You’re a nurse on a med-surg floor with a fresh post-op patient in one room, and report just told you the patient down the hall is a psych admit with a history nobody fully explained. If your stomach tightened reading that, this psych nurse memoir is going to feel familiar. I’m Angela Brooks, and for 25 years I worked as a psychiatric nurse in a psychiatric hospital. The Nurse’s Voice: True Stories From Behind the Locked Doors of a Psych Ward is what I saw, what I learned, and the people I will never forget.
Walking Through Nine Locked Doors to Get to Work
Every door in that building stayed locked for the patients’ safety. I went through two locked doors just to reach the time clock, then another locked door to get to the gated stairwell. The stairs went up to two gated, locked doors, and once I made it into that final gated hallway, there was one more locked door going into the unit. Each end of the unit had its own steel locked door.
Nothing in that building was quiet. The hallways and stairwells always echoed, and as you walked through, you could hear doors banging and clanging shut behind you.
From Med-Surg to Working a Psych Hallway Alone
In 1989 I was a young nurse, and looking back, I was clueless. I came from med-surg and the float team at a traditional hospital, where I was used to beepers going off and staff all around me. This hospital was different. There wasn’t a lot of staff, and for about the first five years I worked many nights on a hallway by myself. I had 15 to 20 patients, and I served their snacks and meals, passed their medications, and did all the charting, with a patient aide working beside me only every now and then.
I know now how unsafe that was, and no hospital should ever staff a unit that way. Years down the road they finally had enough people to put two licensed staff and at least two patient aides on the hall. That was ideal, because everything could be taken care of safely.
What is it really like to be a psych nurse?
Psych nursing is caring for people who are not at their best while keeping yourself and everyone else on the unit safe. Some nights you’re passing meds, serving meals, and charting like any other floor. Coming from med-surg, the biggest difference for me was how few staff there were and how much of the job was sitting down and listening.
The Hardest and Best Parts of Being a Psych Nurse
What is the hardest part of being a psych nurse?
For me, the hardest part was working alone, because at my age now I can see how dangerous that was. Right behind it was learning how to talk to someone who was not at their best, someone hearing voices in their head or caught up in legal problems they didn’t know how to handle.
What is the best part of being a psych nurse?
The best part was sitting down with people and listening to the story that brought them to that moment. No infant is born into this world saying, I want to be crazy. Nobody marries a man thinking, I don’t mind if he abuses me. Seeing people outside their diagnosis and outside what was written in the chart is what stayed with me.
A lot of the women I cared for had rough histories, years of abuse that had completely crushed them as human beings, and some had been sexually abused when they were young. Many of them turned to drugs and alcohol just to cope with what happened to them. Some could mask a really good story and really good behavior, though if you talked with them long enough, you would get bits and pieces of their real life.
For the Nurse Who Just Got a Psych Patient on Her Floor
I’m seeing a lot of new young nurses working in hospitals that have closed their psych units. Instead of being cared for in a specialized area by staff who understand how to work with someone in crisis, psych patients are now mixed in with med-surg and oncology patients who have their own illnesses and surgeries to recover from. That nurse is caring for someone fresh out of surgery in one room while the patient in the next room is trying to climb out the window. That’s a big difference in skill, and it’s a big difference in safety.
How can a med-surg nurse stay safe with a psych patient?
Be very cautious, and find out in report whether your patient has any history of aggression. If they do, protect yourself first and don’t allow yourself to get hurt. Ask for help early. Nursing is not a safe working environment when it comes to people in crisis, and your safety matters as much as your patient’s.
Violence against healthcare workers happens often enough that OSHA keeps a whole section on it, and OSHA’s guidance on workplace violence in healthcare is worth reading if your hospital is taking psych patients onto general floors.
Why I Wrote This Psych Nurse Memoir
Most of it was for me. When I started blogging, I wrote these stories down like a journal so I wouldn’t forget them, because these aren’t things you can tell just anybody. It’s not a topic that comes up when you sit and talk. There are already so many stories I can’t remember, until someone I worked with mentions something and it all comes back.
What I didn’t expect was how many people would find those stories online. Nurses, staff, and people working in the medical field kept telling me, I completely relate to this, so I kept writing. I was careful never to name the hospital, the patients, the staff, or the location, so no one could be identified in any way. This second edition has been fully rewritten, with the stories finally told the way I wanted to tell them.
Is The Nurse’s Voice a true story?
Yes. Every story in this psych nurse memoir is true and comes from my 25 years as a psychiatric nurse in a psychiatric hospital. I left out the hospital, the names, and the locations so no patient or staff member could ever be identified, but what happened on that unit really happened.
Get Your Copy of The Nurse’s Voice
The Nurse’s Voice is a psych nurse memoir available on Amazon around the world in Kindle and paperback, and it’s free to read with Kindle Unlimited. Right now it’s only in English. If you’re outside the US, search the title on your country’s Amazon.
If you’ve already read it, a short review on Amazon helps the next nurse find it. A few sentences about what stayed with you is plenty.
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Be unpolished,
Angela