My short bio: I work at mental facility in southern Virginia, which houses both civil and criminal (NGRIs) individuals from surrounding communities. I worked there four four months last year, had to quit as I left for the summer, and I just recently started working back there again. I cannot reveal any information about the individual's or anything that would violate HIPAA laws.

My Proof: My badge, (printed on paper and taped to a hard-copy badge because the badge-printer was broken at the time and we are in the process of getting a new identification system)

Comments: 177 • Responses: 56  • Date: 

KidDynamite9219 karma

why are there so few upvotes? its an awesome AMA and has a lot of potential...

psychnursetobe18 karma

Haha aww well thank you I'm glad you think so!

JustSayin8675309-10 karma

Perhaps there's an immediate turnoff when one reads your short bio and finds that HIPAA is misspelled....

psychnursetobe10 karma

My mistake?

UpVotesAllDayz17 karma

Do you feel as though sometimes an individual has been wrongly committed to your facility?

psychnursetobe33 karma

Perhaps not wrongly committed, but I do know of certain individuals that while they do actually have a mental illness, their families will file a Temporary Detention Order by making "false" accusations and have them sent back in, for no reason other than to get them off their hands for a while, (which is obviously still wrong.)

Moonreaver13 karma

Why did you guys not let me in?

psychnursetobe14 karma

In most causes I'd say keep trying...

Dabee62510 karma

Have you considered that maybe you're crazy and you're the patient and everyone else is the staff like in that book/movie?

psychnursetobe3 karma

Hahah no I'm not at that point yet. Anything's possible though.

DabuSurvivor9 karma

What do you do, exactly?

psychnursetobe9 karma

My job is actually really simple in some ways. Majority of it is just monitoring and checking on them, making sure they can all be accounted for and none of them are doing anything they shouldn't be (escaping, for example.) Since I'm so petite, I don't do much of anything that is concerned physically. I don't help with restraining or diffusing physical altercations like the big guys do. It's comparable to a CNA job minus all the dirty work. We help the nurses with whatever they need.

Run_bish_ruuun1 karma

This sounds exactly like my job as a CNA. Though, also petite, it included a TON of heavy lifting, changing diapers,etc. I worked "weekend doubles" with an unpaid 30 min break in between the two hour shifts. Sometimes, out of obligation, I worked the night shift between as well. This was in Texas and at that particular job, we had very young schizophrenic patients. I always wondered why they were there, instead of in a mental facility. Could this be due to different laws or (as I'm convinced) was that illegal or a cheaper alternative for the family/state?

psychnursetobe4 karma

I've actually noticed the same thing, vice versa. We have one individual who's either in her late 50s, early 60s with dementia. To me I feel she doesn't belong in a mental facility, but rather they should hire a personal sitter to watch her at her own home. There's been a few others like her that I felt belong in a nursing home instead.

As far as the legalities of it, I'm not too sure.

eliminator198 karma

What type of environments are patients more calm in? I am studying architecture and recently viewed different designs made for mental facilities. How are the rooms designed and how does it help the patient?

psychnursetobe9 karma

I can't personally comment on which environment I feel is most calm, but the facility I work out is an older one, maybe built in the 60s or 70s. The walls there are an ugly off-white, beige with no visual stimuli whatsoever. The rooms are the exact same.

There was an actually a meeting held there a month ago which someone mentioned possibly painting the rooms and walls in specific theme to provide a more "homey" feel, and I am 100% in favor. I think it would definitely help in calming individuals.

MasterTrollKing7 karma

How dangerous is your job? Have you ever been exposed to any life-threatening individuals?

psychnursetobe8 karma

The job can be quite dangerous, depending upon how violent certain individuals there are at the time. I know of numerous employees who've been harmed (often times by the same patient, same day) and sent out on workmans comp. Thankfully, I myself have not been injured yet, though I have had a few women swing at me, nothing too serious.

Heartfull_of_Wind7 karma

Have you ever witnessed something at your work that has made you cry or get teary eyed? If so, what?

psychnursetobe17 karma

Just last week, my two fellow female employees and I were sitting in the nurses station at the end of our shift waiting for the report to be over so we could head home. The nurses station has a huge plexiglass window so we can see and communicate with the patients outside in the unit.

We had a new patient who was very irritate, yelling at us and such when he finally called us "dumb bitches". Another somewhat new patient had been watching from a far as the man yelled at us, and once he called us that, he got up in his face to defend us, almost resorting in a fight (which was quickly broken up).

