new grad seeks advice

  1. I just graduated from an ADN program in mid December. I have received 2 job offers. One offer is for a psych position. I am interested in psych and also have a bachelor degree in psych. I went into nursing thinking that I would end up there. I also received an offer from a telemetry unit. I enjoyed my rotation in telemetry during school and would be interested in pursuing that type of position too. My concern is about my future. I have been told that it is better to take a medical floor position as a new grad and then specialize in a field of interest later. My question is, if I start in psych will it be more difficult to switch to a medical floor in the future if I decide to change fields. Any advice on this topic would be greatly appreciated.
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  2. 17 Comments

  3. by   mustangsheba
    GLW: At the risk of being redundant, I will say again - give yourself a year on a med/surg floor. You would have no problem finding employment in psych after that, and you would have the distinct advantage of the strong physical assessment skills gleaned in working in this very basic area. I have seen many physical ailments missed on psych floors because personnel are not experienced in doing physical assessments. Just recently, for instance, a bowel obstruction that was ignored because the patient was on a psych floor. A nurse who had worked on a medical floor would have zeroed in on the symptoms immediately. Believe me, you will still use your psych skills on med/surg. If you decide to go right into psych, you will still do well. I just know how well having a good med/surg background serves me when working psych. Good luck!
  4. by   Tim-GNP
    When I graduated from my B.S.N. program, almost every one of my instructors discouraged me from going into my specialty of Gerontological Nursing. I actually had professors tell me that I 'wasted' a good education if I didn't get that 'med/surg' experience. Except for one instructor [who I am still friends and colleagues with to this day]. Fortunately, I listed to my heart and the advice of that one instructor, and it has made all the difference.

    Med/surg isn't for everyone, and ANY specialty in nursing requires it's own set of skills. Med/surg skills and fish have one thing in common... Neither keep well if not used! If you delay your dreams of being a psych. nurse, and become a 'med/surg' nurse for a year, because people tell you 'it's what you should do', and then after a year, go into psych. [if a position still exists] and then, try to be a med/surg nurse again, ten years from now... YOU WILL NEED TO LEARN MED/SURG ALL OVER AGAIN. Advances in the technology of medicine and nursing has made a fact.

    "Use it or lose it" and that is the truth of ANY subset of skills in nursing. Good luck in whatever you do
  5. by   GLW
    Thanks for the responses. I've been hearing repetitively that I should start in Med Surg and then go to Psych. I'm not sure that is what your meant - Tim - with your response. I realize that if I go into Psych first, technology will change and my skills may not be up to par as far as other nurses. However, I take my assessment skills and abilities with me wherever I go whether it be Psych or Med-Surg. Maybe I'm confused about Psych but I thought assessment was an important part of this type of nursing too. So, in essence you are telling me that it would be more difficult to go from a Psych position to a medical floor - but not impossible??? Hope you can help me to understand this further....
  6. by   Tim-GNP
    Sorry... I guess I got a bit wordy. In other words, unless you plan to STAY in med/surg. nursing, then you will never have CURRENT med/surg skills. Go to the specialty you want to practice in. What you will not 'gain' in med/surg skills, you will gain in Psych. nursing skills. That is what I meant.

    Don't feel that lack of med/surg skills will not make you a good nurse. Nursing has become so specialized it isn't even funny. For all the education and experience I have in Gerntological nursing, I could NEVER walk into an ICU and provide safe/competent care... Just like an ICU nurse could not do what I do with the degree of skill that I do it. I am cool with that...I hope this clarification helps.
  7. by   GLW
    Tim - Thanks for the clarification. Just to let you know I really appreciate your opinion. I have to make a decision by Tues. and I am really going to take your advice to heart. If you have any other input, I will appreciate it also. Thanks again.
  8. by   sheripa
    GLW, go into the area that you want to go into. You have to be satisfied with what you do. I recently graduated with a diploma in 8/99. I liked working in long-term care and so that is where I went against everyones advice. I loved it. Then I felt as though I was missing out on something in the hospital so I took a job there on the floor and hated it, so I went right back to long-term care where I am comfortable with my choice. Remember yu have to wake up and go to that job everyday no one else. Good luck with yur choice.
  9. by   JillR
    I have to agree with Tim on this one. Do what you really want to do, be happy. It would be better to be a happy psych nurse than an unhappy me/surg or telemetry nurse, it serves the pts better too.
  10. by   GLW
    Thank you for your input. It is so great to be able to talk to experienced nurses and get opinions from them. I really appreciate all the advice. It really helps to make my decision more clear.
  11. by   Mijourney
    Hi GLW. I don't know if you've already made your decision, but I agree with mustangsheba's initial response on this topic. It's true that a nurse may not fit into a particular seeting, but the main reason I would suggest some med/surg is because in psych, you'll still have to manage patients with medical/surgical conditions and injuries. The med/surg experience, if you seek to obtain it, will give you greater confidence and competence in dealing with multiple patient problems in the psych arena. Best wishes.
  12. by   mustangsheba
    GLW: I usually agree with Tim and his point about having to learn things all over again in a few years is valid. However, I stand by my argument that assessing physical maladies (which Tim does in Gerontology)prior to specializing in Psych would broaden your knowledge base. Basic assessment skills never become obsolete. I didn't expect to like working med/surg for two years, and I didn't, but it's what really taught me how to do assessments, communicate with patients, families, and doctors and how to utilize resources. Bottom line is as everyone does agree - go with your heart!
  13. by   babs_rn
    How about a med/psych floor? Hmmm?
  14. by   GLW
    BABS - what is a med/psych floor and where would I find it? I've never heard of a floor like that - at least aound my area.

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