Tina Curtis, Registered Psychiatric Nurse

Major misconception

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"Have you ever seen One Flew over the Cuckoo's Nest?* Not all psychiatric nurses are mean and awful like Nurse Ratchet was. We like to work with people, not make decisions for people. So the hairs rise on my neck when I watch that nurse in that movie.

"Psychiatric nurses obviously work with people who have mental illnesses, and there's a lot of stigma for people with mental illness. One of my jobs is always trying to erase that stigma. I like to think that that's changing."

*Note: This is a movie about people in a mental health care facility in the late 1950's in the U.S..

Where I work

I'm a registered psychiatric nurse employed as a nurse therapist in the General Psychiatry Program at the Health Sciences Centre. There are 12 nurse therapists employed here. I'm filling in for someone who's on maternity leave.

I've been a psychiatric nurse since 2000 and I've been working at the Health Sciences Centre since I graduated.

My patients

I work in the PsychHealth Centre in the Mental Health Department as an outpatient psychiatric nurse.

When somebody is discharged from the hospital, they see me as part of their follow-up program. I have about 90 people on my caseload. Some come from referrals from general practitioners and I will take those patients if I feel I can offer them therapy or treatment.

Essentially I work with people who have one of the following four illnesses: schizophrenia, bi-polar affective disorder, major depression and anxiety disorders.

Assessment skills

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"A large part of my job is assessment.

"I get the referral and call that person in the community and I ask them to come in for an appointment. I interview them for about an hour and I basically get their life story - a history of their present illness.

"Then the next time we meet, the psychiatrist is there and he asks essentially the same sorts of things but gets anything I've missed. He works on the diagnosis and any medication questions. And from all of that we come up with our assessment and recommendations."

Office setting

I meet with patients in my office with the door closed for privacy. There's another office close by with a two-way mirror where we will also conduct interviews. It's often helpful for another nurse therapist to observe or supervise without physically being in the same room. We always ask the patient's permission before doing that.

I do a lot of work over the phone. When a patient calls me in crisis, I talk to them over the phone and sometimes that's enough to calm their situation.

Need people skills

People skills are probably the number one skill that I need. Obviously, I must have a good knowledge of mental illness and the various types of treatment but I must also be comfortable around people. They are coming to me with problems and I'm working with them to find solutions.

I also need very good assessment skills. I can determine issues by how a person speaks, the volume of their voice and the way their thoughts jump from topic to topic. It also helps to be calm. I think most of the psychiatric nurses I know are calm and really good in a crisis.

Travel education

I was born in Portage la Prairie and left when I was 18 to go to Brandon University for a year. Then I went to Europe and Australia for three years. I certainly gained a lot of maturity during that time on the road. It was exciting and really opened my mind to other cultures and ways of life.

I spent a year in Australia, living with a family and working odd jobs. I learned a lot about living while I was away.

A psychiatric nursing family

I have a number of family members in psychiatric nursing: an uncle is a psychiatric nurse and two aunts have worked in the field. If you had asked me when I was a kid whether I would be doing this now, I would probably have said, "Are you kidding?" But looking back now, it makes a lot of sense.

My parents had me when they were very young, so they never had the opportunity to finish university themselves. They wanted me to get the education they never had and that was a big influence on me.

Lucky break

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"I had come back from my travels and I was broke so what I did was I worked at a gas station pumping gas.

"This friend of mine came through and he said, ‘Do you want a summer job that pays a little bit more money?" He got his dream job and couldn't take this summer job at the Manitoba Developmental Centre. A couple of days later this lady phoned and said, ‘Would you like to be a psychiatric nurse's aid? We'll train you.'

"After doing that for a couple of summers, I decided to actually go to university and take psychiatric nursing."

Home and friends

I live with my boyfriend and I have a golden retriever named Hunter. He's a beautiful dog. He's nine years old but he's still my pup.

I like to hang out with my friends, old and new. I still connect with some friends from Portage who I've known since I was five.

I like to sew and do crafts. I also read a lot and we go to the movies. To reward myself, I love to go shopping. It's also a good release from the stress of my work.

Balance work and home

This job does have its stressors so you have to take care of your life outside of psychiatric nursing.

I don't take my work home with me. The work I do is confidential so obviously I can't physically take anything away from the office. But sometimes it's not that easy to walk out those doors and leave it all.

Sometimes at home I'll read a journal article related to my career, but for the most part when I'm at home that's my time and I'm pretty protective of that. I make time to do the things that I enjoy, and try to get lots of sleep.