I kinda got a little teary eyed just at the fact that this individual had so much respect for us whom he hardly knows. Just goes to show that even those with a mental illness still have their morale.

NorbitGorbit6 karma

Many people in jail actually belong in mental facilities, but are there many people in mental facilities that actually belong in jail?

psychnursetobe9 karma

This one is always hard for me to answer because no matter how much of a punk or an asshole an individual might seem, I sometimes think it's not my place to say "Oh, he's not really sick, they should just throw him in jail."

However, yes, I've thought that quite a few times. Primarily with the more violent males, who as I mentioned before will pick a fight with just about anyone.

That being said, I also know of the NGRI individuals who were told to plead insanity so they could get off the hook and spend some time in a mental facility then get out (which often times ends up being longer than the time they would have spent in jail.) These people are actually the most composed and well behaved of them all.

thepimpmeister5 karma

Do crazy people do random, irrational things, or just sit around sedated like they do in movies?

psychnursetobe22 karma

It all depends on the individual. Some come in very psychotic, and yes they will act out and do "crazy" things. I've seen a lot. And after some time, be it a couple days or weeks, if the cocktail of medicines they've been given kicks in, then yes some of them do become very sedated, often the opposite of how they came in.

(I must correct you on calling them "crazy". They have a mental illness. Often times this is something you have no more control over than you would getting cancer.)

DabuSurvivor14 karma

Indeed. We stigmatize mental illness in our society to a really unfortunate extent. :[

psychnursetobe12 karma

I think it's just one of those things you can't really understand unless you witness first hand, and no one can truly understand unless they've experienced a mental illness themselves.

feldamis5 karma

Your badge! Your pretty.

psychnursetobe3 karma

That's a bad picture of me haha but thank you!

_pm_me_your_vagina_4 karma


psychnursetobe5 karma

Haha no it's not.

feldamis0 karma

Question. This may be weird.

I'm in the paranormal. And I've noticed that some of mental hospitals and asylums are active, do you think the place you work has a spirit or two hanging around.

Now I know don't what kind of practice this facility does, but has there been any deaths there or what not.

Yes I know it's kind of creepy and I love paranormal shows. Main Ghost Adventures.

psychnursetobe2 karma

Believe it or not, no I've never been creeped out or felt the presence of any spirits, and I've never heard any of my co-workers (who have been there for years) mention anything about it being haunted.

But yes, there was one death that I'm aware of that took place there. The only details I know it was that it was a male, who hung himself by a bed sheet in his closet. I'm not even sure which room it was in. But I don't think he's ever haunted us!

forest1873 karma

What are some of the, so to say, most ill people you have seen and what have they done in the institute?

psychnursetobe13 karma

It's a step-down facility, so you don't typically see things as bizarre (don't get me wrong, everything you see is still very bizarre) as you would at a higher up facility. The ones who are the most ill are typically either very violent, paranoid, or absolutely clueless.

The violent ones will pick a fight with absolutely anyone, regardless of size, gender, age, etc. The paranoid ones think most of the people around them are out to get them, they take anything people say around them and someone form it into the person talking negatively about them. Also, a lot of the time they think the government or aliens are out to get them. The clueless ones talk in what is referred to as a "word salad" and if a sentence has never been said before, they'll say it.

sassvannah3 karma


psychnursetobe6 karma

I do often wonder now a lot if strangers I encounter have a mental illness. I pay more close attention to how people carry themselves and how they interact with others. I'm also much more careful with how I talk and interact with others, taking their feelings and emotions into a much higher consideration.

adventurepony2 karma

With that said, what visual cues alert you that a person might have a mental illness?

psychnursetobe2 karma

The biggest ones would probably be a disheveled look paired with poor hygiene, talking in circles or in a "word salad" and sometimes a person's "natural" facial expression can almost lead you to believe they could be mentally ill (such as looking lost or frantic).

Not that I would automatically assume someone has a mental illness by any of these, this is just a "trend" I guess you would say I have noticed though.

j_one_k3 karma

Have you read The Devil in Silver? It has a lot of mental facility abuse, and it seems like the author did a lot of research to make it realistic instead of "sadist doctors torture everyone for no reason".

