Am I selling myself short???

santhony44, MSN, RN, NP · Jul 15, 2007

Are there any possible circumstances, where you are now, that might require you to perform those skills? If so, maybe you should ask for the chance to work on those. For example, go to Med-Surg not to take a regular patient load but to work on skills only.

If there will be no need for IV's where you are, ever, then I wouldn't worry about it. You can pick up skills at any point if you need them.

I think it's great that you've found something you really love right off the bat.

smirn80 · Jul 16, 2007

im kinda da same, fresh of nursing school, tried DOU, but i did my preceptorship in a psych unit. I applied to do per diem in the psych unit i did my preceptorship, n they offerred me a FT position. I havent looked back since. I love being psychiatric nurse. Its the thing that I wanted to do while i was in nursing school. But like u, I thought about the "skills" that I may possible lose by not doing med-surge. I may try to talk to my supervisor n see if i can do a couple of days a month in the medical floor at the hospital where i work at.

Guitar_Heroine · Jul 16, 2007

I asked this of many people too when I was thinking of going into psych nursing (there are no FT positions on the unit so I'm starting in med-surg in a week... we'll see how it goes). You know if you get a new case or skill like that there is usually someone else on the floor who can back you up. And if you ever swtiched to a med-surg unit in the future you would need a refresher course anyway so I say follow your heart! And if skills development opportunities come up, pounce on them!

rn/writer, RN · Jul 16, 2007

I was a psych nurse for quite a while. I had six months of med-surg right after graduation, but even so, the "use it. or lose it" principle applied. When I wanted to change specialties, I took an inexpensive refresher course at a community college and got back up to speed pretty quickly. I still had to start in the new area as a Clinical Level I, but I advanced faster than the new grads.

Even if your facility doesn't press the med-surg issue, stay in the learning mode. Keep the edge you acquired for school by doing outside reading and thinking your way through different scenarios. I have enjoyed checking out library books that have to do with medical topics. Not textbooks, but real life accounts having to do with people afflicted by different diseases as well as "how-to" books about living with a variety of medical maladies and conditions. These books can be found in the 610-619 section of the Dewey Decimal system. Or ask a reference librarian for help.

There are also tons and tons of cable medical shows (as well as a few on network TV). Challenge yourself to watch these and guess what's wrong. Listen to the progression of the diagnosis--what tests they do, what clues they follow, etc. and try to think of the A&P behind it all.

Granted, these are no substitute for the hands-on work of med-surg, but you might be surprised at how they can keep you sharp and help you make connections on your unit.

One of the dangers of psych is tunnel vision. There is a tendency to view everything through the psych lens. (This happens, to some degree, in every specialty.) In med-surg, they sometimes forget that patients' minds can affect their bodies. In psych, it's the reverse. Especially with adolescents.

This can lead to a dismissal of physical s/s as somatizing--converting psych issues to more attention-getting physical maladies. It's far too easy to make that assumption, and it doesn't help when you have a patient with a history of histrionic or avoidant behavior. Good assessment skills are your salvation in this kind of situation.

You will need those same skills to monitor med side effects, adverse effects, and med interactions.

You can, of course, come here and learn all kinds of interesting things. And what you don't find, you can Google.

If your unit insists on the med-surg experience, perhaps they'd allow you to split your time between units.

Even if they don't, keep your mind sharp. The skills can be relearned in a refresher course, but being mentally prepared is something you can do for yourself and your patients no matter what happens.

I wish you the best.

kristen38 · Jul 25, 2007

I also just graduated and passed the CRNE (Canadian version of NCLEX) and thought about doing something other than psych, espcially after doing my consolidation on a psych unit.

In the first month I had to do a couple of catherters, had a pateint so depressed that she wasen't eating and agreed to go on an IV to keep her fluid intake up (TPN should be started this week, in an OBS unit, she is also pregnant) and I have had two patients with ostomies. I know that it is not the same a med-surg floor but at least I was able to use the skills I learned in school to help me.

I was told by a lot of the staff that if you don't use it then you lose it and doing a few years in med-surg and then going to psych would be good experience but 15 years down the road you won't remember your med-surg skills, so stick with what you like doing.

Kristen

Seemoni · Jul 30, 2007

I'm glad that you've found your niche in Adolescent psych. I had been training in ER, my first love, but after graduation they didn't have PT positions only full time and as I was continuing for my BSN and still in school FT I couldn't keep it up for long. The only place with 8 hour shifts in the area was Adolescent Psych and I really loved it there. However, now I'm ready to go back to a clinical setting and, by golly. It's like I'm worse than a new grad. I'm sure I can pick up those skills again. I mean I learned IVs in a couple hours the first time, couldn't take much longer the second time around could it. But to most recruiters and managers I've just been out of touch for too long. If you're sure you want to stay in Psych indefinitely, you really have no need to worry. But if you plan on ever doing something else, or having the option to, you may want to consider pulling some med-surg time.

RN1263 · Aug 7, 2007

Edisonnurse how's the job going?......

I'm a new grad also and I just got hired this morning at a private psych hospital on an adult unit that requires pt's to be medically stable, ect. and I'm absolutely THRILLED that I won't have to do endless med/surg skills, that I'll have a chance to sit down here and there throughout the shift and even be able to pee when I need to. I even took less pay than the E.R. job I had so that I can deal with the "mind" more so than the "body". Yeah, I know they're connected, but you know what I mean. :lol2:

I know HOW to do med/surg skills I just don't WANT to......LOL! and if over time I lose those skills and I find it necessary to know them again...then, well, I learned them once I could learn them again.