Does choosing "Psychosocial" nursing ruin a new grad?

xtxrn, ASN, RN · Jul 13, 2011

This is JMHO....I've been an RN for 26 years, and worked in many different areas, including adolescent psych, and a freestanding chemical dependency center. My first job was in a nursing home (the only RN-educated person in the building on that shift, for 6 months, until I got my boards results and license)...great for time management. My job at 6 months when I moved to TX was in neurology. I loved it, but as a new grad, the basics of med-surg are SO important. You will use those anywhere you work.... even psych patients get appendicitis and pneumonia ! Knowing medications is also helpful....lots of addicts have heart disease, diabetes, high blood pressure, a fib, aneurysms, sepsis, emphysema, etc. Having a 65 year old alcoholic with an abdominal aortic aneurysm that was picked up during the physical at the rehab center, then returned to sender to his doc at home to have surgery, or an IV drug user going into septic shock (but the night nurse thought that his temp being subnormal after being 102 the shift before was a GOOD thing) needs someone who knows what they're looking for.

And don't think the facility won't throw you in over your head if it means they don't have to pull the shift...great if they do, but don't count on it.

The first 3-5 years of nursing are setting the groundwork for the rest of your career. I loved neuro, but wish I'd had more med-surg before specializing. And the longer you're in nursing, the more you realize how much you didn't know 'back then'.... basics are crucial.

Any nurse that doesn't feel like a bit of an idiot for the first year or so is a scary person IMHO. :) There's a lot to put together, being on your own (even after preceptorship, which didn't exist back in 1985 where I was- it was sink or swim). I learned a lot of med-surg in whatever area I was in, since I'd get all magazines I could, buy reference books, and ask people with more experience to teach me. And look at each day as another day of education. But nothing makes up for actually doing it.

I originally wanted to work NICU....couldn't as a new grad. After being a nurse for 17 years, I got a job on peds, and floated to NICU. I hated it- lol..... But I'm very thankful for the other experiences, and even that one.

Good luck. Just remember that whatever you do will help in any area of nursing. People are very multidimensional- there are very few, if any, "only" psych patients, "only" addicts, or "only" medical/surgical patients. There is a lot of cross-over simply by being human.

rose-n-arrows · Jul 13, 2011

Wow. Thank you so much for responding. The rehab facility that recruited me is definitely inadequately staffed and I admit I felt it may be an inappropriate first job because I'd be completely on my own right off the bat. I just don't want to miss the boat, so to speak. Your response made me cry-in a good way. I've needed to let out some of this angst for a while...am I good enough, will I really be a good nurse, will I make a difference in the lives of my patients and their families? The highlight of my student nursing career was when my favorite instructor wrote at the bottom of a journal assignment, "I hope you're my nurse someday." Thanks again, and have a wonderful day :)

Whispera, MSN, RN · Jul 13, 2011

I always wanted to be a psych nurse. I dove into it after graduation. I learned oodles. I've been a med/surg nurse since then and was able to re-learn the skills pretty easily. Since psych is my love, going into it first was not a mistake. I don't think you can lose if you follow your heart.

xtxrn, ASN, RN · Jul 13, 2011

rose-n-arrows,

another idea is to work full time at either a medical or psych/rehab facility, and have a prn job at the other- you'd have a foot in the door at the prn job, while learning the med surg basics (even if only once a week, you'll pick up skills and assessment tips that are so important). You'll use psych in any area of nursing, just like med-surg skills crossover into psych.

You will be a great nurse :nurse: as long as you keep asking questions, and know your limitations and strengths at any point on your career journey. It's a marathon, not a sprint. :) And when patients drive you nuts, remember how lousy it must be to be them forever vs just having to deal with them for limited times- lol .

I've recently found this forum (I'm a disabled RN and have found a 'home' after being so alone for so long). It's great to be able to share my experiences, and learn from others. :)

KADRN · Jul 14, 2011

I went into addictions directly out of nursing school and worked in it for a year and a half. It was not my first choice, but I needed a job and could not find anything else. I just recently started a new job at a hospital on an ortho/medsurg floor. I enjoyed my job in addictions and learned a lot, but I definately believe starting out in medsurg is the way to go. If you think you will stay in psych then starting out in it may not be that bad, although medsurg is great for the fundamentals.

rose-n-arrows · Jul 14, 2011

Thanks again, everybody. Your input is comforting. :redpinkhe