Advice on Deciding Which Job..Family Practice or Psych...

Nurses General Nursing


  • by ivyleaf
    Specializes in Ambulatory Case Management, Clinic, Psychiatry.

Hi all! I would gladly appreciate your input in helping me decide..I have been offered one job, and had an interview for another today, which went well. I will hear back by Monday. Although I don't know if I have the job, I wanted to pose this question ahead of time, as I probably won't have too much time to make a decision if I am offered both jobs.

I graduated with my ADN (RN) 2 years ago, and have since been working PT/per diem in psych, and going to school for my bachelor's (in psych) full time. I graduated this past week and have been looking for a full-time job.

Job 1: 32 hours, 24 hrs (evenings) as charge nurse on a 6-bed inpatient unit (working with one counselor, a psychiatrist, and social worker) 2 week days and one weekend day. 8 hours would be as admission nurse for the whole psych hospital; at this point I don't know which day (it wouldnt be a weekend day) or whether it is day or eves.

Pros: I hate getting up early for days, I like psych and love my psych patients, I am already comfortable with psych nursing, pay is better (at this point not sure exactly how much, but most likely 3$-6/hr more)

Cons: I'll be the only nurse on the unit which can sometimes feel isolating (although i am in the same position in one of my PD jobs now), I prefer days b/c Id be home in the evenings and have trouble falling asleep at 12am when I get home

Responsibility/Stress: From the interview I know Id have extensive training (I would start out on the main unit with other nurses), but I would eventually be on my own in the unit;Also, admission nurse for the psych hospital (3 units; about 60 beds) sounds like a big responsibility

Job 2: 36 hours (days) as the main nurse for a family practice doc

Pros: hours are good, no weekends, I would get medical experience without doing med/surg (which Is not my cup of tea), the doc seems like a good match personality-wise and says he values his nurses as "partners", it would open up doors to other job possibilities (besides psych..I am possibly interested in being an FNP), I would learn a lot

Cons: I would be working with kids and the elderly (I prefer working adolescents, young adults, and adult adults), the pay is lower, I will probably miss my psych patients, I would be the youngest person on staff by about 20 years (worried about the whole eating your young thing), I would be the only nurse for the doc so if I wasn't up to snuff/dont pick up think fast enough, or if we weren't getting along, that would be a big issue (vs being one of many staff nurses on the floor); there are a fair amt of administrative tasks (care coordination, doing PA's, urines/hemoccults/minor lab tests) and the doctor said up front that I might feel like I was underutilizing my education at times (his words, not mine)

Stress/Responsibility: There is a lot of tele triage, which I dont have experience in; i have been told many times that the practice is *busy*; I have no medical experience besides school and a brief stint as a CNA several years ago,

Option 3: wait to hear back from the other places I have applied to and/or continue applying to jobs

Cons: I have been looking for work since January and am exhausted/sick of it (I was previously looking for a research position, long story...)

As I havent even been offered the job, I know I have some time, and will ultimately make the decision myself, but I would LOVE *any* input from other nurses who have more experience or who have been through a similar dilemma.



Whispera, MSN, RN

3,458 Posts

Specializes in psych, addictions, hospice, education.

I question the likelihood of there being a social worker, counselor, and psychiatrist being present throughout an entire evening shift. I suspect the first two go home at about 5 and the psychiatrist, if employed by the facility, would probably do the same, maybe being "on-call" otherwise. I have worked as only nurse on an inpatient unit and it isn't always a good situation to be in. What other staff will be available or present?


366 Posts

Specializes in Ambulatory Case Management, Clinic, Psychiatry.
I question the likelihood of there being a social worker, counselor, and psychiatrist being present throughout an entire evening shift. I suspect the first two go home at about 5 and the psychiatrist, if employed by the facility, would probably do the same, maybe being "on-call" otherwise. I have worked as only nurse on an inpatient unit and it isn't always a good situation to be in. What other staff will be available or present?

Thanks for your response!

Yes, there would only be a counselor/MHW on for the entire shift. I am in this situation in the psych crisis unit I currently work at, and I feel safe--but pts are less acute and there are no active detoxes (unlike the job offer). I like the autonomy of the situation; however, it can be a little "lonely" working alone! The unit is adjacent to the main unit (there is a door in btw), so I could go over there for help/with questions. Also, the unit takes less acute pts than the main floors. I guess I'm more concerned about not having people around to banter with, vs. safety issues.


42 Posts

It seems that you have received most of your experience working as a new nurse in psych and your going for your bachelors in psych so just that alone I think you would excell better on the psych unit. So to be employed in the field that interest you most I think psych is your best bet! Now I've worked in the psych unit as a Nursing Assistant in the past and I cant say that I enjoyed being locked in a unit. There was adequate staffing but the situation didnt always feel safe. I remember several times myself and a Mental Health Tech (not a nurse, not security) had the responsibility of transporting Psych patients to their court hearings by ourselves! We had one patient that kept trying to open the van door while the van was in motion, one older gentleman that kept telling the judge he was Santa Claus, then as protocol when arriving at the court, the court deputies took the patients to the holding cells along with others that were awaiting there hearing that werent allowed to roam "free" and here I am thinking no formal training I'm just filling in and the hospital has me transporting Psych patients?

Now on the other hand I think if you weren't so sure of what specialty to pursue then I would advise you to try Family Practice. I have woriked for a Family practice Physician and in an Urology office for a short period of time as a Medical Assistant and I gained so much valuable experience as well as I've witnessed some ordinary and not so ordinary cases so I'm sure everyday would bring you an exciting challenge!

I have children and most holidays and weekends I find that I always have to work!! I keep saying I want a job that closes on holidays, weekends, and bad weather (I live in Michigan) So if a regular work week, no weekends or holidays suit you best try the Family Practice office. My boss said everyone wants more money but surveys have been done and being happy on the job really isnt about getting an extra couple of dollars? I beg to differ in my case but I think your calling is in Psych unless starting out that's all your used to and all you know and your just comfortable or scared of change? I honestly think even if the Psych job paid less you would still be happy.

You could rewrite your pros and cons on paper and in colums to get a better look at the situation. But remember just like dating "there are other fish in the sea"

One more thing, I dont mean to offend anyone but I have always heard jokes about how the Psych Nurses are just as crazy as their patients? I guess in some sense the nurses have to step down to their level to better interact with the patients? Hell my long time fiance says I'm bipolar. but has he left? Of course not, he must be crazy too for sticking around!

I wish you the best, Only you can Utimately make that decision, if your a religious person, Pray about it.

roser13, ASN, RN

6,504 Posts

Specializes in Med/Surg, Ortho, ASC.

After reading through your post, I would hazard a guess that your heart lies with the Psych position.

I learned early on to make lists when faced with two choices: the pros and cons.

You have done that.

BUT, the deciding factor is NOT how the list ends up. It is how YOU FEEL about how the list ends up.

If the Psych position loses out in a pros/cons list, how do you feel about that? Are you disappointed?

If the Family Practice position loses in a pros/cons/ list, is that a relief?

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