Graduating in May - Need Advice

Bailey500 · Mar 21, 2005

Hi!
I will be graduating in May from an RN program. I am very interested in psych nursing and have had several job offers. I also have a BSW. Eventually I would like to go on for my Masters degree, in order to be able to be a therapist. I would like some advice from current psych nurses. Do I really need a year of med/surg first? Are you happy being a psych nurse? What suggestions can you give me to make a smooth transition from student to RN?
Thank you!

Good luck to you in your last couple months. I'm a RN in Geriatric psychiatry. Have a BA in Psych, and AD Nursing. After work as a case manager, I decided to go into nursing. I've found the transition to be very smooth...as far as med surg--everyone told me I "had" to do at least a year of med-surg. I opted against that advice, and it has been a good decision for me. you do not need a year of med-surg. While we do have medically comprimised patients, the majority of the issues are psych related. I would suggest that during your interviews, you get a clear idea of what exactly your job will entail, and request some sort of preceptorship/mentor program. Psych nursing is very challenging, but it is definitely a unique opportunity to work with a diverse group of patients. And your SW degree will certainly help with the psych aspects. Consider geri-psych nursing-has a good balance of a little med-surg, and a lot of psych...great for a new grad. good luck again with school and your decision making process...

melissa_rn · Mar 22, 2005

Hi!
I will be graduating in May from an RN program. I am very interested in psych nursing and have had several job offers. I also have a BSW. Eventually I would like to go on for my Masters degree, in order to be able to be a therapist. I would like some advice from current psych nurses. Do I really need a year of med/surg first? Are you happy being a psych nurse? What suggestions can you give me to make a smooth transition from student to RN?
Thank you!

No med/surg necessary! I graduated Dec '03 and went right into residential psych for adolescents. Dec '04 I was made nursing supervisor. Med/surg will never hurt, but it is not necessary. I think that I wouldn't be a nurse right now if I had done med/surg first. In your transition, don't be afraid to ask questions. Just because you are now "officially" an RN doesn't mean you know everything. When I started I felt stupid if I didn't know something I thought I should have...but ultimately you'll look worse if you don't ask. Find yourself a good mentor and watch and learn.

What city are you in?

lgrninmay · Mar 22, 2005

Thank you ! You don't know how long I have wanted to hear that I don't have to endure a year of med/surg. Not that I don't respect those that choose that speciality, it's just not my thing. My instructors have been pushing the med/surg idea - (except my psych instructor). It's great to hear from those already in the field! I will be looking for a job in the Baltimore, MD area in May.

JeromeG1234 · Mar 22, 2005

I'm also a recent graduate (May '04), and I went right into psych on an acute adult with no med/surg experience. It has not been an issue. There are times when medical issues come up and I feel inept, but there are always other nurses around to help that DO know what to do, and with time I've gotten better at dealing with these situations as well. Nursing school gives you the basic foundation you need to handle the issues that will come up.

CharlieRN · Mar 22, 2005

There are times when medical issues come up and I feel inept, but there are always other nurses around to help that DO know what to do, and with time I've gotten better at dealing with these situations as well.

Do you really want this to be you? Do you want to be the weak link? Do you want to be the one who does not have the experience indepth and has to go to other nurses for it? Med surg is h*ll. Necessary h*ll. Get med/surg experience. Then get emergency department experience. ED is also h*ll but more interesting h*ll. Then when you go to psych you are the resource person. You are the one others seek out when things are going to pot.

JeromeG1234 · Mar 23, 2005

CharlieRN, I think that you missed the point of my post, which was that after a few med/surg situations in which I had to ask other nurses for help (which, I might add, they gladly gave), my skills improved and I now know what to do. I am hardly the weakest link in my nursing team and am offended by your assumption that such is the case.

You have posted yourself that medically compromised patients aren't generally admitted to psychiatric hospitals, so it would seem logical to assume that you are aware that med/surg emergencies (codes, etc.) issues are not every day occurrences.

Do you really want this to be you? Do you want to be the weak link? Do you want to be the one who does not have the experience indepth and has to go to other nurses for it? Med surg is h*ll. Necessary h*ll. Get med/surg experience. Then get emergency department experience. ED is also h*ll but more interesting h*ll. Then when you go to psych you are the resource person. You are the one others seek out when things are going to pot.

CharlieRN · Mar 24, 2005

Sorry I was offensive.

I do feel strongly that in the psych environment Nurses need to be the physical health resource people. Psych treatment teams are rich in people who have specialized in psych; psychiatrists, social workers, chemical dependency counselors, psychologists, art and occupational therapists, etc. The patient does not need their nurse to be just another psych specialist.

I can recall being asked by another nurse to give her patient an enema because she was a psych specalist and said, "I don't do body fluids."

Another time I had to tell a psychiatrist that I would write an incident report if he refused to send a patient to the emergency department. He did not recognize black tarry diarrhea as a medical emergency and thought a clinic referral the next day was appropriate treatment.

elkpark · Mar 25, 2005

I've been a psych nurse for 20 years, a psych CS for the last ~10, and I agree strongly with CharlieRN on this. I've worked enough med-surg over the years to keep my skills up, which is, unfortunately, very unusual in psych.

Few things bug me as much as being told by a fellow psych nurse, regarding some sort of necessary medical procedure or assessing and intervening with an urgent medical problem, "Oh, I don't do that -- I'm a psych nurse ..." I'm real sorry to be the one to break the news, but that "RN" after your name means that you're accountable for all the same skills and knowledge and abilities that every other RN is. I've seen very scary situations arise on psych units because nobody, including the nurses, was paying attention to a client's physical condition. Just because there are psych facilities willing to hire people straight out of school, doesn't mean it is a good idea ...

To the OP: If you know that you want to be a therapist, is there some reason why you're not just going ahead and doing that? It would be much easier to just get an MSW than to go through nursing school and then grad school ...

lgrninmay · Mar 25, 2005

It's great to hear from a psych nurse with your experience. I may try to get some med surg experience while also pursuing the psych area. I am an older student with several years experience in a physicians office, which may help with the medical portion of psych.I would refer to a text or other resource, before I would ever say "I'm a psych nurse - I don't do that!"

It's been many years since I have worked as a social worker - got tired of the low pay, contractual positions with no benefits, and systems that are not set up to benefit the client. I would rather have the medical knowledge on board, in working with clients. For example, as a SW I knew nothing about the meds that a client was taking, and had little medical knowledge related to their disease process. I am interested in case management also, and may pursue that avenue. Thank you so much for your imput!

CharlieRN · Apr 4, 2005

lgrninmay

Social workers need unions, same as nurses do. Preferably they are the same union.

jetskier · Apr 24, 2005

Congratulations on making the decision to become an RN, inspite of already having a degree. I think your question is a good one but I do not think there is a black or white answer. I am currently in my master's program for Psych...I started out as a critical care nurse. Before that people told me I had to have med/surg experience. Looking back it sure would have helped...but I did just fine. I also compare your question to this: Do you really need a BSN to be a better RN? For many nurses the answer is no, for me the answer was yes. The sociology, anthropology, psychology....I am certain played a role in my decision making processes as a nurse, for the better. I was more informed. Knowledge is power!!!!! Is nursing an art or science??? You will get every answer under the sun. It's a personal decision you need to make. I don't think you have to do it...do I think you will benefit from the experience, ABSOLUTELY!!!! In short, good luck. There is no right or wrong decision just keep on nursing.