Psychiatric nursing... do you really lose all your nursing skills? - page 3

Hello! I'm a new grad and I have accepted a position on the inpatient unit in mental health. I'm excited to start my career in this field, but I have a question for those who have or already work... Read More

  1. Visit  Newbienurse36 profile page
    1
    As a new graduate, I am conflicted about which area to work in. Yes, I would love med surg - yet there are not a whole lot of these jobs available to new grads, presently, in my area. However, I also am really interested in psychology and have a decent chance of working in a comprehensive psyche residency program. I am puzzled and discouraged by the lack of support many nurses offer one another. We are taught that comprehensive nursing involves a holistic approach. Holistic nursing incorporates the physical and the mental components of the patient. How sad it is we do not respect all aspects of nursing, and nurses, who provide different areas of care. It seems we are sometimes our own worst enemies.
    WantAccel.BSN likes this.
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  3. Visit  AlphaPig profile page
    1
    Quote from Dragonnurse1
    I was sent to the psych unit several times for "emergency" situations - they did not keep a crash cart in the unit we had to bring it from the ER.
    Wow - they don't keep a crash cart on a psych inpatient unit? I thought every place in a hospital had a crash cart. I mean, anyone can have a heart attack or anaphylactic (did I spell that right?) reaction.

    Also, just wanted to comment that I once floated to our locked inpatient psych unit to work as the med pass nurse (for 26 patients!) and had a great day. It was fascinating being there, seeing how things worked. Also, while I was there a medical doc came over and decided to order a bunch of labs and an IV for some fluids on a patient and the other nurse (a psych veteran) literally had NO idea how to enter them into the computer or start the IV. I was happy to help her and she was so thankful. Then, a patient went completely pyscho and watching the veteran psych nurse handle the situation was amazing - calm, skillful, confident, kept the situation completely under control. Impressive.

    So, yeah, this med-surg nurse could start an IV and draw some labs but was CLUELESS with the rest of the psych world!
    Meriwhen likes this.
  4. Visit  AlphaPig profile page
    0
    I hope my post didn't come across wrong - I was trying to make the point that while psych nurses may "lose" some basic hands-on skills, they gain so many other amazing skills and in-depth knowledge. I enjoyed the few times I got to float there as a med nurse.
  5. Visit  Robert2012RN profile page
    1
    Just to play devil's advocate... you might just fall in love with psych nursing and lose your interest in emergency care. Regardless, go for it, and as others have said, you can always look for a per diem med/surg job. Also, there is an emergency nursing course offered at a university near me (So California). Perhaps there is one near you. That would strengthen your appeal to an ED Manager beyond possession of ACLS and PALS certifications.
    Meriwhen likes this.
  6. Visit  wingding profile page
    0
    If you are a psych nurse wanting to keep all your med-surg skills "fresh", then put in to float to med-surg when there is low census. This will keep you doing procedures & adding personal communication skills to your med-surg skills.
  7. Visit  Retired APRN profile page
    6
    I just have to pipe up and mildly protest this prevalent idea that "nursing skills" means "procedures". Putting in a Foley or starting an IV or taking an EKG are all really exciting and seem to measure your advancement toward becoming a "real nurse" when you're in school. But is that what nursing is? Procedures?

    No. for past century or so, the emphasis has been on our place as members of the health care team. That means "silent skills" like observation, analysis, evaluation, decision-making, problem/risk assessment, patient advocacy, environmental safety, and many more are becoming key points of concentration. The argument could be made that these nursing skills become honed on a psych unit much more than on a more procedure-based unit.

    I'm not really comparing one against the other, except to make a point, maybe give us something to think about it. If you really enjoy doing procedures, psychiatric nursing is probably not for you, but it is not a question of losing nursing skills, just strengthening other ones.
    Puppylv, boushie87, agee4273, and 3 others like this.
  8. Visit  Meriwhen profile page
    4
    Quote from Retired APRN
    I just have to pipe up and mildly protest this prevalent idea that "nursing skills" means "procedures". Putting in a Foley or starting an IV or taking an EKG are all really exciting and seem to measure your advancement toward becoming a "real nurse" when you're in school. But is that what nursing is? Procedures?

    No. for past century or so, the emphasis has been on our place as members of the health care team. That means "silent skills" like observation, analysis, evaluation, decision-making, problem/risk assessment, patient advocacy, environmental safety, and many more are becoming key points of concentration. The argument could be made that these nursing skills become honed on a psych unit much more than on a more procedure-based unit.

