From psych to med-surg??

GooeyRN, ADN, BSN, CNA, LPN, RN · Jan 23, 2006

I worked Psych right out of school for one year. I then moved and had to change jobs. Med/Surg was the only thing available where I live. I had a two week orientation. A different nurse orienting me every day. Then put on night shift with no orientation. It's a little difficult to make the switch, but it is doable. You don't forget nearly as much as you think you would. Don't worry about loosing skills. You can always look them up if you forget the procedure. The most difficult thing is going from spending so much time interacting/talking with the patients, to so little time talking with the patients. In psych you get to talk all about their lives, and there isn't a whole lot of time for that in med/surg so you can get behind until you adjust. Do what makes you happy!

midnightRN · Jan 25, 2006

I read the post and thought I'd reply. I have been an RN for a year. Like you I LOVED psych in school, and was also told I did really well there (they offered me a job). Because the facility was 50 minutes from my home, I started in a local hospital in med/surg. I'm okay with med/surg, but lately feel a bit burned out. I'm here at this forum because I'm thinking about driving the distance for a job I hope I love. It's hard to make the right decisions, but the beauty of nursing is it's diversity and opportunity. My only limits are location!

Louisepug · Jan 28, 2006

Thanks for your responses! I just went back into my med-surg rotation for the first time in over 10 weeks, and I have to say, psych is REALLY looking tempting! I am just not a fan of adult med-surg nursing. More power to those who love it though, they are special people!:)

Barb2000 · Jan 28, 2006

I worked psych for a year, then went to labor and delivery, then med-surg. (I was in the military, so was expected to go where they needed me). I really enjoyed psych, and was told that my psych experience would help me in all areas of nursing. This was so true. And it has actually helped me get jobs in other areas, such as med/surg and ER, as the staff was happy to have someone there who was completely comfortable and experienced with taking care of the patient with a psych history.

CharlieRN · Jan 28, 2006

In the US at least nurses are expected to be generalists. The license is good in any speciality.

In fact I have seen a number of nurses go from psych to med/surg. One was an unoffical mentor of mine. One day she anounced she had taken a job in the recovery room! Since this was a latteral transfer within the med center we worked for, I am sure she was taking care of herself by moving to a lower stress environment. Recovery room patients don't talk much.

I'm on record for prefering that psych nurses have a med/surg background, but if someone is offering you a good job in a psych department straight out of school, go for it.

You can certainly keep up med/surg skills in continueing ed classes. You also can volunteer for the Red Cross or some emergency rescue group like the ski patrol. Volunteering is an excellent way to keep your hand in. Volunteer organizations will train you for free and entertain you while you are trained. Just pick an area that's fun for you. I spent 10 years in the nordic ski patrol and am a certified Red Cross Disaster Nurse.

friendlymulan2004 · Feb 2, 2006

Hello...I love reading the posts.I'm a Med-Surg nurse for 3 years and want to work in Psychiatric floor. What are the advantages and disadvantages working in Psych ward? What are the routines during day and night shift. Is it less stressful compared to MS ward? I need some advice please. Thank you very much!

karynfrances · Feb 2, 2006

I work in psych in Australia, have also worked in med/surg wards and wouldn't go back. Psych is a lot less heavy physically, but at the end of the day you still feel exhausted, talking to people and giving emotionally is pretty draining. I enjoy psych nursing it's fulfilling to help people to reconnect with others and provide time out for people while they get their head together.

CharlieRN · Feb 2, 2006

Hello...I love reading the posts.I'm a Med-Surg nurse for 3 years and want to work in Psychiatric floor. What are the advantages and disadvantages working in Psych ward? What are the routines during day and night shift. Is it less stressful compared to MS ward? I need some advice please. Thank you very much!

Advantages: no uniform. Little or no lifting. Relatively little contact with bodily fluids, though if it needs to be done, nurses will do it. You can go years without making a bed. On some units you will go years without so much as giving am IM injection. Little need to keep up on the latest technical health care gadgets. Again, if one shows up on your unit it will be you responsiblity. The focus of the nurses duties are on "minding the process", not "getting the tasks done".

Disadvantages: You will most likely be strongly discouraged from unnecessarily touching patients. If you are "touchy feely" in your style of giving comfort this may be a problem. Where I used to hug, I now offer a kleenex. Reasonable and low key, but constant, awareness of your own safety and that of your coworkers. Responsiblity for modeling good mental health. You will be onstage and under observation. Just because someone has a mental illness does not make them stupid or unobservent. If you do not have your sh*t together you will be called on it, one way or another.

Routines vary by the focus and philosophy of the unit but one standard will be "checks" or "census". Several times during the shift someone will go around and physicly look at every patient to assure their safety. The frequency of these full unit checks varies from every other hour to q 15 min depending on the acuity of the units population. This is the primary safety care of the unit and is everybody's responsiblity. When I was in charge I liked to do at least 2 of them each shift personally.

Day shift will start with waking the patients and encourageing them to get up for breakfast and am meds. Usually they are expected to come to the med room for their meds at 8,noon, 5 and bedtime. After breakfast therapys will start, either groups or individual meetings with therapists and psychiatrists. Nurses are expected to assure that patients go to their various assigned therapies. Some nurses will run groups or assist as co therapists. You likely will have an assignment of patients to check in with. There will be several staff meetings, team meetings etc. which nurses are expected to participate in. Finally you will have to chart on your observations and assessment of each of your patients and evaluate their progress.

Evening shift will have the focus of helping the patients unwind and calm down after being stirred up by therapy. Nurses will encourage the patients to process what has been learned during the day. Most units have a unit wide "wrap up group" lead by nurses before HS meds.

Night shift is encouraged to help the patients sleep. Usually we discourage the nurses engaging in intense conversations at night. Nights are skeleton staffed. As always safety is the primary concern.

Louisepug · Feb 9, 2006

Again, thanks everyone for your replies. Its been kind of an upsetting week as far as this decision goes. It seems like everyone and anyone in nursing that I tell I want to possibly go into psych, I get a negative comment. Have you all noticed that some people view psych nursing as "not real nursing?" In my graduating class, if you are not applying for the critical care internship for ICU etc. then it's almost like you are looked down on. Oh well, I went to school to become an RN, not to win a popularity contest. :rolleyes:

Havin' A Party!, ASN, RN · Feb 18, 2006

Charlie -- Thanks much for taking the time to fill us in!

I too will be graduating in a few months and have pondered going directly into this nursing specialty.

crb613, BSN, RN · Feb 18, 2006

I am so glad I found this thread. I too will graduate in a few months (May). I have several job offers from my clinical rotations (M/S & Psych). I loved Psych & I also liked M/S. I am a little worried about going to Psych first.... reason....I don't want to loose skills before I have them down pat. Psych is where I excelled & won awards.....I have always liked anything to do w/Psych, & why people act the way they do. I asked this in another thread so I will ask for your opinions also....would it be to much to take the M/S job & then do Psych on a prn basis? Thanks for your opinions!