Getting organized

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"First of all, I work Monday to Friday from 8:30 until 4:30. No day is the same but there are elements of sameness everyday.

"The first thing I would do when I come in is I would check my voicemail for any messages, and I check my email. I'll think about when I can call those people back. Then I will go for coffee with the other nurse therapists. After that I will pick up the charts for any of the patients that I'm seeing that day from the front desk, read through them and make some plan for those patients for the day."

No set routine

If I get a call from a patient in distress, I may perform 30 minutes of crisis intervention over the phone. Or I may visit one of my patients if they're in the hospital. Sometimes I need to phone a family member. Or, I may need to get a prescription for a patient from the psychiatrist and drop it off at the pharmacy.

I may have a patient assessment booked, which takes about an hour and a half. On certain days I book meetings involving the patient, the psychiatrist and myself. There's also peer supervision where, once a week, we take turns presenting articles or interesting cases.

Fast-paced week

It's a regular 40-hour week, but the pace is very busy. I look after 90 people, which is a lot, and on top of that I do the assessment work.

I do find pockets of down time where I can chat with the other nurse therapists or do other things. But for the most part, I am doing something related to my work from the time I get here until the time I go home.

Weekly classroom

Once a week, I attend a class where all the nurse therapists take turns presenting either a journal article on a new treatment or a complex case in which we'd like to hear advice from others.

This peer supervision keeps us current and is a good way to gain insight from others. So I do spend time on the Internet or in the medical library researching topics to present.

Job satisfaction

There's one part of my day that I always take great pleasure in.

When one of my patients, especially someone who has been in hospital for some time, is discharged back into the community, I feel really good. It may be someone who's been depressed or suffering in some way and together we've found a way for that person to get control of their situation. Maybe they can't work quite yet, but they're finally returning to their lives. That's a very meaningful time for me because I know I've helped.

I like people

What I truly like about my job are the patients. I get to help people everyday. Sure, sometimes I meet with people when it's not always pleasant but that doesn't bother me.

My job is never, ever boring. People's stories are always interesting and I'm always learning something about somebody. It's mentally challenging to learn so much everyday.

Academic preparation

I do a lot of writing in my job. Some days, I have hours of patients' paperwork to prepare. I find the computer is very much a part of psychiatric nursing. If you're thinking of getting into this profession, hone your computer and writing skills in high school.

Any of the university entrance courses are beneficial, especially science courses like biology and chemistry. Besides the obvious scientific application, those courses help develop critical thinking skills which are essential in helping solve other peoples' problems.

Teaching others

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"We do a lot of teaching in our job.  In nursing, we call it a ‘preceptor'*, it's like a mentor. I teach [psychiatric] nursing in the practical sense - how do you talk to somebody who has delusions or hallucinations. There's the piece you learn in school but there's the piece where you actually are doing it.

"I've been a preceptor for many nursing students, so that's pretty interesting. They keep you on your toes all the time. You know, they'll ask you questions and you're like, ‘Oh gee, I better go look that one up.'"

*Note: preceptors are nurses that teach other nurses.

Waiting lists

There are waiting lists in health care and my area is no different. People want to be seen as soon as possible by doctors and nurses and I wish that would happen, especially when you know they're suffering. But the truth is many patients have to wait and that delay is frustrating.

I'm dealing with people who have really serious problems and I just want to fix those problems for somebody, but I can't always do that, so that can be frustrating.

Talk is stress buster

When I'm with patients, I do hear stories that are quite horrible. Often I will talk with another nurse therapist or colleague about what I've heard and just debrief about the situation. I find I need to do that with difficult cases. That helps me to retain my balance.

I'm dealing with confidential files so I'm limited to what I can say at home to my friends and family at the end of the day. I do talk about hypothetical situations and general issues, but I would never divulge patient information.

A go-getter

I think my greatest accomplishment has been putting myself through university. I paid for it. I stuck it out. It was a very busy time in my life and I came through it with a career.

As far as my work goes, I'm very satisfied to be in this particular job. This is an advanced role and I did a lot of volunteering on committees and researching on my own to prepare for and to get this position. I wanted to demonstrate I was the kind of nurse they needed and the kind of psychiatric nurse I really wanted to be.

Educational history

I took my Bachelor of Science in Psychiatric Nursing at Brandon University*. It's a four-year degree. I had my basic science from high school and I had taken University Entrance courses, so that served me well.

I had okay grades in high school. I wasn't the top of our class, for sure. I enjoyed History, English, French and Geography. I really wasn't into the Sciences at all but I took them because I thought I might need them. I guess I was right.

