Psychiatric nursing... do you really lose all your nursing skills?

  1. 3

    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 there. I keep hearing rumours that nurses in mental health lose their nursing skills and thus the chances of receiving a job in acute care are limited. My long-term goal is to become an ER nurse, so I'm wondering if there's anything I should do to ensure that I can do to achieve this goal in the future?
    Adelene, Wild Irish LPN, and Joe V like this.

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  2. 42 Comments...

  3. 10
    As a psychiatric nurse, you will use your critical thinking skills, your assessment
    skills, your communication skills... invaluable tools that are difficult to relearn
    once gone.

    As a psychiatric nurse, you probably will not start too many IV's, give blood,
    insert foleys... except for on rare occasions. After a while you may lose some
    of your hands-on skills, but those are so much easier to relearn.

    Having said all of that... if you spend six years in psych, you are much much
    less likely to get hired to an ER crew than if you spend say, six months to a
    year in psych. I've known new grads who started their careers in psych, and
    then moved on to ICU, Med Surge, wherever. Good luck!
  4. 4
    My friend just got hired at the mental health complex, and she also feels that she will lose her skills.

    Many nurses I know who work at the complex said they really don't do anything (hands-on skills) and they are fine with that.

    I don't really have any advice or experience but I think you could probably take a refresher course on skills you felt you lost before you transition into acute care. Technical colleges have weekend IV or NG tube insertion courses.

    Congrats on your new job!!
    pyriticsilence, Fiona59, GrnTea, and 1 other like this.
  5. 1
    If you want to be in the ER, then get out of mental health now and find a job in acute care... I have worked in mental health for the past year and there is no way I would be able to get a job in acute care now, let alone an ER... Or you could keep this job in mental health, but have a job on the side in acute care at least... to keep up your skills.
    I do think though that mental health is a select set of skills pertinent to that area, but very different from acute care in general.
    kestrad3 likes this.
  6. 7
    Quote from pinkfish333
    Or you could keep this job in mental health, but have a job on the side in acute care at least... to keep up your skills.
    I do think though that mental health is a select set of skills pertinent to that area, but very different from acute care in general.
    This, pretty much.

    Never let anyone tell you that psych nurse requires "no nursing skills". I learned tons in my psych rotation in nursing school, but more in terms of communication and "thinking outside the box". It's definitely a different type of nursing than one traditionally thinks of, but it's one that only certain people can do. I, for one, can handle all sorts of med-surg stuff but I'd drown in psych.

    There are extremely few "hard nursing skills" (hands on stuff, like dressings and IVs) to be found in psych nursing, though. I remember when I was on psych as a student, a patient had a bad allergic reaction to their meds and required IV medications to counteract it. The psych nurses made such a fuss about it because some of them literally hadn't seen an IV in years. It's not a reflection on their skills as nurses, but it's just the reality of the job description. "If you don't use it, you lose it" kind of idea, in terms of their skill and knowledge of IVs in that instance.

    I second the idea of doing both psych and acute care if you wish to do ER nursing. My psych clinical instructor actually did that - she was an amazing psych nurse but because she didn't want to lose her "hard" skills, she also picked up shift in a general surgical floor. She even was a clinical instructor in both fields. So, basically, she had many nursing skills that could be applied in so many different ways. I'd do the same but unfortunately, I'm just not cut out for psych nursing!
    HarryTheCat, Robert2012RN, splendid, and 4 others like this.
  7. 9
    You will lose some "skills" as others have said, but you will gain many others that will translate well to the ER. Thinking and acting quickly in an emergency, is a big one that I can think of. Time management is another, as you will often be managing and passing medications for upwards of 10 people. I've worked on units where the med pass was split, each nurse passed meds for 10-12 people, and I've worked on units where there was 1 med nurse for a 27 bed unit. Passing meds for 27 people requires great time management. You will learn how to interact with physicians, as well as work in a pretty autonomous environment, much like (I imagine) the ER to be. You will learn to be a patient advocate "hey (psych) doc, he is pretty out of control, I think he needs a nice dose of (insert your favorite psychotropic here)...OR "hey (medical) doc, I know you hate coming down here and you think all our people are just crazy, but I really think this guy is going into DT's. I really need you to come evaluate him now." (Okay, maybe leave the first part out :lol: )

    So, if we are being realistic, (because is it REALLY that easy to just go grab yourself an acute care job and get the "right" experience?), take full advantage of what you have now, keeping the big picture in mind. Try to get a dysrhythmia course somewhere, take ACLS, and when you do get that chance to sell yourself to that ER manager, remember to play up the relevent aspects of psych as they relate to the ER.
    HeyNurse2014, QueeenB, Robert2012RN, and 6 others like this.
  8. 22
    This question comes from the perspective of a student or very new grad, who thinks that all nursing is, is "tasks," which is what they call "skills." This is because they have just spent their instructional time focusing on the lab check-off sheet and being jealous of their peers who "got to do a ... !!" as if putting in a Foley, starting an IV, or sinking an NG were such great shakes that they'd remember every one they ever did forever. (Hint: Not.)

    Do not ever say a psych nurse has "lost all her skills." There are very, very specific skills that psych nursing demands; just because your friends don't think they see the nurses at the mental health facility "doing anything" doesn't mean that those nurses are not, in fact, doing a great deal. They are. If you are savvy enough to learn from them, you'll learn a LOT you can definitely use in ER. No worries on that score, really. Where do crazy people go, anyway? Right! The ER.

    And I say this from the perspective of a long-time critical care nurse who "got to do...!!" everything you can think of and a lot you can't. Take the psych job and be thankful you have the opportunity to do it.

    Note: to get full impact of this message, it should display in Comic Sans, green. Thank you.
  9. 9
    Any smart hiring manager would be thrilled to hire a nurse with expeience in psych. Or LTC. Or any other speciality where nurses are said to "lose their skills". As a psych nurse you'll bring lots of unique skills to the table. Trust me, any hospital floor will have plenty of crazy patients who would benefit from a seasoned psych nurse. Also plenty of geriatric patients who would benefit from a battle hardened former LTC nurse being on the floor. The "skills" everyone is so worried about losing can be learned relatively quickly. Being specialized in a particular area of nursing takes YEARS and is priceless.
  10. 3
    No experience is ever wasted. You never know where this job might lead. You never know what job you will have in the future that these skills will transfer well to. Besides, in a few years the pendulum will swing back to there being a nursing shortage and you'll find something.

    Also there are nursing refesher courses offered in different areas. There are several in the area where I live. I'm a dialysis nurse, bit if I ever decide to do bedside nursing I will probably take that course. But so far I haven't felt like I have to so I haven't done it.
  11. 4
    I have been a psych nurse for about a year and have thoughts of transferring to a med surg unit in the near future to keep up my clinical skills. From what I have heard, the hands on skills like putting in a catheter or starting an IV will come back to you much quicker than you think. And not to mention, the communication skills and conflict management that a psych nurse possesses would definitely come in handy in the ER. The majority of our patients come from the ER and are much more acute and difficult to manage there, so I can imagine that the ER nurses possess similar qualities of a mental health nurse. They must be able to handle all types of patients with different personalities and many of whom have mental health diagnoses. They must be able to diffuse a situation and be prepared to handle anything, which is exactly how I would describe the role of a psych nurse. Inpatient psych units are often very chaotic and so you learn how to function and remain calm in a chaotic environment, which is a marketable quality when applying for that ER job! Good luck as a psych nurse and keep the ER in your future plan. I think you'll find that you're more than capable to transfer the skills you have gained as a psych nurse!!

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