Have you ever wondered what it’s like to work with psychiatric patients?
Surely, it’s not like many movies and television shows have portrayed. Not even close.
To get more information about becoming a psychiatric nurse, we interviewed Jessica Martinez, RN, a Behavioral Health Registered Nurse working on CareRev’s platform at Bergen New Bridge Medical Center in Paramus, New Jersey.
What follows is our interview, edited for length and clarity.
Jessica Martinez, RN, is a Behavioral Health Registered Nurse at Bergen New Bridge Medical Center in Paramus, New Jersey
How did you get interested in working as a psychiatric nurse? What drew you to it? How long have you been doing it?
My mentor from nursing school was a psychiatric nurse instructor, and she told me she thought I should try it. She helped me get my first job.
I fell in love with it after working as a psychiatric nurse. That was in 2019, and I still really love this area of medicine.
Briefly explain what you do as a psychiatric nurse. What types of patients do you serve—what ages and how are they approved to be in the program? What do you provide for them?
As a psychiatric nurse, I assist patients from ages five to 105 with a mental health diagnosis who have been admitted to the hospital.
I ensure patients and staff stay safe, and a big part of the job is administering medications so patients can return to their daily lives. I work with patients to help reduce the stigma of their mental health challenges and help them understand it is a chronic condition that can be treated.
Some of my patients–once they start their medication and begin to feel better–think they don’t need their meds anymore. As a result, I work with patients in a group therapy setting to help them understand they have a diagnosis and that the best way to deal with it is to follow the doctor’s orders.
Did you need to get additional education to become a psychiatric nurse?
I earned an associate degree in 2018 and a bachelor’s degree in 2022, and I’m currently pursuing a master’s degree.
You can do this job with an associate degree, but a bachelor’s is preferred.
What do you like most about working in your job?
My favorite part is seeing patients get better and feel more like themselves. I work with patients to help them develop new routines for improved health and wellness. When a patient is ready to go home, that is the best feeling in the world.
I work in the hospital through CareRev, a technology platform that allows me to maintain my schedule based on what is going on in my life. I can build my work schedule around my life, not the other way around. This has helped balance my work and personal lives, pays well enough for me to travel, and allows me time to schedule a break when needed.
What are your biggest challenges?
Sometimes, patients are frustrated, but we work hard to ensure everyone navigates to a healthy outcome.
What are your greatest rewards in your work?
The biggest reward is working directly with patients and knowing that every day is different. I’m constantly learning and growing in my role.
Is there anything else that is important for our readers to know?
Nursing has changed a lot. I work through CareRev’s platform, where I work side-by-side with hospital professionals daily. However, I have the flexibility to control my schedule so I can pursue further education, accommodate my family’s needs, and pick up shifts close to home.
We need more nurses going into psychiatry. It’s a field that has changed so much, and so has society’s understanding of mental health challenges.
Drug overdose deaths in the U.S. reached a grim milestone in 2020. The CDC estimates that 93,331 people died, representing the highest number of deaths recorded and a 29% increase over 2019. Opioid-involved overdose death rates rose 37% in 2020, with synthetic opioids involved in a majority of fatalities. Additionally, overdose deaths involving cocaine and methamphetamines also increased in 2020.
The COVID-19 pandemic has been a main contributor to this loss of life, but a major barrier has been and continues to be, a lack of access to treatment. Data from the Substance Abuse and Mental Health Services Administration shows that in 2019, only 1.5% of individuals aged 12 years and older received any form of substance use treatment.
Though there isn’t an evidence-based medication to treat all forms of substance use disorder (SUD), three do exist for opioid use disorder (OUD): methadone, buprenorphine, and naltrexone. Only half of clinicians with waivers to prescribe buprenorphine, however, actually do so in practice, according to a 2019 Pew study. Other research has shown that only 50% of nursing schools in the U.S. include education related to SUDs in their curriculums, and some findings are even direr.
Kristin F. Wason, NP, who works at Boston Medical Center‘s Office-Based Addiction Treatment (OBAT) Training and Technical Assistance (TTA), has been treating patients with SUDs for 12 years and recognizes the need for more addiction education in both nursing and medical schools. This is why she and her colleagues published the Addiction Nursing Competencies in The Journal of Nursing Administration. The first of its kind, the comprehensive toolkit outlines the framework and clinical skills necessary to educate, train, and evaluate nurses in the addiction space.
Article republished courtesy of Boston Medical Center’s HealthCity. To sign up for regular updates, register here.
HealthCity recently spoke with Wason about what drove the creation of this toolkit and the steps needed to increase medication access for SUD.
