Psych nursing vs the OR

Nurses General Nursing

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Specializes in psych, ltc, case management.

Hello nurses! I need some opinions because I'm feeling pretty stuck right now, so if you would be so kind please share your thoughts! I appreciate your time. :)

I am now one year out of nursing school, working in a LTC facility. It's not really my thing but it was where I could get hired, and beggars can't be choosers in this economy as many of you well know.

I'm lucky enough to possibly have a job offer from two very different fields. One is in an acute psych unit in a hospital and the other is in the OR. I've always been interested in psych. It was my favorite clinical in school, and I have a background in speciAl education. I really enjoy the therApeutic aspect of working with the patients. I've Been strongly considering attending school to become a psych NP.

However, while I was in nursing school I did develop an interest in the OR. We did not have a rotation there though, only a few brief observation days. But what I saw I loved. I enjoyed the feel of the controlled chaos, and the amazing sites I saw. I could see myself really enjoying going to work and experiencing so many amazing procedures. I've also spoken to some OR nurses and done a bit of reading to develop a sense of what the job entails.

I have a strong intErest in both specialties and I have personality traits that could really lend a hand in either field. I'm not going to make the decision based on money. I do want to consider that i am planning on starting a family within the next 2 or 3 years (approximately) and that being able to work on a part time basis while I have children is important to me.

The OR position has a one year orientation and is a big commitment. If I find I do not enjoy it i will not be a happy camper. However I am aware that OR training is not easy to come by, and I am thinking perhaps I should take the position while I can. I imagine it is easier to switch from OR to psych than from psych to OR.. Right?

However I'm not sure what my long term goals in the or would be. In psych I know I would want to become an NP eventually. Sometimes I think it's like this.. I don't really want to be a psych nurse... But I want to be a psych NP. Does that make any sense?

So as you can see I am waffling about, and could really use a sounding board to reflect on. Any thoughts are welcome. Thank you friends!

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Specializes in Family Nurse Practitioner.

In my experience OR nurses are similar in temprement to psych nurses so that might be why the choice is so difficult. I love em both! If you really want to be a psychiatric np someday please get psychiatric experience. Not that it is needed to get into a program :rolleyes: which I think that is BS because a solid psychiatric background is necessary for an advanced practice psychiatric nurse imo. Good luck.

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Specializes in Critical Care, Education.

Wow - talk about opposite ends of the nursing spectrum! I think you need to ask yourself whether you'd be happier in a very structured & rule-bound environment (OR) or one that is really ambiguous (psych). That is not a negative opinion on either area.

I really appreciate the attention to details & adherence to established practice that characterizes perioperative nursing. I certainly don't want anyone getting 'creative' with my choley, would you? I love the technology associated with OR as well as the cool factor of seeing anatomy up close and personal. The biggest downside for me was having to work that closely with egotistical surgeons.. srsly. I never could get into psych -- hey, I had a hard time differentiating the patients from the staff unless I looked for the wristbands :lol2:

Probably, the deciding factor should be where you want to go in the future. OR nurses are highly prized, particularly if you are qualified in specialty areas such as CV so this would increase your work options. Psych nursing is a bit more uncertain because of the unknown impact of health care reform on this area... less reimbursement will mean fewer hospitals. In my area, Psych NPs are employed in ambulatory and inpatient settings, but I don't think there is such a thing as a perioperative NP, so you would probably have to switch to another area for a while to get the clinical experience to qualify you for an NP program.

Best of Luck to you! Keep us posted on your decision.

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Was in the same dilemma before. I am a Psych RN and an opportunity for me to be in the OR opened up. I thought really hard about it since I really like Psych but then realized that the OR thing was just a fling thing :)....and nothing serious :) I am still in Psych.....and still content.

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Your special ed background will also help if you go OR, and decide to go back to psych.

Another consideration- OR= hours on your feet in a small area (at least with psych, you can walk around, and sit for charting and doing orders), the need for a decent bladder capacity (LOL), and the ability to go without even a crumb in passing (no blood sugar issues that aren't easily fixed on the fly).....plus- the docs.... surgeons have to be sort of 'thugish' in their abruptness and confidence to get through tough cases.... psych docs do a lot of "uh huh....I see....here's a prescription" (ok, so both of those are simplistic generalizations!!). :D

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Specializes in psych, ltc, case management.
In my experience OR nurses are similar in temprement to psych nurses so that might be why the choice is so difficult. I love em both! If you really want to be a psychiatric np someday please get psychiatric experience. Not that it is needed to get into a program :rolleyes: which I think that is BS because a solid psychiatric background is necessary for an advanced practice psychiatric nurse imo. Good luck.

