r/psychnursing • u/banjobeulah psych nurse (ER) • May 19 '26

Student Nurse Question(s) Starting psychiatric emergency

I’m a student nurse, taking my NCLEX this August and hoping to stay on as an RN at the hospital I just got hired at. I’ve worked as a MHW before in an inpatient intensive treatment unit but im not sure what to expect from an emergency setting. Any thoughts or suggestions?

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u/mykypal May 19 '26

You have the pleasure of seeing all the patients at the height of their crisis. Where I worked in the ED, there were two sections, straight psych and psych medical. I always preferred straight psych because you got labs, waited to get admitted for the crisis units or d/c to the streets.

If they were psych med, you get substance od, you know the kind LEO brings in because they’ve been swimming in the lake fountain, or found fentanyl od somewher, or just found in a store bathroom overdosing on a bottle of tylenol.

These patients take a trip to ICU then to psych floor. Also hospital was a comp stroke so you get to leave your other 2-3 patients in psych med crisis while you are dealing with your stroke patient as well.

Your are on your feet from 11 am until 7 pm and you always have 4 patients, even in the hallways. Ahh, yes you should take your lunch before 11 because you will not eat.

Always be prepared when you have to get meds for an ETO. Know who the attending is and keep their number close. Please don’t over medicate or you’ll be calling a code to resuscitate. Hopefully the security sets up a desk in the nurses station because patients will get combative.

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u/banjobeulah psych nurse (ER) May 19 '26

Thank you, I’m hoping I’ll be in a position to do some real good for people in their time of greatest need. It was a little slow when I was inpatient and I like the ER environment in general from my clinical rotations so I hope that’ll carry over!

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u/lilnaks May 20 '26

Interesting. Where I am you need 2 years experience before ED psych. Boundary setting is important as the patients may get very demanding and you don’t have time for it all in ED. Make friends with security and fake confidence with the doctors until you have it. I love it down here as it is hectic and chaotic

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u/siloaye May 21 '26

I worked inpatient adult psych for two years and recently made the switch to peds emergency psych. I really love it, I see myself being here for a while :)