter and jelly sandwiches. The patients would snack and then dance to the music, which really opened a door for them. They would talk about their memories from the 1930s and 1940s." Most of her patients were suffering from Alzheimer's disease, plus secondary infections. "Something like a urinary tract infection can make Alzheimer's much worse." A patient Kathy treated at Dorchester General Hospital in Cambridge, Maryland, exemplifies the severity of secondary infections for geriatric patients. The gentleman, in his mid-60s, was found wandering in the facility's parking lot, which sits directly on the Choptank River. "He obviously had dementia," says Kathy. "But it was as if he had amnesia because he had no idea where he was or how he got there." After his secondary infection was stabilized and he returned to his baseline, the staff discovered that the patient—an avid sailor—had been living at home independently, but with some confusion. "One day, he boarded his boat and sailed from a nearby community to Cambridge," relates Kathy. "We spent 2 months trying to identify him. Each day, I would greet him and ask, 'Can you tell me where you're from?' He would reply, 'No, I don't remember.'" Kathy appreciates opportunities to provide one-on-one counseling to her patients, but says reserving time to work with them individually is difficult on bigger units. Another challenge Kathy notes is treating drug users, who are sometimes admitted to adult mental health units and diagnosed as suicidal, but are not truly mental health patients. "To be a successful psych nurse, you must be emotionally balanced so you can handle your patient load in a professional manner. And today, many hospitals are merging their units. In the next few years, I think we'll see a trend of more outpatient clinics and more home monitoring aimed at stabilizing patients to prevent hospitalization." Presently taking a break from psychiatric nursing, Kathy is fulfilling an assignment on the oncology unit at the 304-bed Memorial Medical Center in Modesto, California. "I still practice psych nursing every day with my medical patients," she states. "It's just not classified as psych. But no matter the kind of patients you work with—orthopedic, ICU, or surgical—they're all sick and concerned. So, take your baseline psychiatric knowledge and use it." Kathy credits her mobile career with exposing her to various treatments and different group and individual therapies. "Everywhere I go, I pick up new skills to take with me to my next assignment." Kathy, who describes the travel lifestyle like being on vacation for 13 weeks at a time, is currently working toward her bachelor's degree. "I want to earn my Master's degree so, one day, I can teach psychiatric nursing." Fostering relationships Maryann Thomas, BSN, RN, is the nursing division manager for TeamStaff Rx, located in Clearwater, Florida. She has noticed that many of the nurses she places on assignments are mature and in the second phase of their careers. "As their profession has grown," she observes, "they've developed a greater interest in the psychological and social aspects of nursing." She notes that more contracts are available in states that have established psychiatric programs. "It seems like the Northeast has a very strong professional population devoted to psychiatric nursing," says Maryann. "Southwest and western areas like Arizona, Colorado, and New Mexico also have more psychiatric institutions than the Southeast and a higher concentration of opportunities for travelers." As members of society age and live longer, Maryann has noticed a rise in geropsych and adult mental health travel nursing positions. "We're seeing increasing incidents of senility and Alzheimer's, so psych nurses should be prepared to deal with families and end of life issues, too," she advises. "As our median population age increases, acute care facilities will be affected and may soon require specialized units to care for geriatric patients. Any nurse who cross-trains to take care of both the medical and psychiatric implications of geriatric conditions will be well equipped to find travel assignments." Maryann describes the ideal mobile nurse candidate as being experienced in multiple psychiatric settings—such as acute locked units and medical/psychiatric combinations. Also, continuing education opportunities exist in geropsych, adolescent psych, and psychiatric medicine, and independent companies now offer certification in these subspecialties. "An increasing number of psych nurses who present profiles to me have earned certifications prior to looking into healthcare travel," says Maryann. "Because psych nursing is so specialized, I suggest travelers do their research on different facilities and treatment regimens to ensure their clinical skills are a good fit." Maryann has noticed a 50/50 split in the number of psych nurse travelers who hit the road solo, and those who are married and travel with their spouses. "We've even placed teams of psych nurses at facilities, and we've placed partners who met on assignments and became travel buddies," she states. "Psych nursing displays a high level of camaraderie, and our company fosters such relationships." How can you increase your placement potential on the road? "Flexibility is truly key," says Maryann. "The more receptive you are to different shifts, the more hours you'll pick up. And, the more open you are to floating to different clinical areas, the more opportunities you'll find." Opportunities abound As the shortage continues to intensify and the number of patients with adult mental health needs increases, the demand for clinicians who subspecialize in this area will lead to an array of travel opportunities. Whether you are a psych nurse considering the mobile lifestyle or looking to pursue a subspecialty, think about practicing in adult mental health. You may find the skills you already implement in your patient care are well suited for a mobile future. |
