Psych ER or inpatient

[justdoiting]

Hi all,

I am an RN with 1-year med-surg experience looking to transfer to psych.

I am trying to decide if I should apply for psych ER positions or go for inpatient psych instead. I eventually want to go back to school to become a psych NP.

Any thoughts?

Thanks

[LPC2RN]

Having worked both, I prefer the fast pace and excitement of the psych ER. If you enjoyed getting to know your patients as a med-surg nurse, you would probably like IP psych as the patients are there longer. As a psych ER nurse you are probably going to be doing quick assessments, getting labs, preparing and giving haldol or B-52 IMs, getting them out of clothes and be focused on getting them in and getting them out. An IP psych unit would be more like your med-surg experience. You would get report, get assessments, pass meds, chart, pass more meds, chart, get PRNs, chart, go to patient staffings, meds, chart, etc.

Regarding becoming an NP, either one would be useful as you are getting exposed to psych assessments, crisis intervention, etc. You would probably get more experience and comfort with psych meds as an IP psych nurse though as the psych ER would be more focused on sedatives (benzos, zyprexa, haldol, thorazine, etc.)

What NP programs are you considering?

[elkpark]

Lots of psych ERs are looking for people who already have psych (inpatient) experience. You have more "room" to learn, make mistakes, grow professionally on an inpatient psych unit. You would also learn more about psychiatric disorders, treatment, and client population on an inpatient psychiatric unit, where you would spend time with and observe people over the course of their hospitalization, rather than an ER in which you are just stabilizing and moving people.

[Meriwhen, ASN, BSN, MSN, RN]

Keep in mind that working psych ER involves much less medical nursing than you think. Some of your patients may be medically unstable, but it won't be anything that couldn't be managed on a psych unit or psych-med floor. The patients you will encounter in the psych ER will have psych as their primary complaint, not medical issues, so you're going to have to understand psych conditions, interventions, medications, and managing behaviors (hint: it involves a lot more than Ativan and restraints) for patients that can be very unstable. A nurse who doesn't have any psych experience is going to have a steep learning curve in a psych ER.

Also, as Elkpark alluded to, the focus in the psych ER is assessment, stabilizing and dispositioning patients, because you'll have them for 24 hours or less..though you'll have a lot of frequent flyers that you'll get to know pretty well. You need a good background in psych to know what you should be assessing and treating.

IMO, go inpatient first and gain psych experience. Then if you're still feeling the itch for psych ER, you'll be in a better position.

Best of luck whatever you decide!