Do I NEED Med-Surg training to be a psych nurse?

  1. I'm sure this has been posted a gazillion times before, and I appreciate in advance any replies!

    Do you guys think that psych nurses need experience in med/surg before going into psych nursing? Why or why not??

    Thanks!
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  2. 28 Comments

  3. by   hypnotic_nurse
    YES!!!

    Those who are mentally ill grow older and older and physically sicker. You may find yourself on a geropsych unit and you will need all your medsurg skills in addition to your psych skills.

    Adult psych patients take not only their psych meds but also the meds that people who have poor living skills (or just plain bad genetic luck) wind up with -- meds for hypertension, diabetes, congestive heart failure, emphysema, hep C, AIDS...so you have to be up on a wide range of meds and have to be able to assess for health problems in addition to psych problems.

    Your psych patients may have colostomies, amputations, healing surgical or self-inflicted wounds (have had several gunshot victims, self-inflicted)...the list goes on.

    Yes, your psych skills are most important for psych. But the other skills are as well.

    And all those of you who are wondering if you need psych in med-surg...ask any med-surg nurse!
  4. by   LeapNurse
    [font='times new roman']from neophyte nurse day one, i went directly into psych, focused only on psych, and developed a knowledge base and advocacy in psych. at a free-standing inpatient psych hospital, we sent medical problems to the er. when i worked in a denver co hospital we sent medical problems downstairs to the er, med unit, etc. yes, you have to be able to recognize a medical problem, but every psych unit takes vital signs and i would hope a first day nursing student could recognize a medical problem, or that "something is wrong." if you don't understand basics, i'd wonder how you passed boards. also, as a new nurse, ask others. in conclusion, med surg experience is fine, but certainly not a necessity to be a skilled, intelligent, altruistic, and caring psychiatric nurse.
  5. by   EarthChild1130
    Here's something I thought about this morning: Would I as a new graduate (in August next year, anyway! lol) be able to float between med/surg and psych floors? So I can work both at the same time? Or could I do something like work primarily on a psych nursing floor but ask every so often to be floated down to med/surg?? I don't know how most hospitals work but that would be great! LOL

    Thanks for the replies guys...it's a lot to decide!!
  6. by   lucianne
    It's not a bad idea, but I think the facility might prefer that you work mostly med-surg and float to psych. It's rare to have anyone from another unit willing to go to psych, so they'd probably love you on the psych unit.
  7. by   EarthChild1130
    That sounds good to me...that way I can get the med/surg experience out of the way and still 'get my toes wet' in the psych ward. Only thing now is to get through school!! LOL Thanks again!
  8. by   limandri
    I have been a psych nurse for a long time (both in-patient generalist and out patient advanced practice) and I truely believe a new grad should first get psych experience before going into med-surg. It is much more difficult to develop those interpersonal and supportive skills in med surg and they are so very needed. On the other hand nursing skills in any area that aren't practiced will get rusty. Starting with a year of med-surg doesn't assure that your skills will be current, it just postpones developing psych skills. After a year where ever you are practicing you will find those skills you haven't been practicing get outdated. If you choose to be in psych, start there. I worked in med surg briefly after graduating and can't say it was all that helpful in my career except to affirm my desire and talent was better in psych.

    Personally, I think this one year in med-surg is a myth promulgated by med-surg faculty and hospital employers.
    Quote from EarthChild1130
    I'm sure this has been posted a gazillion times before, and I appreciate in advance any replies!

    Do you guys think that psych nurses need experience in med/surg before going into psych nursing? Why or why not??

    Thanks!
  9. by   EarthChild1130
    My teacher always told us that she wished med-surg folks would spend a year as psych nurses and not the other way round for that exact same reason...thanks so much for posting for me...I love having experienced views!
  10. by   rachaelm4
    No. I'm a new graduate nurse and I started right into a psychiatric hospital. If psych is what you want to do then go for it, times have changed you don't NEED med/surg before going into a speciality....
  11. by   CharlieRN
    Need it "no". But should you make every effort to get it "yes". It will make you far safer for your patients and more useful to your employers. Those who don't have med-surg experience are the ones who say you don't need it. I hated my year of med-surg, but it has saved the lives of about a dozen of my patients over my 25 year career as an RN.
  12. by   EarthChild1130
    That's a very good point Charlie...thank you!
  13. by   Spazzy Nurse
    I too say ideally yes. I don't know if it's my imagination, but the field of psych seems to have become loaded with medical problems in the past few years. When I first started psych. 6 years ago, it seemed there were more chronic, older patients who had been in the system for years. Now the patients seem to be getting younger and more medically fragile in some cases. Or maybe I'm just nuts.

    As for rotating med surg and psych. as a new grad, I know that lots of hospitals won't put brand new nurses in psych. On the other hand, when my brother started his first job he floated med surg and psych, so check into it.
  14. by   CharlieRN
    I don't think its your imagination. Insurance companies are applying constant pressure to only admit the sickest patients. They would like to have only duel diagnosed patients on inpatient units. In the fantasy world they live in there are no single dx psych pts who can't be managed outpt. So we get sicker and sicker patients.
    Also there is the turf thing, med hospitals find psych pts a problem to manage so they want to place them somewhere else. They don't realize that just cause it says "hospital" in our name does not mean we are prepared to handle physical illness. Since I have worked both sides of the street I have some insight into this. I can remember being irrate when the psych unit refused to accept one of our pts because she was bed ridden. I actually said, "What's the problem, they have beds don't they?" Later I worked on that psych unit and found out that infact they did not have beds! The clients slept on day-beds that became couches during the day.

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