I agree that we can become "ghettoised" as psych RNs. For example, this morning, when I d/c a patient's IV, the family member exclaimed, "I forgot: you must be a real nurse too!". I also trained in the big city tertiary hospitals (in Toronto, Canada) where MH nursing was discouraged. I worked as a psych orderly at a provincial psychiatric facilty while in nursing school, but after graduating, I did the med-surg gig: a full year in cardiovascular sugery, which I hated. I found that the highly efficient and specialised areas, meant for streamlined service, had a side effect for me of boredom. Ever worked in a unit doing only CABGs and valve jobs? I thought that every patient came in with the same Dx, same Rx, same Tx...I then did some palliative care, a lot of agency work, and finally returned to my true love: psychiatry. Now, I see that every day is different. I am the MHN in a remote hospital, which means that I must assess anybody who comes in the door...not just the "big" Axis I things, but all the AODA stuff, eating disorders, PDs, etc. Each day presents brand new challenges. After more than a decade, I would not do any other type of nursing, unless I were to specialise within psych itself, e.g., forensics, dual dignosis, etc. My own personal opinion is that all of those other med-surg skills are just those: skills. We can teach lay people to administer their own insulin, regulate their PCAs, or whatever. In the same way, the MH nurse can learn to do bloods and the like. My manager recently tried to coerce me into ACLS, which I think was intended to meet his agenda of having a greater pool for the ICU! (Fortunately, I am at graduate schol on the ACLS days!) In sum, I would say to you, not to worry. You will always be able to work in general nursing, concurrently with, or after, your psych days. As a psych RN, you can do both, but you might discover that you don't want to!