Inside the Psychiatric Unit: A Conversation with Alice, Inpatient Psychiatric Nurse
In this installment of the blog, I wanted to offer a window into inpatient psychiatric nursing through the eyes of someone I’ve had the privilege of working closely with. We will call her Alice, a name chosen to protect her privacy. She is a deeply experienced, thoughtful nurse who brings a wealth of life and clinical knowledge to her work. Her voice speaks to the compassion, resilience, and complexity required to care for patients in crisis.
We sat down virtually for this question and answer conversation, which has been lightly edited for clarity but stays true to her original words.
Q: Can you share a bit about your educational or professional background?
Alice: My professional background includes 26 years as a pharmacy technician in both a hospital setting and a chemotherapeutic clinic. After those 26 years, I decided it was time to take that experience and move toward the bedside by getting my associate degree in nursing. The opportunities were plentiful and the experiences entirely different, but still connected.
Since becoming a registered nurse, I’ve been fortunate to work in a variety of settings, which has given me a wide range of experiences and a better understanding of medical and nursing processes. I’ve worked in sub-acute and long-term skilled nursing, medical-surgical units, home health and hospice, corrections, emergency departments, and now psychiatric care.
Q: What inspired you to become a psychiatric nurse?
Alice: Honestly, psychiatric nursing kind of found me. I was working in a female correctional facility in Connecticut, and I was placed in the acute inpatient psychiatric unit there. At first, I was intimidated. I realized quickly how unpredictable psychiatric illness can be and how vulnerable it can make people. But over time, I began to see it as an opportunity to learn, not just about mental health, but about the mind itself. I wanted to understand how to connect the mind, body, and spirit in my care. That has really stayed with me.
Q: What does a typical day look like for you in your role now?
Alice: On our adult inpatient unit, the day starts with a detailed report on the patients. We need to know exactly who we’re working with and how to structure our day to keep everyone safe and cared for. We check medications and orders, making sure everything complies with legal guidelines and meets the patient’s clinical needs.
We spend time greeting each patient, getting a sense of their mental state and level of acuity. That also includes paying attention to physical needs. Meals are provided, and there are groups and activities throughout the day, some for therapeutic work and others just for fun. We observe behaviors and interactions constantly. That includes everything from aggression and sadness to humor and moments of insight.
It is our job to walk that line, being deeply present with our patients while also collaborating behind the scenes with the broader clinical team. And we have to stay objective. We connect with patients on a human level, but we do not let our emotions guide us. That can be hard. Sometimes patients lash out, but later they come back and apologize. You learn not to take it personally.
Q: How does the role of a psychiatric nurse differ from other specialties in nursing?
Alice: In many ways, all nurses are doing the same fundamental work. We are caring for people. But in psychiatric nursing, the barriers to healing are often much less visible. They are not always measurable in the way a lab result or imaging scan might be. You are working with emotional wounds, cognitive distortions, trauma histories, and addiction. That is hard to quantify.
We still teach. We still focus on prevention and coping skills. But in psych, the diagnosis and treatment are more layered and subtle. You have to be comfortable with the fact that some things are not easily defined.
Q: Can you share a moment or story that reminds you why you chose this career?
Alice: There have been so many, but what comes to mind are the moments when patients go through emotional pain and lash out at us—calling us names, screaming, sometimes threatening or trying to hurt us—and then, later, come back and apologize.
They are often shocked that we do not hold it against them. It means a lot to them when we treat them with dignity even at their worst. And for us, it is incredibly moving to see them come back to themselves and feel remorse. It shows healing. It shows that they are still in there, underneath the suffering.
That contrast between who they are in crisis and who they really are as people—that is why I stay in this work.
Q: What advice would you give to someone considering a career in psychiatric nursing?
Alice: Be prepared to be verbally, and at times physically, attacked. It comes with the territory. But you have to be able to disconnect from it. It is not personal. It is never personal. It is the illness, not the person. And it is exactly why you are there.
Final Reflections
Alice’s work is not easy. Psychiatric inpatient units are often emotionally charged places, full of suffering but also full of strength. Nurses like Alice provide structure, empathy, and safety when everything else feels unstable.
At Calivor Psychiatric Solutions, I often think about the collaboration between inpatient and outpatient teams. Patients leave the hospital changed, but the work continues. And it is often because of nurses like Alice that they leave with hope.
If you have ever wondered what it takes to care for someone in the depths of a psychiatric crisis, Alice’s story gives you the answer. It takes clarity. It takes compassion. It takes the kind of strength that allows you to stay steady when others cannot.
