First Year, I don't often respond, but thought this worthy of a couple words. I have worked psych for several years. Long ago, when I graduated, I was told to get some med-surg experience first, and I have been ever-so grateful that I did! It has been an incredible resource that just can't be replaced. Actuallyl, I wish I would have worked ICU, because the decision-making level of a critical care nurse is so amazing---they really think through how the systems work!! Too, I have worked with several others who went straight into psych, and they just don't seem to grasp the medical side of the patient as well---they just don't get enough exposure on the psych floor. Geriatric psychiatry may be a different story, because most of the elderly are affected in some way or another, but the intensity still isn't the same as on a medical floor. You just don't get the skills of doing dressings at lightning speed AND sterile when you only have to do them once in a while. Too, after working a medical floor, you get a 'feel' for conditions, or the 'picture', that is almost intuitive--and it doesn't go away. Actually, some of the psych patients present so differently than the average Joe, there are times you have to look at subtle signs and symptoms--and labs---because the patient is not going to be of any help. My vote: hone your medical skills first, then do psych. Of course, my first suggestion is this: listen to your own heart. What do you feel is right for you? Best of luck.