Have you seen any of the things it describes?:

  1. Police using commitment as a way of punishing annoying arrests
  2. Patients punished for choosing not to take their medication by withholding food
  3. Patients restrained for longer than regulation

psychnursetobe2 karma

No I haven't read it but it definitely sounds like a good read! I might have to check it out. But no at our facility, we do our absolute best to make sure we are not manipulating our patients to get them to do what they should. Patients do have their own rights, and they are informed of them once they are admitted. They have the right to refuse their medicine, and we do not seek ways to punish them. And as far as restraints, that's always considered a final resort.

UnseenAseen3 karma

I have personally spent time in one of those facilities and was outraged by the prescription habits of the doctors, such as giving adult dosages to the fellow teens that were in with me or blatantly prescribing medications that would cause the "zombie" effect as we called it. What do you think of these habits in doctors that work at these hospitals?

psychnursetobe2 karma

Of course I don't like some of the side effects a patient has to endure from certain medications, but it's kind of liking trading off even worse side effects they had before. Naturally you'd rather see someone being dormant instead of violent. Apathetic instead of a suicidal/homocidal. This is usually only at first you see this happening because the doctors and nurses are trying to find the perfect median with the cocktail of prescription meds.

Greathunter5123 karma

How were your grades in highschool? How big of a impact did your grades account towards your medical career ?

Should I take some special classes for this field. Psychology also interests me!

Edit- I'm 16 and a sophomore

psychnursetobe2 karma

Honestly, the position I have at this institution requires nothing more than a high school diploma. A lot of what I do is just common sense. Physically and task wise, overall it's a pretty easy job. It's just a job that requires much patience, common sense and social skills.

Good luck in what ever you pursue! Anything in the social/medical fields is so rewarding.

dude2132 karma

have you ever fell for a patient?

psychnursetobe3 karma

Definitely not.

kewkiez71 karma

Wtf lol

psychnursetobe3 karma

For starters, that's a huge violation of the policy.

blueangora2 karma

What made you choose to work there?

psychnursetobe10 karma

Well for starters, I knew it would be great experience for my nursing career (starting nursing school in the fall). And I've always had a love for psychology, it's so interesting to me.

I love my job. It's always something new, every day. I've never been bored there. The patients there are so much more than their illnesses, they truly make me laugh and smile on a daily basis. Once they get stable on their medication, they often times have no trace of mental illness. It's a very rewarding job, to see them go from one of the lowest points in their lives and working towards being (and actually getting) well again.

AutoBond2 karma

I'm sorry, but I had to upvote you. You're AMA was right next to one about Ballerinas. And it just seemed so... wrong.

psychnursetobe2 karma

I'll take it nonetheless.

KidDynamite922 karma

  1. what do you think about medical/recreational use of cannabis?
  2. any scary ass hannibal-type cannibals? :D

psychnursetobe10 karma

  1. Before I worked here, I saw no problem at all with cannabis. Still, I personally have no problem with it. But yes it is true, smoking weed or the use of any mind-altering drug can either worsen, heighten or bring out psychosis in an individual. I've had patients personally tell me about the negative experiences they've had with cannabis, primarily hallucinations and paranoia.

  2. As far as I've been there, I've never known of an cannibals. I've heard of very violent crimes, but no cannibalism (yet.)

pumpmar2 karma

do you feel like failed suicide victims deserve whatever pain they're in and deserve no compassion? also, why do they put violent patients in with the non violent patients? why aren't we allowed to call our family, or anyone, at the hospital? or have magazines, music, or any media? i feel like they're more interested in punishing us than making us better. not having access to our families or being able to read or listen to music and having to watch our backs isn't going to make us better. writing this is bringing up alot of shitty memories. i'm off to r/aww.

psychnursetobe4 karma

I don't believe anyone deserves to go through any type of mental pain of illness. But at this facility, they are allowed to have visitors and call their family members throughout the day. As they progress they gain more privileges, and are allowed to have media items such as an MP3 player. I'm very sorry for whatever you experienced at your facility. I hope you're doing much better now.

pumpmar3 karma

you say gain more privileges as if they should be taken away in the first place.

psychnursetobe2 karma

If they are violent or suicidal, then yes.

pumpmar2 karma

violent i get. but what about suicide deserves punishment? its a symptom of a disease not a crime.

psychnursetobe3 karma

You're mistaken. We don't take away their right to watch television or shower. More so as in they can't have a belt or shoe laces until they proven they are well enough that they won't take advantage of such items and try to harm themselves. It's to protect them, not punish them.

destiriser1 karma

But why mp3 players? They won't harm anyone with a mp3 player, especially non-violent patients.

psychnursetobe1 karma

They're allowed to have MP3 players.

wolfmuffin-2 karma

This begs the question of whether cutting off contact with their family is ever even slightly appropriate or ethical.

psychnursetobe4 karma

It's not. Which is why we do not do that.

notlibvalance1 karma

Do you ever deal with teens? If so how many are just misunderstood by their parents and how many actually need help?

psychnursetobe1 karma

No, the youngest we accept is 18 (which I know is still considered a teenager) but not the younger adolescents I feel you are asking about.

