Deciding to make the switch

marilynmom, LPN, NP · Jun 11, 2010

Out of school I started off in the ICU as well and though I enjoyed it, I knew I didn't want to spend the rest of my career running around like that, coming home completely worn out, stressed out, etc. Though Im glad I have my medical background I wouldn't go back.

I was always interersted in psych in school as well, I loved my psych clinicals so I just decided one day to apply and I got a job working with teens. I am SO GLAD I went into psych. Its a lot less stressful than ICU for sure, but also more interesting....psych patients are fun and I love getting to know my patients, talking to them, some get better, some never will, I enjoy the meds and seeing the changes they make in their lives. Ive been in my position now for about a year and a half and have decided to apply to psych NP school (hopefully to start next year).

I think you should try it out! It definatly a totally different type of nursing so prepare for that-- I was so shocked to go from a super fast pace ICU nursing job to the psych unit Im on (I work on a residential tx unit, our pt's are here for about a year so you get to know them very very well). I do a lot of paperwork, milieu management, po meds, some prn (we do zyprexa IM), a lot of teaching basic life skills (basic hygiene, coping skills, impluse control, etc), you have to maintain professional boundaries with the patients (some nurses cant seem to do this). I really enjoy it.

Simply Complicated · Jun 11, 2010

Out of school I started off in the ICU as well and though I enjoyed it, I knew I didn't want to spend the rest of my career running around like that, coming home completely worn out, stressed out, etc. Though Im glad I have my medical background I wouldn't go back.
I was always interersted in psych in school as well, I loved my psych clinicals so I just decided one day to apply and I got a job working with teens. I am SO GLAD I went into psych. Its a lot less stressful than ICU for sure, but also more interesting....psych patients are fun and I love getting to know my patients, talking to them, some get better, some never will, I enjoy the meds and seeing the changes they make in their lives. Ive been in my position now for about a year and a half and have decided to apply to psych NP school (hopefully to start next year).
I think you should try it out! It definatly a totally different type of nursing so prepare for that-- I was so shocked to go from a super fast pace ICU nursing job to the psych unit Im on (I work on a residential tx unit, our pt's are here for about a year so you get to know them very very well). I do a lot of paperwork, milieu management, po meds, some prn (we do zyprexa IM), a lot of teaching basic life skills (basic hygiene, coping skills, impluse control, etc), you have to maintain professional boundaries with the patients (some nurses cant seem to do this). I really enjoy it.

Same with me, I really enjoyed my rotation in school. My instructer suggested I go into, as I was able to develop a good rapport with the patients. She said I was a natural for the field. ICU is ok, but I've always wanted ER. But now that I have a 1 year old, and hopefully another soon, I'm just not sure I want to do the crazy hectic job that an ER would be. I've been planning on going back and getting my masters in Counseling anyways, so I'm starting to think it would make sense to just make the switch sooner rather than later. I really just want to find that job I love, and as much as I do like the critical care/ER aspect of a hospital I'm not so sure it's where I'm meant to be.

Did you have any trouble getting hired? Without the experience in that area?

pandora44 · Jun 18, 2010

I made the switch from med-surg nursing to inpt adult psych about a year ago. I was on the medical floor for about a year and hated it. I felt that my particular talents were wasted in the fast paced unit where I worked and I longed to get to know my patients better and spend some "quality time" with them. I love my job now.

Psych is very different from medical nursing. It took me about six months to get use to the change in pace and how to deal with different patient behaviors. And psych takes a lot out of you emotionally. There is a really great thread in the psych nursing page about med-surg vs psych nursing. Check it out if you haven't yet.

Bottom line, if you think you'd like it, I would certainly try it. In my experience, those who have a feeling they'd like this field generally do. And if it doesn't work out, you have plenty of experience to find an ER job.

Simply Complicated · Jun 19, 2010

I made the switch from med-surg nursing to inpt adult psych about a year ago. I was on the medical floor for about a year and hated it. I felt that my particular talents were wasted in the fast paced unit where I worked and I longed to get to know my patients better and spend some "quality time" with them. I love my job now.
Psych is very different from medical nursing. It took me about six months to get use to the change in pace and how to deal with different patient behaviors. And psych takes a lot out of you emotionally. There is a really great thread in the psych nursing page about med-surg vs psych nursing. Check it out if you haven't yet.
Bottom line, if you think you'd like it, I would certainly try it. In my experience, those who have a feeling they'd like this field generally do. And if it doesn't work out, you have plenty of experience to find an ER job.

