In Defense of Psychiatric Nursing: An Insider’s Perspective

Written by Kaitlyn Coleman BSN, RN

I like to say that I “fell” into being a psychiatric nurse, but I think that very few people buy into that. It is a very simplified version of the truth. When patients ask me how I ended up in the mental health field, I like to tell them I was inspired by my own brain; no one knows mental illness quite like those of us who have suffered from it.

I already knew what I wanted to do going into nursing school. I had an externship the summer before my first year, and I was completely sold on the idea of being a psychiatric nurse. I found that people had two reactions when I informed them of my desired specialty.

The first group would nod in appreciation and say something along the lines of, “it takes a special person to be a psych nurse.” Well, yeah, it takes a special person to be any kind of nurse. This group understands that while they may not have a desire to work in the mental health field, it is still important work.

The second group would either look confused or disgusted. Sometimes it was subtle- the gradual furrowing of a brow or slight upturn of the nose- but I was always sensitive to these nuances. This was a reaction unique to psychiatric nursing; no one seemed to find the idea of working with children, pregnant women, or critically ill patients offensive.

I understood that mental illness was stigmatized. I am comfortable admitting that I had to confront some of my own biases to work in this field. However, I never knew that there was stigma surrounding those who choose to work with the psychiatric patient population.

Psychiatric nurses experience this stigma from a unique perspective. We could work with any other patient population, but we still choose mental health. To many nurses, that seems like a loaded decision. Psychiatric nurses are “bound to lose their skills.” “Mental health is where nurses go to retire.” “Psych nursing isn’t real nursing.”

I have heard it all, and I am here to tell you: none of it is true.

Psychiatric nurses are experts in communication, a vital skill across all specialties; nobody can bring a patient in the midst of mania or psychosis back to equilibrium quite like we can. Oftentimes, these interactions lead to insights we can bring back to the treatment team. There are a lot of specialties where I could hone in on my hands-on skills, but no specialty schools nurses in communication quite like mental health.

I find that mental health attracts an eclectic variety of nurses. I have had the pleasure of learning from both new and seasoned nurses. Most of the older nurses have devoted their entire careers to mental health. None of us are there to retire. If I had to guess, most of us showed up hoping to help some people and found it impossible to ever leave.

I am a nurse first and a mental health professional second. As wonderful as my inter professional team is, they see each patient through a completely different lens. The nursing process is at the forefront of everything I do, my assessments taking the form of fluid conversations.

Psychiatric nursing interventions require an abundance of creativity. Not only do we have to look at each patient as an individual, but we also have to understand how their presentation impacts the milieu. Imagine how agitated a patient with overwhelming internal stimuli may feel when they are neighbors with a mania patient who is singing at the top of their lungs; it is the psychiatric nurse’s job to not only foresee this problem but to solve it.

If you still think that psychiatric nurses fall short of earning the coveted “nurse” title, I challenge you to broaden your definition of what a nurse is. The value of a nurse can be found in the impact they make on patient lives; I do not have to be delivering babies, performing CPR, or inserting IVs to make a profound difference. Think beyond saving a patient’s life- although it can be argued that we do that, too. Sometimes, it is about saving a patient’s quality of life.

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