ASN-MSN Psych NP

roser13, ASN, RN · Jan 20, 2016

My thoughts are that virtually all pre-nursing and nursing students are "sure" that they know exactly what kind of nurse they want to be and where they want to work. In my experience, very few nurses end up in the position they dreamed of, at least not at first. Whether due to scarce positions open to new grads or a change of heart with clinical experience, things just change.

Again, from personal experience, a stint on a med/surg unit can only help. Psych patients bring the same med/surg issues along with them as the general population. One of my most frightening psych rotations was in a closed unit where (seemingly) none of the staff knew how to deal with a fresh surgical wound, a colostomy, or even a simple dressing change.

In other words, try to focus on your education, letting your experiences guide your next step. At 19, you have so much to experience in nursing. Try not to stress years in advance because when those years arrive, your head may be in a completely different place.

Jensmom7, BSN, RN · Jan 20, 2016

My thoughts are that virtually all pre-nursing and nursing students are "sure" that they know exactly what kind of nurse they want to be and where they want to work. In my experience, very few nurses end up in the position they dreamed of, at least not at first. Whether due to scarce positions open to new grads or a change of heart with clinical experience, things just change.
Again, from personal experience, a stint on a med/surg unit can only help. Psych patients bring the same med/surg issues along with them as the general population. One of my most frightening psych rotations was in a closed unit where (seemingly) none of the staff knew how to deal with a fresh surgical wound, a colostomy, or even a simple dressing change.

I worked in a psych unit where none of the other nurses knew how to mix a piggyback, let alone hang it correctly.

Patient got 2 days worth of saline (six doses) before the night nurse (me, who had been off those days) noticed that the antibiotic vial attached to the bag hadn't been cracked and mixed with the saline. I asked around-everyone looked at me like I had three eyes.

FuturePMHNP14 · Jan 21, 2016

Wow! I guess experience can't hurt anything. Thank you for the advice.

FuturePMHNP14 · Jan 21, 2016

Your advice was greatly appreciated! I need to put more thought into this. Thank you!

Whispera, MSN, RN · Jan 21, 2016

I think med surg experience will be valuable to you as a psych NP and psych nurse experience is critical for you to be able to assess psych patients and know what to do. You won't get enough of what you need in school. Experience on-the-job is fundamental. Some schools won't accept you without it.

Trauma Columnist · Jan 21, 2016

Moved to Student NP forum

elijahvegas, ASN, RN, EMT-P · Jan 22, 2016

personally, i'd say go with your first option. I really can't see why you would "need" med/surg experience if you know 100% you want to do psych. Plenty of people have gone straight to psych without the intermediary steps and have done just fine. Working in a psych setting with your ASN as you make your way through your MSN is definitely a prudent course of action however, its's never too early to delve into the specialty of your interest. It gives you insight as to what you'll be getting yourself into, with plenty of time to change your mind.

They say it couldn't hurt, and the experience helps you in all facets of nursing, and while that is true, psych is a whole different beast. Not to say that you wouldn't benefit because obviously any experience > no experience, but I doubt you'll be seeing enough of a psych population in med surg in the "suggested year" of experience to really grasp the full scope of what its like to work with said population day in and day out.

To me, saying you need med/surg before going into a specialty like psych is the equivalent of one saying it's a good idea to start off as a cna or lpn before pursuing an RN. Sure, plenty of what you learn as a cna and lpn are utilized as an rn and you're expected to be competent in those tasks, but upper level classes you're taking is less than half practical, and mostly theoretical/qualitative/management coursework. Your clinical setting throughout will put you where you need to be in terms both general practice like med/surg, and when you are in your masters program, I'd assume you'll be placed in mostly psych settings (If you're going into a specific PMHNP program and not simply FNP) So any skills you might feel you need to brush up on, just review the procedure, watch some videos, don't let it escape your mind completely.

There was a post i read on this topic some time ago about a nurse that jumped right into psych w/o the med/surg year and essentially conveyed the same idea.

wayemika · Jan 22, 2016

I feel like the experience is a must in psych because as a floor you get to see the patient all shift. how they are when they are psychotic/manic, borderline activity and so on. if you just jump right into being a NP your only seeing them for the admit assessment and daily fallow ups. your kind of selling yourself short. plus you can get floor psych experience in all kinds of ways. med/psych, a basic CSU, detox, eating disorder centers, out patient and so on. I'm personally so glad I have worked in psych first for the exposure. but that's just me. do what you think is best for you.

calsmithlewis36 · Feb 4, 2016

I went right into Psych right out of nursing school. I worked in Psych for over 4 years across the lifespan. I wish I would have done Med-Surg first, because a lot of psych patients do have a lot of medical issues.