Charge Nurse on a Psychiatric Intensive Care Unit (PICU)
We have spoken with Ben elsewhere on this site (see what he said about RMN Nurse Jobs
. So we thank him for his time again!What’s your job title, and in what kind of mental health institution do you work?
I’m a qualified RMN, working as a Senior Staff Nurse in a PICU (Psychiatric Intensive Care Unit).Is there such a thing as a typical day... Can you briefly describe how a day might pan out for an RMN doing this job?
One of the 'perks' of my job is that there is not a typical day. With ten patients and their myriad needs, ward rounds, documentation to attend to, staff to meet with and a team to manage one day can vary greatly from the next. For those who may not know, can you explain when a mental health nurse may need to restrain a patient, and what skills are needed?
For many reasons patients can become agitated and/or aggressive and therefore compromise the safety of both the ward and themselves.In such instances staff may have to immediately 'lay hands' on a patient or, if there is time to forward-plan, assemble a PMVA team (Prevention and Management of Violence and Aggression) to approach the patient and restrain in order to either de-escalate or remove to a place of safety and low stimulous. Such a team are also assembled to assist in the safe administration of medication should a patient’s presentation require it. So that we’re under no misunderstanding, can you paint a general picture of what an RMN is required to do if it’s clear a patient is about to harm themselves or others?
Again, a PMVA team would normally engage with the mental health patient or, should the patient prove unmanageable, nursing staff may require the assistance of the police. How big a part of your job does therapeutic care take?
A good question. The PICU is often the first point of contact for many mental health patients with in-patient acute care. As such, it is often the role of the PICU team to ensure 'stabilisation' of the patients mental health before further treatments, or therapies, can be offered. However, this work in itself is also regarded as part of the wider therapy process. Is it possible for an RMN to build up good relationships with patients with mental disorders? And is this seen as unprofessional, or is it encouraged?
A healthy, boundaried therapuetic relationship is essential to promote recovery. The manner in which this is 'dispensed' is varied and individual to each nurse.Given what you’ve said, what personal skills should someone be sure they have before considering working in a secure psychiatric intensive care unit?
Good communication skills, an understanding of medication, an ability to work within a varied and multidisciplinarary team, an understanding of mental health law, a sense of humour and common sense. Of course, it’s important to ensure that proper procedure and best practice is followed, but is there a tendency in the NHS to over-report – and if so, how could this time be better spent?
All staff are of course obliged to adhere to mental health law and the policies and proceedures of their NHS Trust and, of course, the responsibilities to their professional body.Documentation goes hand in hand with the more 'hands on' elements of nursing but, to answer the question, I would imagine many nurses would like to spend more time with patients rather than attending to paperwork.What do you enjoy about your job as an RMN on a PICU?
The responsibilities of being a qualified practitioner, the variety each day can bring and believing that I'm part of a wider team helping to make our patients lives a little better.Finally, your’s is not a typical job, or one that many of us can conceive dealing with on a day-to-day basis. How do you unwind from a day on a PICU ward?
The usual - trying to not think about the job too much, friends, sport and a subscription to Viz. My partner’s also a nurse and she and I do our best not to talk shop too much...