Will I hate psyhe nursing more, less or same?

[myoglobin, ASN, BSN, MSN]

I've been an RN for three years. My first job out of school was in ICU and they gave me the boot after three months to PCU. I've worked in PCU and now overflow (where we take everything from medical to PCU) since and am now going back to ICU this month. My favorite nights by far (in overflow) are those nights where they send me to watch the Baker Acts (that's what we call the mandatory hold patients here in Florida mostly from suicide attempts or threats of suicide attempts). Usually, it's just me and three or four fairly stable patients. Sure sometimes they are trying to escape, being vulgar, verbally abusive ect (I've been punched on several occassions and nearly stabbed on another)., but generally I find that I make real, sincere connections with these people and offer at least some measure of nursing benefit. By far my least favorite part of nursing is the medical. I'm a mechanical moron to the point that starting IV's, dealing with NG tubes foley's, and patient gowns (especially when people are on multiple drips and you cannot remove the lines) makes me miserable. I would literally rather be shot stabbed with a needle than have to start an IV. To make a long story short I'm thinking about switching to Psych. nursing and eventually becoming a psych. NP (thereby abandoning my amitions to become a CRNA). So here are my questions that are holding me back:

1. 12 hour shifts. By far my favorite thing about nursing is the three 12's per week. I've never worked an hour of overtime in fact I tell my co-workers that "if you ever see me on overtime don't even say hello, just call the cops because I've obviously gone over the edge and need to be put down like a rabid beast". As I like to tell my significant other I wouldn't work even one shift of overtime even for a million dollars (although I suspect that might be hyperbole, but no one has offered me the chance to find out). So can I get three 12's as a psyche RN how about as a Psyche NP? Also I've only worked nights. An albino vampire on tetracycline would fare better than me during the day (unless you're talking the beach where I spend most of my days off).

2. Pay. I currently make $38.50 per hour with no benefits. My significant other has benefits, but she won't marry me so I don't even have health insurance, and don't really care to (as I like to tell her if I had crushing chest pain, I take a couple of aspirin and think about calling the dr. in a day or two if I was still alive). Is this a realistic number for psych. nursing? Much of a pay cut isn't really an option since I have about 50K in student loan debt.

Give me some insights and things to think about. Currently the stress of my job makes me borderline depressed and anxiety ridden (and it is about to get much worse going back to ICU). Is psyhe nursing likely to be any better?

[Meriwhen, ASN, BSN, MSN, RN]

First of all, let me clear up the misconception that psych nursing is either easier or less-stressful than other fields of nursing. It may be for you or it may not be for you...all I can guarantee is that it is definitely different than a lot of fields. While you don't do as much of the technical hands-on stuff that you do in the ICU, you will be relying more on therapeutic communication and medications. Dealing with psychiatric patients can be very stressful...and if you're stressed yourself, you're going to be bringing that dynamic with you when dealing with them. You will also have to deal with the fact that your patients are not going to see rapid improvements. In fact, you will get used to seeing many of your patients over and over again. There is a high rate of relapse/regression in psych. All of this may be a nice change of pace from ICU or it may be a living frustrating hell.

Shifts: many places offer 12s, so you will probably be able to keep your 3 days-a-week schedule.

Pay: in my area, psych pays better than many nursing areas. However, in your area, your mileage may vary. Keep in mind that if you are entering into psych without any psych experience you will start off on the lower end of the pay scale for the job...could you live with a couple of dollars an hour less if that's what it came down to?

Will psych be better for you than ICU? I honestly don't know. The only person who can know that for certain is YOU. Since the job market sucks even for experienced nurses, if possible I'd suggest trying out psych first before quitting the ICU. Why not pick up a per-diem psych job somewhere to see if you like it?

[myoglobin, ASN, BSN, MSN]

Thanks, for the input. Yes, I could live with a couple of dollars per hour less. The problem with picking up the per diem is that my current work expects me to work three days per week (even though I'm PRN, non benefitted). Also, keep in mind that I'm just starting ICU AGAIN (I've been overflow/PCU), but that I expect that once again I won't be successful (as I wasn't with my first job out of nursing school three years ago). I've got real issues when it comes to so called "mechanical, hands on nursing schools". I'm able to "slip by" on my current unit just by working hard, not taking breaks, and really not engaging in much of any coversation with co-workers. So I expect that in about three to four weeks they will be giving me the boot from ICU anyway (I don't start offically until next week). Most of the Psych jobs that I see are "medical/inpatient" with a five to six to one ratio this sounds an awful lot like "medical/ or med tele" and I know I don't want to go in that direction. I need the money, but would allmost rather work at Wallmart than my current job (although my significant other would kick me out if I did that).