    I'm not really comparing one against the other, except to make a point, maybe give us something to think about it. If you really enjoy doing procedures, psychiatric nursing is probably not for you, but it is not a question of losing nursing skills, just strengthening other ones.
    There's a couple of "skills" threads going on in specialty forums right now...and guess what: the top skills people are listing as being essential for that specialty aren't all Foleys and procedures. In fact, you'd find their lists similar to the skills listed here.

    But it's psych, so everyone thinks it must be different since the organ we specialize in doesn't always manifest its problems as visibly as a heart, lung or kidney might.
    boushie87, QueeenB, agee4273, and 1 other like this.
  9. Visit  shamrokks profile page
    4
    Quote from Retired APRN
    I just have to pipe up and mildly protest this prevalent idea that "nursing skills" means "procedures". Putting in a Foley or starting an IV or taking an EKG are all really exciting and seem to measure your advancement toward becoming a "real nurse" when you're in school. But is that what nursing is? Procedures? No. for past century or so, the emphasis has been on our place as members of the health care team. That means "silent skills" like observation, analysis, evaluation, decision-making, problem/risk assessment, patient advocacy, environmental safety, and many more are becoming key points of concentration. The argument could be made that these nursing skills become honed on a psych unit much more than on a more procedure-based unit. I'm not really comparing one against the other, except to make a point, maybe give us something to think about it. If you really enjoy doing procedures, psychiatric nursing is probably not for you, but it is not a question of losing nursing skills, just strengthening other ones.
    I love what you said. Period. :-)
    DermottMcSorley, Meriwhen, Puppylv, and 1 other like this.
  10. Visit  wingding profile page
    3
    Sad thing - I had a doctor tell me that nurses were for comfort care. Retired APRN is right - nursing is much more than "procedures". My outlook is that once we are shown, do with coaching & then with observation (3 times) we are fixed & ready to go. This is unlike the ever learning of observation, lab values & medical as well as psychiatric disorders. To me the Psych Nurse encompasses all of nursing, because not only do we observe & assess general psych & health, we do wound care (they often come in with wounds), Infection control (MRSA wound patient no stranger to psych floor), Lung Assessment (COPD, CHF & pneumonia pts. after they come off of vent from OD); LOC assessment (daily, hourly, sometimes by the minute), & Medication side effects (EPS, B/P, etc.) & interactions. All of this while we do the daily discharge, admissions, documentation & pharmacy & kiss the Doctors & anyone else up the food chains' butt. All with a smile, with empathy & concern because god knows we don't want a patient complaint (who is a drug addict) to the program director about how we don't give all the PRN medications at once! Comfort Care --- righhhht.
  11. Visit  mon00707 profile page
    0
    I'm glad to hear a lot of these responses. I have been in mental for 3 months now but my ultimate goal is to someday become an ob nurse and lactation specialist. I have tried many times and never got a job in med surge so I took this mental health job to get nursing experience. Do you think 6 months is enough experience? I want to start looking elsewhere ASAP to get out if mh
  12. Visit  HarryTheCat profile page
    0
    Bear in mind that a certain percentage of ER admissions are Psych admissions, and the experience you get in an acute Psych unit is invaluable in those situations. If you're concerned about losing those other nursing skills you can always take a PRN position in a Med-Surg unit and keep your beside skills up. Even one day a month would be helpful.
  13. Visit  boogalina profile page
    3
    I'm still pretty new, but here's my thoughts on this topic.

    As a CNA, I worked with several gifted ICU RN's who did charge, precepted, etc, who worked in Psych. Didn't seem to hurt their careers a but.

    Putting in a Foley can be learned from YouTube. Putting a Foley in a scared person with Schizophrenia, keeping them calm and performing teaching? That's "real" nursing skill, and working in Psych to lose the "fear" of people with psych conditions is valuable experience and a gift.
    HeyNurse2014, QueeenB, and Retired APRN like this.
  14. Visit  DermottMcSorley profile page
    1
    Psych nurse for many years. prior to this I did med surg,telemetry,transplant and several other things. As a psych nurse I still do occasional post op care,wound dressings,foot care etc. I don't assume chest pain is all in the head. Those skills are still current for me. As others have said the assessment skills never go away, they do have a different focus at times.
    Retired APRN likes this.


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