SuperBandGeek971 karma

What age group do you usually work with?

psychnursetobe1 karma

You have to be at least 18 to be admitted and no older than 64. Usually see people in their 30s or 40s.

deadheadmike1 karma

What's the craziest shit you ever saw?

BrianSRT81 karma

I've seen patients throw themselves through glass windows to try to attack their nurse.

psychnursetobe1 karma

Same. A certain individual broke the glass windows of both nurses stations, one day apart.

Vroni21 karma

How does therapy work in a mental institution? Do therapists have shifts?

Is there anyone in your mental institution who is there for other reasons?

psychnursetobe1 karma

The doctors are typically there from like 8-5 Monday-Friday, and often on call during the night or on weekends. The only ones who are there 24/7 are nurses and the DSAs (which is what my position is, the aides).

And what exactly do you mean by "other reasons"?

PyjamaTime1 karma

Um is 'mental' an acceptable term?

psychnursetobe6 karma

Basically you shouldn't identify someone by their mental illness. They HAVE the mental illness, they're aren't the illness themselves. You wouldn't call someone "Cancer" simply because they have it.

becomingelite1 karma

Have you known anyone who's made a full recovery from their mental illness?

psychnursetobe1 karma

I think it all depends on what you mean by "full recovery". It's definitely possible and in fact very common for these individuals to go from rock bottom to being extremely successful in their lives, that is once they stabilize on their medications and CONTINUE to take them. We even have a woman and her husband who were once patients of this facility (which is where they met) and are now full time employees who are doing extremely well and help in rehabilitating our current individuals.

But odds are, once you have a mental illness you are kind of "stuck with it" for a lack of a better term. They typically do not fully recover in the sense that the illness will just suddenly go away and them no longer needing their medications.

Mercinary9091 karma

A bit late but What is the worst act committed by a patient to get them sent there. Also curios as to the sanest patient.

psychnursetobe2 karma

On the forensic side, many of then have committed murders. On the civil side, many of them have just experienced a psychotic episode and they are sent in when they are at risk for harming themselves or others.

evilteddybear1111 karma

Is the facility in any way similar to how the mental facilities are depicted in movies? Like are people not allowed to leave until a certain amount of months etc?

psychnursetobe1 karma

To a certain extent, yes it's quite similar. It all depends on how the patient progresses or if they regress.

There's two sides, the civil side (patients coming directly from the community) and the Forensic side (which holds NGRIS, those who have committed a crime but plead insanity). On the forensic side, most patients will be there for years. On the civil side (which is the side I work), patients are typically there for just months. There are, however, a few patients who have been on the civil side for years. One has been in since the early 2000s.

permacathman1 karma

what is the most potent medication given to patients when they are getting too rowdy?

psychnursetobe2 karma

I'm not too familiar with the medications because that's something the nurses and doctors handle, but I do believe I've heard of Thorazine being given PRN (as needed) for when a patients starts to act up.

JuantheTacoFairy1 karma

Do the patients talk to you often? Are any of them actually enjoyable to have a conversation with?

psychnursetobe5 karma

Oh of course! I'd say about 90-95% are can easily carry on a conversation. And majority of those are able to carry on a normal conversation (once they've stabilized on their medications), the others can't carry on functional conversations but are still hilarious to converse with. The rest of them (very few) are either too shy or withdrawn to talk.

You get to know them very well and form very special (while still therapeutically appropriate) relationships with them. I adore these individuals, you get to know then beyond their illnesses and actually see who they are as people. Makes me love my job so much more.

gallifreylives1 karma

My mom is a nurse, and when I was a kid she worked briefly at a psychiatric hospital. One time, this schizophrenic, bipolar manic woman grabbed my mom by the hair and dragged her down the hall. It took 3 body guards to get her to release my mom, and she ended up with chunks of hair ripped from her scalp and whip lash, lol. What's the craziest thing to happen to you while working in a mental health facility?

psychnursetobe3 karma

Wow I couldn't imagine that happening to me! What field is she working in now, if you don't mind me asking?