Thanks for the advice. I'm going to get a small view into the world of psych this next week. I'm working as a super user for our medication barcode scanning system this next week at the final hospital in our system to be starting it. I got my schedule and placement the other day, and it just so happened that out of like 50 nurses to be working it I am assigned to the psych units:) So I will have 3 nights of 12 hour shifts that I will be on those units and can atleast observe and have the opprotunity to talk to some of the nurses, as well as hopefully the manager. I've been looking for a per diem job with no luck, so maybe I can atleast get my foot in the door! I thought it was quite a coincidence that I was assigned there!

Davey Do · Jun 28, 2010

I appreciate your looking before you leap, nursemandalyn. Gathering data is an important part of the problem-solving process.

I'm not sure if my situation is fitting, in that, I started out in "psych" (once in nursing), bounced around for years in medical, yet always seem to end up back in psych. I believe it's my "calling".

I believe there is as much expertise involved in reading and reacting to a schizophrenic's psychotic behavior as there is is to reading and reacting to the EKG of a cardiac patient in V-tach.

Your plan to try it per diem is a good one.

If you wouldn't mind, it would also be interesting to be kept up on the status of your transition.

Good luck to you, nursemandalyn.

Simply Complicated · Jun 28, 2010

I appreciate your looking before you leap, nursemandalyn. Gathering data is an important part of the problem-solving process.
I'm not sure if my situation is fitting, in that, I started out in "psych" (once in nursing), bounced around for years in medical, yet always seem to end up back in psych. I believe it's my "calling".
I believe there is as much expertise involved in reading and reacting to a schizophrenic's psychotic behavior as there is is to reading and reacting to the EKG of a cardiac patient in V-tach.
Your plan to try it per diem is a good one.
If you wouldn't mind, it would also be interesting to be kept up on the status of your transition.
Good luck to you, nursemandalyn.

Thank you. I'll definetely update. I just did the superuser shifts in the psych units, and being there definitely reinforced my interest. They unfortunately don't have any open positions, nor will they for a while probably. They have 3 per diem nurses already. But I'm still looking elsewhere as well. I'm going to keep my eyes open, and just periodically check to see if anything opens up!

Meriwhen, ASN, BSN, MSN, RN · Jun 29, 2010

A heads-up: you will need a thick skin to survive in psych...not so much from dealing with other staff as it is from dealing with patients, especially those with personality disorders. They can be very cutting and manipulative in their remarks about you, other staff, their treatment, the facility, etc...and you have to learn to not take it personally. You do have to learn to be consistent in dealing with their behavior, no matter what.

A majority of your interventions with patients will be therapeutic communication and medications. Be aware that unlike med-surg, where you can perform an intervention and often see immediate (or nearly immediate) results, it can take a while for interventions in psych to work. Also, different patients respond to different approaches or staff better than they do to others. So if a patient doesn't verbalize feeling better after your 1:1 with them, or if you have difficulty redirecting their behavior while the tech has no problem getting the patient to comply, you can't take that personally either...it's not necessarily a reflection on you and your performance. That's just the nature of the psych beast.

Definitely try it out on a per-diem basis to see if it is right for you. Good luck!

Simply Complicated · Jun 29, 2010

A heads-up: you will need a thick skin to survive in psych...not so much from dealing with other staff as it is from dealing with patients, especially those with personality disorders. They can be very cutting and manipulative in their remarks about you, other staff, their treatment, the facility, etc...and you have to learn to not take it personally. You do have to learn to be consistent in dealing with their behavior, no matter what.
A majority of your interventions with patients will be therapeutic communication and medications. Be aware that unlike med-surg, where you can perform an intervention and often see immediate (or nearly immediate) results, it can take a while for interventions in psych to work. Also, different patients respond to different approaches or staff better than they do to others. So if a patient doesn't verbalize feeling better after your 1:1 with them, or if you have difficulty redirecting their behavior while the tech has no problem getting the patient to comply, you can't take that personally either...it's not necessarily a reflection on you and your performance. That's just the nature of the psych beast.
Definitely try it out on a per-diem basis to see if it is right for you. Good luck!

Thanks for the heads up! I've been browsing through the old posts here, and have came across quite a few posts that mention this. I will have a lot to learn, but I think, or atleast hope, I would be able to handle it. I've always been pretty decent at keeping work.. work. Obviously I'm human, so things do get to me. But even as a new nurse, I didn't have the problem I would here my fellow students/ new co-workers talk about, that they would go home and dwell on their day, or worry non stop. I made a valid effort to leave it at the door when I left. I have my moments of course, but I compartmentalize pretty well, IMO. I worked as a server for years, so I think that helps me quite a bit though.