[trustsupplyguy]

My background: I'm just starting my student preceptorship in Psych Nursing, and if all goes well I think they will offer me a job there.

My problem: I wish I could work Psych, but ideally I'd like to work in other areas too. I'd sure hate to get typecast and lose the opportunity to work in other areas so soon in my career.

My question: Can I have my cake and eat it too? In other words, is there any way I could work in psych and the ER as well? The manager of the psych unit is a reasonable person open to new ideas, so if I had a feasible plan in place he might go for it.

The psych unit is connected to the ER in the sense that a psych nurse must go there and evaluate patients medically for admittance into the psych unit. In fact, my wife (a psych nurse on the unit with no previous med / surge experience) and my preceptor both work this role. Perhaps I could make a case for being cross-trained? Now that I think about it, I might even be able to work this into my preceptorship some way. My wife has worked at this hospital 8 years, and I volunteered there for two years. I think I could make a strong case for my commitment to the hospital, and that the extra training and hassle would be worth it because it would be a long-term investment in someone who won't leave.

I enjoyed my experiences in med / surge, telemetry (I have my ACLS), and the ICU. I would probably like ER too (but never had any exposure there so I'm just guessing). My grades are great (close to a 4.0 out of 4.0), and I really enjoy learning about pathophys.

What do you think? Feedback is greatly appreciated -- thank you!

[TazziRN]

As a new grad/new hire you will be going through an orientation and preceptorship. You can't do a preceptorship in more than one area at a time, but there's no reason why you can't do ER after working Psych for a while.

[trustsupplyguy]

There are some situations in life that are "either/or" and maybe this is one of them. I just may need to commit to one thing, and not worry about the other for now.

> but there's no reason why you can't do ER after working Psych for a while.

I'm getting feedback from nurses with both psych and non-psych experience that says that once you go into psych you are typecast and you'll never be able to get other experience. So I hope you're right, but either way I'll keep my options open until I get a job offer, and then just relax and make a 100% commitment to my new area of nursing.

Thanks for your thoughts!

[RunnerRN]

If you are worried about being "typecast" as a psych nurse, why not start off in the ER? We get more than enough psych pts to keep most people happy, but you'll get experience in pulmonary, cardiac, peds, OB, onc, etc at the same time.
Good luck with you decision!

[trustsupplyguy]

Excellent thought, thanks! I could stop by the ER and introduce myself to the manager? What do you think about that approach to job hunting?

[Altra]

I agree w/RunnerRN ... if you believe you'd thrive in the ER environment why not try to find a position there? Believe me, you'll use everything you learned in school about psych nursing and then some ...

Just MHO, but I think it would be more difficult to move into another med-surg or specialty nursing area after having had only psych experience as an RN, than to move into psych after some other experience.

Good luck to you!

[fleur-de-lis]

What about trying to hire into an ER then looking for a PRN in the Psych unit?

[psych_nurse_2_be]

I like your idea about the in between person for the 2 departments. I started psych right out of school because I knew that's what I wanted to do. One of the first things I realized when working psych full time was that no one in our ER knew anything about a psych patient - be it the nurses or the doctors. Having pts brought over who were carrying weapons in their pockets - they were never checked - to having a pt with a previous psych history brought directly to us - although their complaint was about the pain in their back. They had staples that had not been removed after 18 days & some had pulled apart in his back - needless to say, it was a bad mess & the guy was septic. But, his last admission was for psych, so they just sent him on - no report about the big purulent draining wound on his back in that report. I always said that they need a psych nurse in the ER - someone who truly knows how the psych admissions & patients are handled. Will that happen at our hospital - probably not. Psych pts do get sick too - believe it or not is what I always say. But, I can also speak to your other claim about being labeled. I worked in psych for 10 months & felt myself getting drained - like there was something more exciting I could be doing. So I transferred to surgery. There was no question about being labeled a "pysch nurse". I went & I learned the job & I do it pretty well. But, after having a psych pt in surgery & no one else knowing how to calm him down - of course all I did was talk to him like he was a person - I started to realize that psych really is my true calling & I'm going back. Of course, the surgery dept hates it because they are all saying I make a great perioperative nurse & I need to stay there because they need good nurses. What can I say? I'm following my heart - so you'll know what is right for you when you start, but I do believe if you really want the excitement of the ER, get some psych experience under your belt also & you could always help with psych pt assessments, etc when they came in. Good luck!

[TazziRN]

As an ER nurse, I can tell you that psych pts scare the willies out of me. Not because I'm afraid for myself, but because I'm afraid of saying/doing the wrong thing. If a psych nurse kept up his/her other nursing skills, I would welcome them into the ER with open arms and a homemade cake!!!

I didn't think about the skills part. I agree, it would be better to start out in ER and move to psych from there.