HealthCity: Why are nurses so critical in the care continuum for patients with addiction?
Addiction specialist Kristin F. Wason, NP, Boston Medical Center
Kristin F. Wason, NP: Substance use disorders are chronic medical conditions that are far too often life-threatening or fatal, despite safe and effective treatment options. Additionally, data shows that due to an increased risk for developing other chronic health conditions and acute care needs, persons with substance addiction present to the medical system more often than the general public—often for reasons other than primarily seeking treatment for their use disorder.
Nurses are a diverse group of frontline workers who are often the first healthcare provider that a person with SUD encounters when they present for care. Unfortunately, there continues to be a lack of addiction education within many nursing programs, leaving many nurses unprepared to appropriately screen and care for persons with SUDs. That is what motivated our team to develop this toolkit to support both individual nurses as well as nursing managerial teams in their efforts to build and evaluate nursing addiction care.
This toolkit, called Addiction Nursing Competencies, supports a holistic approach to patient care, focusing on an individual’s strengths, motivation, and personal definition of recovery. Paired with tools such as medications for addiction treatment and harm-reduction strategies, these competencies aim to enable nurses to safely and effectively deliver care to persons across the spectrum of the substance addiction from active use to long-term recovery.
HC: We know that keeping patients with SUD engaged in care can lead to additional improvements in health outcomes. Can you please describe these benefits?
KW: By engaging persons with SUD into care and providing education about harm reduction, we could also expect improvement in commonly co-morbid health conditions, such as HIV, hepatitis C, skin and soft tissue infections, and improvement in chronic health conditions, such as hypertension, diabetes, and respiratory illnesses.
Programs, like BMC’s OBAT, that are integrated within our primary care and other health systems help promote access to a variety of resources, such as family planning services and preventative healthcare. Our nursing teams have been vital in ensuring patients are adequately immune to hepatitis A and B, in particular, by checking titers and providing vaccines during addiction treatment appointments. We are also able to help coordinate and facilitate behavioral health treatment services within our institution and community.
HC: You’ve been treating patients with substance use disorders for a majority of your nursing career. Why did you choose to go into this specialty?
KW: I grew up within a community that very much struggled, and continues to struggle, with substance use and addiction. I have always carried a strong belief and understanding that good people are impacted by addiction and deserve care.
Upon graduating, I was not familiar with the role that nurses could have in caring for persons with addiction. It always seemed like a field that was more focused on “counselors” or 12-step programs.
Within a few days of working with the BMC OBAT team, I felt at home. The way the patients opened up and shared such intimate details about their lives was fascinating. The patients encouraged me to ask questions as they clearly enjoyed teaching me, a new young nurse, about the dangers of the drugs they were using, how they were using them, and all of the work that they were doing for their recovery. Many had been to numerous detoxes, meetings, counseling, residential programs, and psychiatric facilities. They had tried it all. They shared the barriers to recovery, and there were, and continue to be, many.
Some patients also said that the best treatment was finding a program, like OBAT, that provided ongoing treatment, including medication, which allowed them to feel normal, function during the day, and live their own life within their community safely and proactively. The medication for addiction treatment and care team support provided a form of relief and freedom.
I have been fortunate to work in the field of addiction for nearly my entire nursing career and it has been incredibly rewarding to partner with patients on their journey to recovery. Some patients I met immediately post-incarceration, who are still connected to OBAT, are now employed, housed, and maintaining long-term recovery. Many of my patients have become parents over the years and now bring their kids to our visits. It’s incredible.
HC: It’s clear that stigma still plays a role in both patients with SUD accessing treatment as well as clinicians’ willingness to treat patients struggling with addiction. How will publications like this help reduce the stigma on both sides of this equation?
KW: Substance use disorders are complex, chronic medical conditions that have been historically viewed as social rather than medical problems. Persons with substance use disorders deserve empathetic, respectful, evidence-based care for their condition, and the current lack of training and knowledge by clinicians and providers is a significant barrier to accessing care.
The Addiction Nursing Competencies aims to provide nurses, who are frontline staff trained in acute and chronic disease management, with the clinical and education guidance to provide safe and effective care to persons across the spectrum of substance addiction from active, ongoing use to sustained recovery.
While progress has been made, stigma still exists related to evidence-based care, particularly centered around ongoing medication treatment and harm-reduction strategies. We have a lot of work to do in terms of educating our workforce and the public about the benefits of comprehensive addiction treatment for all patients across the spectrum of substance use and recovery.
This interview has been condensed and edited for clarity. The original version of this article can be found at the HealthCity website.