*Note: For more information, see Brandon University in USEFUL LINKS.

Late decision

I had no idea what I wanted to be when I was growing up. I thought maybe a teacher. When I first when to university I took general arts, because I still didn't know, so I just continued with courses I liked.

It took me until I was 23 and had been around the world before I knew what I wanted to do. The psychiatric nurses who I worked with at Manitoba Developmental Centre in Portage also gave me a lot of insight.

Odd jobs at first

My very first paying job was at McDonald's. I also worked at Coles Bookstore, which was a great job. I stayed there for four years. In Australia, I did a bunch of odd jobs, working in a resort and cleaning. And for several summers I worked at Manitoba Developmental Centre as a psychiatric nurse's aide.

I also worked in a group home, when I was going through university, to make extra money. And I worked for Child and Family Services doing respite care. Those are all the jobs I had before I became a psychiatric nurse.

On-going learning

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"We always have to do ongoing learning, so I've been to countless conferences related to illnesses, related to psychiatric nursing. I also have been to a couple of leadership courses.

"I've volunteered on a lot of committees, so that I found has been very helpful in terms of learning. I've done volunteer work for the College of [Registered] Psychiatric Nurses. I volunteered for the [national] Schizophrenia Conference last year. Absolutely, I think you should contribute in that way."

Happy with work

I'm pretty happy now. I like having my job to go to everyday. I enjoy the people I work with and that's a big part of who I am.

This job I'm in now ends in August and I'll go back to being an inpatient psychiatric nurse in the hospital. I'm glad I got the opportunity to fill in because I wanted more of a challenge. Eventually I would like to have a permanent job as a nurse therapist. I can see more of these positions being created in the future and I think I'm in a good position to move into one.

Research and school

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"One of the interesting things about a nurse therapist role is you really get to be involved in research. You can publish in journal articles or that sort of thing. That's interesting to me, and that's challenging. I would love to do something like that, somewhere down the road, related to the clinical piece of things.

"Eventually I would like to go back to university, but I would like to do it very differently than what I did. I'd like to do it part-time and more at my own pace, because I work full-time and I need to have a bit of a life outside of work."

Be calm in a crisis

I'm a pretty calm person and I think I'm pretty good in a crisis. I don't get rattled very often and if I do, I don't let it show.

I think anyone in this type of job needs to be level-headed and able to make good decisions. You need to be a problem-solver and I feel that's part of my personality. Anyone thinking of this line of work should ask themselves if they have these qualities.

Career opportunities

Quite a high number of people visit their family doctor with mental health problems. Psychiatric nurses are always going to be needed.

There's always going to be a place for us and within the system and there are all kinds of different things a psychiatric nurse can do. You can work in geriatrics, with adolescents or adults, or even in addictions. You can work in the community, you can work in an office like I do or you can work on an inpatient unit.

World of change

One of the things that I've come to see about health care is that things always change. How you are able to adapt to that change is what's really important.

Job market info

The links below take you to federal and regional government information on employment, education, salary ranges and long range prospects for this career.

The official title for Tina's occupation is "Registered Psychiatric Nurse" and its NOC code* is 31524.

Manitoba Job Futures

Employment Prospects - Labour Market Information

*Each occupation has an official name and unique number called the 'National Occupation Classification' code or 'NOC'.

Education

Useful High School subjects

-Biology
-Chemistry
-Math
-English

*Source: JobFutures.ca

For those out of school, Adult Learning Centres can help you get or upgrade your high school diploma, including adding subjects that are required for work or further education. All Manitobans are normally entitled to four free courses.

Below are links to various programs and courses that will you on the path to a career as a Registered Psychiatric Nurse:

Brandon University

Bachelor of Science in Psychiatric Nursing
Bachelor of Science in Mental Health
 

Skills

Useful Skills/Experience*

Multidisciplinary teamwork
Personnel management
Committee work
Interpersonal skills
Training staff
Organization skills
Critical thinking skills
Interest in helping people

Source: Job Futures.ca

There is not yet an Essential Skills* profile for this occupation.

*For more information on Essential Skills and their importance, go to: Essential Skills.

Professional Resources

College of Registered Psychiatric Nurses of Manitoba
Serves as an informational source about the profession and as its regulatory body to the public of Manitoba.

Related Careers

Licensed Practical Nurses (NOC 3233)

Head Nurses and Supervisors (NOC 3151)

Nursing service managers (in NOC 0311 Managers in Health Care)

Registered practical nurses (in NOC 3233 Licensed Practical Nurses)