Thank you Jules. I would be interested to know what you are thinking of when you say the temperament of the two nursing specialties are similar? just curious, it sounds like an interesting observation.

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Specializes in psych, ltc, case management.
Wow - talk about opposite ends of the nursing spectrum! I think you need to ask yourself whether you'd be happier in a very structured & rule-bound environment (OR) or one that is really ambiguous (psych). That is not a negative opinion on either area.

I really appreciate the attention to details & adherence to established practice that characterizes perioperative nursing. I certainly don't want anyone getting 'creative' with my choley, would you? I love the technology associated with OR as well as the cool factor of seeing anatomy up close and personal. The biggest downside for me was having to work that closely with egotistical surgeons.. srsly. I never could get into psych -- hey, I had a hard time differentiating the patients from the staff unless I looked for the wristbands :lol2:

Probably, the deciding factor should be where you want to go in the future. OR nurses are highly prized, particularly if you are qualified in specialty areas such as CV so this would increase your work options. Psych nursing is a bit more uncertain because of the unknown impact of health care reform on this area... less reimbursement will mean fewer hospitals. In my area, Psych NPs are employed in ambulatory and inpatient settings, but I don't think there is such a thing as a perioperative NP, so you would probably have to switch to another area for a while to get the clinical experience to qualify you for an NP program.

Best of Luck to you! Keep us posted on your decision.

your creative choley comment cracked me up! You bring up some good thoughts that i hadnt considered, thank you. Honestly, i have days where im not sure i would want to be a psych NP. I thought i did...but lately i feel like i dont know which way is up. I've also considered the fact that i might like to teach nursing one day (again, i hint that i used to teach...) and if that were the case i think OR would probably be better from the perspective of being able to draw on clinical experience for future lessons and clinical classes...there are so many directions you can go with nursing, which is turning out to be both a blessing and a curse for me.. oy!

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Specializes in Family Nurse Practitioner.
Thank you Jules. I would be interested to know what you are thinking of when you say the temperament of the two nursing specialties are similar? just curious, it sounds like an interesting observation.

This is just my opinion having interacted with both extensively but these specialities are stressful and non-traditional. We see some crazy stuff and have to be able to roll with it. It seems like in the OR or pychiatry you are more likely to hear your coworkers telling not so proper jokes and laughing over the strangest things. Does that make any sense? Only con for me about OR is I can't wait that long to pee. :D

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Specializes in psych, ltc, case management.
This is just my opinion having interacted with both extensively but these specialities are stressful and non-traditional. We see some crazy stuff and have to be able to roll with it. It seems like in the OR or pychiatry you are more likely to hear your coworkers telling not so proper jokes and laughing over the strangest things. Does that make any sense? Only con for me about OR is I can't wait that long to pee. :D

Okay haha. I know EXACTLY what you are talking about. I do have an oddball sense of humor for one..

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I don't know much about psych nursing but I've just started training in the OR and I can say it's a lot to learn and really does take a year or so to be comfortable at it. If you are looking for advancement in the OR you can choose to become certified in a specialty, become a first assistant, or even NP that assists the surgeon in surgery. Of course you can always go the management route too. I can say from my experience coming from med-surg, I absolutely love the OR. The things you get to see are amazing. I'd say the only drawback you will find will be dealing with difficult personalities, and that can be anyone from the team including fellow nurses. You definitely can't be a pushover. Of course you can say that about any nursing job you get too. Hope this helps.

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Specializes in Cardiac Care.

I think Psych Nursing is closer to the classroom environment than OR.

But since I want to become an OR nurse, I say OR all the way. However, I do hear alot about the fact that OR nurses can get "stuck" in the OR because their skills are so very specialized. But if you are NP minded how about CRNA or First Assist specialties in the OR?

I hear that Psych Nurses loose their skills for procedures as well, since you don't do them as often.

Hummm.. tough choice! Good luck

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Specializes in psych, ltc, case management.
I don't know much about psych nursing but I've just started training in the OR and I can say it's a lot to learn and really does take a year or so to be comfortable at it. If you are looking for advancement in the OR you can choose to become certified in a specialty, become a first assistant, or even NP that assists the surgeon in surgery. Of course you can always go the management route too. I can say from my experience coming from med-surg, I absolutely love the OR. The things you get to see are amazing. I'd say the only drawback you will find will be dealing with difficult personalities, and that can be anyone from the team including fellow nurses. You definitely can't be a pushover. Of course you can say that about any nursing job you get too. Hope this helps.

What would be the difference between a first assist and an np that assists in surgery?

I used to be drawn to the idea of being an RNFA, but I heard they get screwed a lot as far as actually getting paid..which would be unfortunate, to do all that work to get your cert and have to wrestle with insurance companies and surgeons to make any money..

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