[Jedi of Zen]

Student here - I have heard it said that nurses who work in psych tend to lose some of their nursing skills (due to not having to use them as much). Have any psych nurses out there found this to be true? And if so, do you ever 'moonlight' in another department to keep fresh on your skills?

Thanks for your time.

[Thanet]

Originally Posted by Jedi of Zen

Student here - I have heard it said that nurses who work in psych tend to lose some of their nursing skills (due to not having to use them as much). Have any psych nurses out there found this to be true? And if so, do you ever 'moonlight' in another department to keep fresh on your skills?

Thanks for your time.

Sorry, I am not too sure what you are trying to say here.

Are you saying that there are no skills in Psych nursing?

Psych nurses are not 'real' nurses?

[Jedi of Zen]

Originally Posted by Thanet

Sorry, I am not too sure what you are trying to say here.

Are you saying that there are no skills in Psych nursing?

Psych nurses are not 'real' nurses?

What? lol. No, not at all! I have heard two instructors say that "you tend to lose a lot of your basic skills" when working in psych. I didn't get a chance to ask them personally what they meant, as they were speaking to a large group of us. I'm assuming that they were referring to more non-psych-related skills, things like changing dressings, inserting foleys, etc. Although I'm sure you still do all of those things in psych, but I was wondering whether any psych nurses out there agree. And if so, how do you "remedy" that problem?

[kiwipsychnurse]

It's like anything, if you dont use it you lose it.
For me to return to a medical hospital I would need a very good induction.

Skills are there but would really need alot of polishing.

For example wound care, I did it in my training and when I did placements in medical hospitals, however over the past 5 years have probably dressed about 3-5 wounds.

[stef595]

ok, I'll try once more to post....I am a psych nurse that went straight to psych after graduation. I get plenty of drsg changes, but many of the other skills are not used on my inpt unit. when I work in admissions, the ED nurse does all of the skilled procedures, such as IV's and blood draws. Heck, in the ED we dont even give meds. I admit when I was a student I had gotten to a point where I was comfortable doing IV's and NG"s and PEG's, but now I have to do the skills checkoffs that my hospital offers so I feel like if the need arises I would be qualified to perform the skills. In reality, I never practice these skills on real people, so I feel I am not prepared to perform them. My hospital is considering opening a medical psych unit, which is greatly needed... and I am really looking forward to it. Most of my pts now have ongoing medical problems, in fact, I saw some of my most interresting psych pts when I was doing my preceptorship on the medical floors. As for being a real nurse, my 'real nurse' skills are super. I am a counselor, a best friend, the one you can talk to when you are down...these skills didnt come with my degree, I earned them caring for my patients. My people skills are far better than any medical nurse I know.

[RNKittyKat]

I think we all know what the OP means. Its like another poster says, use it or lose it. On the other hand, knowing what to do when a patient is seeing snakes all around him is a skill you never forget.

[batgirl23]

I was reading this thread and thought I would put in my 2 cents. I have been a psych nurse for over 20 years with absolutely no regrets. I heard the same thing about "losing skills" when I trained and I still think it's a bogus idea. If anything my assessment skills have to be sharp to tease out an emerging medical problem (ie delerium, drug toxicity, infections, etc.) from psychiatric "behaviours" or delusional thinking, for example. And what about the people who cut and burn themselves? More than enough dressings here sometimes. What about the results of suicidal behaviours? What about the HUGE numbers of psych patients with very serious, yet often undiagnosed endocrine problems like type 2 diabetes and all the associated medical risks? What about serious psychiatric medical conditions such as neuroleptic malignant syndrome? What about foot care problems? What about the incidence of Hep B & C, TB, CA-MRSA and all the other infection issues in a population that is often homeless and/or living in sub-standard housing, etc. We may not do a lot of the "sexy" stuff with high-tech gizmos or do a lot of IVs, catheterizations, central lines, etc. but we do need really good basic nursing skills.

For all you students and new grads thinking about psych as a career... DO IT!! A wise faculty advisor told me in my final year that the technical skills / technology can be learned or re-learned at any time - the skills you learn in psych nursing are invaluable and will always be relevant wherever you go in nursing or in life. I have never forgotten that and I have found it to be true.

[green12]

I agree batgirl23- thanks for your 2 cents. Also, many of the patients at our facility don't have outpatient medical care and when they get to us they unload every discomfort/medical problem they can think of and some they haven't thought of yet. That helps to keep me on my toes.
And all this talk about losing skills... I never wanted to do that stuff in the first place thank you very much.

[EarthChild1130]

I think it's all about what skills you need for your specialty...I may not be the world's best at starting an IV, but when someone's about to flip out and start throwing stuff, I am the one who gets called to deal with him...or if someone has to be restrained, I am the one who gets called...My communication and education skills are the most honed skill I possess now...the ability to gain trust, and the ability to maintain control of an environment that can at times be chaotic, and the ability to help a person who can be mistrustful of the system become an active participant in his care. Those are the skills I use most, and the ones I consider most important...the clinical skills are important yes, but I can relearn those if I need to, and working in the county mental health clinic, I do have to change the occasional dressing...I can give a heck of an injection, though!

[NurseyBaby'05]

Like it or not, there is a lot of truth to the "use it or lose it" adage. As a new grad, it may not be a bad idea to work on a medical floor for awhile. If psych does not work out, you will at least have a good foundation to go elsewhere. I know there are people all over the place who specialized right away and it worked out, but they were lucky. How many people say at their first nursing jobs out of school? How many threads on this very board are about not finding your niche/finally finding your niche, etc? If you go medical not as a new grad, you will miss out on a more thorough orientation. Just my .02.