Luckily I've never had anything violent happen towards me. I don't think I've been there long enough, though I do get scared quite often that eventually I'll have to have my "turn" and I'm just waiting to be bitch slapped one day.

Orangepotato1 karma

Have you ever identified with any of the patients in the facility you work for?

psychnursetobe2 karma

I can't say I "identify" with them, but for the most part as you begin to socialize with them and get to know them on a deeper level past their illness, you do start to empathize with them in their sickness and you want to see then get as well as you would want to get yourself if you were sick.

Swarleymon1 karma

Have you ever been physically attacked ( or seen a coworker attacked) or had something thrown at you?

I only ask because I work in nursing homes and have seen a lot of shit happen. Also I've been hit, punched, kicked, choked, and had feces thrown at me. I would assume people actually in a facility like that might be a little worse or maybe even the same who knows.

psychnursetobe1 karma

I've never been personally attacked, but yes it's not uncommon to be injured while at work here.

thejamjam1 karma

If I admitted myself into that hospital, would I be able to get out?

psychnursetobe1 karma

No, the facility isn't a "check in or out as you please" kinda of institute. Here, you have to be reviewed by a community services board or a physician at the ER to decide if you need to be admitted. And the same as with you leaving, the doctors, nurses and social workers of the facility will determine when you are well enough to leave.

BrianSRT81 karma

I work as a security officer at a similar facility. Although I am posted on more of a forensic unit, I am often working with both civil and criminal patients. I applaud you for starting an AMA here! I know what you've been through!

psychnursetobe1 karma

Well thank you! And same goes to you!

SDStormtrooper1 karma

Tell us about some success stories!

psychnursetobe1 karma

A lot of them!

Many of these individuals will come in either completely violent, in another world, or just so deep in their psychosis or depression you almost feel they're helpless. But after perfecting the mix of medications, combined with supportive therapy and groups, they become unrecognizable from the person who they were when they were first admitted.

However, unfortunately, many of them will begin to stop taking their medications after a certain period of time, and will be re-admitted multiple times after their first stay.

prancingElephant1 karma

I have OCD, and I was wondering, have you ever seen someone committed for severe OCD? If so, what were they like, how were they treated, and how'd they end up?

psychnursetobe1 karma

I can't say that I've ever seen anyone come through with OCD.

OreoObserver1 karma

How long are the patients usually isolated in a day?

psychnursetobe1 karma

The patients are never isolated, unless they've been put into seclusion (a room where they are put in if they've been acting out violently).

OreoObserver1 karma

So are they in units with other patients?

psychnursetobe1 karma

Yes, there are two sides with two units each. Forensics has two units, civil side has a male and a female unit. The patients also share a room with one another (2 in one room).

Seungtaek1 karma

You ever watch a movie called Session nine?

psychnursetobe1 karma

No I haven't! What's it about?

brennan3131 karma

What is the craziest thing you've witnessed so far?

psychnursetobe2 karma

Nothing super huge crazy yet, but it's always the little things on a daily basis that crack me up. Like finding a deck of cards in a man's Depends.

DivinePrince1 karma

Do you keep the dangerous individuals away from the non-dangerous individuals? My mom was in a ward once, someone tried to light the elevator on fire while she was still in it. And is one of the reasons why I fear mental wards. In fact, my very own psychiatrist told me not to go to a psychiatric ward because they can keep you in there forever if they want to- and my psychiatrist wouldn't have enough authority to get me out. Scary shit. I will never go to a ward no matter how bad I ever felt. Never.

psychnursetobe1 karma

Unfortunately, unless a dangerous individual goes off and needs to be secluded, all females will be on one unit and the same goes with the males. However, if we have an open room with both beds being empty, then we would most likely move an irritable individual to that room so they can be in there by themselves.

NateJC0 karma

I've seen a few movies that broached on the whole topic of rape in mental facilities, such as Halloween and Kill Bill (In a hospital). Do you believe this ever went on?

psychnursetobe1 karma

At the facility I work at, no I don't believe that has ever happened. I am aware of a few staff members (who were employed and terminated long before I began working there) who pursued relationships with some of the patients, which could technically be considered rape as sometimes a mentally ill individual cannot legally consent.

The more brutal rapes and such probably would've taken place during the 50s or so, back when mentally ill patients were regarded as monsters and were mistreated horribly in such facilities.

AnarchyBurger101-1 karma


psychnursetobe2 karma

That's a good question! Wish I knew how to answer.