Hospital/Acute care experience first?

[sameasalways, ASN, RN]

I have two job offers, one for a Nurse Residency Program and another for a youth acute unit in a major psychiatric hospital. I am a single mom and have no family around, and am going through a divorce. After that divorce I will likely relocate. Therefore, I need to know what job I should take as my first year of nursing experience begins. The pros of the residency program are that I will get that one year of hospital acute experience and in my mind, be able to get another job at another hospital relatively well regardless of where I move to within the next one to two years. The cons are that is is 12 hour shifts and I will not likely get an area of the hospital I am passionate about. The pros of the psych hospital are that I will be working with one of the patient groups I am passionate about (12-17 y/o), and the hours are great (7-3:30 five days/week). I am really worried about when I move and not knowing how to do basic nursing skills. How concerned should I be about my career potential by skipping the hospital work environment right out of school?

[SummerGarden, BSN, MSN, RN]

are you stating you want to be a psych nurse? if so, i would not be concerned about hospital experience at all if i could land the job... if my goal was outpatient anything and i could land the job right out of school, i would not have hesitated. i have friends who wanted to be hospice and ltc nurses and did so right out of school. no regrets thus far.

[sameasalways, ASN, RN]

Hi, thank you for responding! My problem is that I will be moving in about 1-2 years and I am worried about finding a nursing job then. I have different areas of interest though, and have not settled on one specific area. I want to further my education and either become a NP or a nurse researcher (but that is a LONG way down the road). My interests are as follows: Postpartum/Womens/Infants/Breastfeeding; Public Health; Hospice; and E.D. and ICU. My problem is I don't know which area I want the most, or where I would fit in the most. Everyone EVERYONE said I would know when I graduated. The thing is, I think I would be excellent in Public Health, and excellent in Womens Health/Postpartum. I also think I would be great at Hospice care (but not sure if I want to do that for a life-time) and really love it, and lets not forget the ICU and E.D. which have always INTERESTED me, but I can't say that I have any knowledge or experience with those areas or that it would be the right fit for me. As for Psych Nursing, I am 34 and when I was 18 I had to choose between social work and Nursing. I chose Social Work at the time, because I wanted to do one or the other, and to be honest, Social Work seemed easier. I didn't feel smart enough to be a nurse. I ended up getting my Associates in Behavioral Sciences but staying home with my kids since I coudln't afford childcare to go back to school and finish up at the time. By the time the kids were older, I realized I wanted to do Nursing and that I was going to do it whether I thought I could or not. So now here I am. My biggest concern is limiting my career opportunities. Would I be good at Psych Nursing and enjoy it? I know I would be excellent at it and probably highly enjoy it. I am just worried about things down the road or not getting to do the other things I want to try. Lets put it this way..I haven't even put in an IV yet!!! (as a new grad).

[SummerGarden, BSN, MSN, RN]

ok... you sound like me except you do not know what you want to do when you grow up (this is ok).:wink2: i too worked social work and have a degree in that area. similarly i choose nursing because of the numerous opportunities it presents in comparison with my former field of work. with that said, unlike you i do not like psych nursing enough to do it! instead, i fell in-love with emergency nursing and public health nursing (i am moving into an er soon and i plan to work public health when i retire from the ed). if you think you will be happy as a psych nurse at this time then go for it!!! there is no way to predict employment opportunities in any region or in any area of nursing.

also, if you start medical surgical nursing or in a specialty within the hospital setting, you will not be able to move easily into another area of nursing at this time due to the economy. employers can always reject you because you do not have x,y,z experience in whatever job opening even if you have medical surgical nursing or another specialty nursing experience. in addition, employers are rejecting experienced nurses because they do not have "recent" experience in whatever even when they have worked in that specialty for years before moving into another specialty.

thus, at this time it really does not matter where you start because no matter your choice, you will be limiting your options. in fact, if i were in your boat, i would join nursing organizations and become involved in whatever specialty interested me the most. therefore, when i move i will have a better chance of landing a job in that specialty or in something similar because i have connections. it is who you know and not what you know that will get you the right job these days. that is how i landed my current ed job. gl!!!

[sameasalways, ASN, RN]

My true passion is working with women and young adults/teenagers...Anything involving that will make me happy! However how do I do this without limiting marketability? I have always seen psych nursing as very self-limiting when it comes to marketability in a job market/nursing field. I don't mean that to offend anyone so please don't take it that way. I just hear constant negative comments about "psych nurses". I would LOVE the most to work public health, and I LOVE teaching, I think it is why I want to work with a specific age group..they are being thrown so many more choices and decisions their way and really there is such opportunity to guide. I loved teaching birth control in germany and I love that i have helped so many women with their breastfeeding issues. When you said people are no longer marketable even with years of experience after leaving a field and then coming back to it because they don't have "recent" experience, it makes me cling even more to the fact that it is "safest" to stay in the hospital and stay current with what is going on in that environment, so that when I move, i will be up to date on current practices. I do not know that psych nursing is my passion. I never thought about it seriously. I just wanted a parttime position at the psych hospital because its an area I know I would do well in and I have a strong psych background, and the pay is wonderful for perdiem there. Perhaps it is safest to just take the parttime position once a week there and see if psych nursing is really for me or not, and work fulltime in the hospital. Its true i dont know what i want...other than job security and freedom to grow,learn, and spread my wings.

[SummerGarden, BSN, MSN, RN]

perhaps it is safest to just take the parttime position once a week there and see if psych nursing is really for me or not, and work fulltime in the hospital.

this may not be a bad idea! after working the worse medical surgical floor in my hospital for an entire summer i would never suggest to anyone to give up a job they like! btw, i normally have two jobs but earlier this summer i was downsized out of my pt job. in any case, i think you should also join a women's or ob/gyn or l&d or breastfeeding etc. nursing organization to help grow your training and your interests in this area (marketability), the local chapter of your ana and the one when you move (connections), and a ft job in the specialty (experience). if you are unable to get a ft job in your specialty area, then volunteer somehow in that area while working ft in the hospital setting. gl!