[ccoombs]

If you hate your current job that bad then I say just go for it. I'm a new nurse but I knew for a while that psych was my thing. As a specialty it is incredibly rewarding and there is never a dull moment, if things are quiet or the census is low then you can just spend more time with your patients. As far as the pay goes, I was started at a rate that is slightly higher than my classmates and with a benefits package that is vastly superior (yay, state work!)

[Jules A, MSN]

So you won't give psych a try on a prn basis because you might have to work more than 3 shifts a week?

[myoglobin, ASN, BSN, MSN]

It's not just the "more than three shifts per week" rather it is that it takes every bit of emotional, spiritual, and motivational energy that I can muster just to face my primary job (new ICU orientee) and the thought of an extra shift per week is enough to push me over the edge. Heck, my significant other now often complains because on the night before I have to work I insist on 12 hours of sleep. I won't go out to eat, engage in relations, go to the beach or do pretty much of anything else save contemplate my upcoming shift(s) of doom. When she says "so go do something that you like", she has the unspoken caveate (which will also pay the bills). I loved being a security guard years ago at a small rural college. I only made $7.00 per hour, but we were located in the girls dorm and I got to talk to girls my whole shift, and play chess in between my four or five rounds per night (plus I lost like 20 pounds from all the walking). However, if I went back to "what I loved" it would mean roughly a $30.00 per hour pay cut and on a given month I'm only left with a few hundred dollars in my account (despite a household income over a 100K, we are pathetic on budgeting). The other day when I was floated to ICU one of my significant other's best friends said to me "so if you don't like ICU go do something that you like" I replied "well I want to lay in bed, eat gummy worms until I gain 100 pounds and die, but no one will pay me for that."

So I'm left with doing my best at my current job. I don't think that my best will be good enough and when my three weeks of orientation is over I'm likely to be in a position of begging my old boss back in overflow for a job back (keeping in mind that overflow won't be there probably in a year or two at the most since they plan to phase it out).

[Jules A, MSN]

It's not just the "more than three shifts per week" rather it is that it takes every bit of emotional, spiritual, and motivational energy that I can muster just to face my primary job (new ICU orientee) and the thought of an extra shift per week is enough to push me over the edge. Heck, my significant other now often complains because on the night before I have to work I insist on 12 hours of sleep. I won't go out to eat, engage in relations, go to the beach or do pretty much of anything else save contemplate my upcoming shift(s) of doom. When she says "so go do something that you like", she has the unspoken caveate (which will also pay the bills). I loved being a security guard years ago at a small rural college. I only made $7.00 per hour, but we were located in the girls dorm and I got to talk to girls my whole shift, and play chess in between my four or five rounds per night (plus I lost like 20 pounds from all the walking). However, if I went back to "what I loved" it would mean roughly a $30.00 per hour pay cut and on a given month I'm only left with a few hundred dollars in my account (despite a household income over a 100K, we are pathetic on budgeting). The other day when I was floated to ICU one of my significant other's best friends said to me "so if you don't like ICU go do something that you like" I replied "well I want to lay in bed, eat gummy worms until I gain 100 pounds and die, but no one will pay me for that."

So I'm left with doing my best at my current job. I don't think that my best will be good enough and when my three weeks of orientation is over I'm likely to be in a position of begging my old boss back in overflow for a job back (keeping in mind that overflow won't be there probably in a year or two at the most since they plan to phase it out).

In reading this with the asumption that you are not 15 years old I really think there are many things going on here that a change of units or specialities will not fix. Please consider counseling in an effort to get a better grasp on things. I can't imagine the stress of having to work as a nurse if I hated it.

[Guest717236]

Not sure how they work the crisis teams in Florida. But, working

on a psychiatric crisis team is very steady work, you have

mobility ( onsite evaluations at police stations, homes, and hospitals),

so your security guard type feet would not be sitting at a desk all day.

The pace is brisk, so the day, evening or night goes by quick, especially

if your unit also has a small inpatient area.

Might be worth looking into, pay was good, benefits were terrific.

You need to look for a team that is cohesive, safety comes first

in this business and being a team is essential.

[Aspiring2bNP]

What is a typical day (if there is such a thing) for a nurse on a mobile crisis team? I have asked this question before and was lead to believe that social workers, not nurses that were on the team. It sounds interesting.

[aloevera]

First off, no worries re: shift.......I have only worked 12 hr. shifts in psych....

I can relate to your feelings and dislike of the clinical aspects of nursing, I too got tired of all the clinical skills required of us early on.

That is why I changed to psych.

BUT....keep in mind that we have to be extremely keen in assessing and identifying any medical problems in our pts. to bring to the docs attention due to the fact that our med docs only see the pt. one time after admission.

After that, we assess and identify QD......... so if your assessment skills are sharp and you find you enjoy communicating with the psych pts. on your unit, then definately GO FOR IT!!!!

I don't know about pay.........I have been in psych for some time and think I am at the lower end of the pay scale, but I really don't know.....I assume q. area is different....???