Is med-surg a must? Not wanting to get pidgeon-holed..

Nurses General Nursing

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I was offered a job today at a psych facility...psych nursing is exactly what I want to do so im very excited to be in such a position. I'm a new grad by the way...I have a 2nd round interview this monday at an acute care/rehab hospital where it's more traditional med-surg-y type of stuff... if they offer me a job as well, would it be silly to decline since i believe psych is what i want to do? I'm pretty sure psych exp is only really transferrable to other psych facilities lol...

Specializes in OB.

Take the psych job...I started out in psych and learned a lot of valuable experience that has carried over with me to NICU and L&D. You always utilize those "people" skills, crisis intervention (rampant no matter where you are), and a proactive approach. You will learn to always be looking five steps ahead-which is so important no matter where you work. On our psych unit, we pulled lab levels-so I was able to take IV courses. And of course you will become a master at IM injections ;) We also had a great relationship with the ED and I floated there numerous times when our census was low. I learned a lot. Just take any extra's that you can. Don't let the naysayers psych you out (pun intended!) and let you believe that you aren't a "real" nurse. If you like it--do it.

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i kept hearing through school that if you go into psych nursing you will "lose your clinical skills" like starting IV's, inserting foleys, etc.

in actuality, you don't have a high skill set to "lose" when you first graduate anyway. you get the most practice on the job. if you leave psych to go into another area, you will get trained on the job, still have all the knowledge you gained in school, and learn the skills through practice just like everyone else.

if you're worried about losing your clinical skills or not getting enough practice you could always take the psych job and then take a PRN position somewhere else where you can keep your skills up.

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i kept hearing through school that if you go into psych nursing you will "lose your clinical skills" like starting IV's, inserting foleys, etc.

in actuality, you don't have a high skill set to "lose" when you first graduate anyway. you get the most practice on the job. if you leave psych to go into another area, you will get trained on the job, still have all the knowledge you gained in school, and learn the skills through practice just like everyone else.

if you're worried about losing your clinical skills or not getting enough practice you could always take the psych job and then take a PRN position somewhere else where you can keep your skills up.

So the story often went: If you go into "OR" you loose bedside skills. If you go into Peds/Infant you loose adult skills, and so and and so forth.

Quite honestly if one has found one's "spot" then few leave so it is hard to say what is really "lost". Unless one works in a place that does a fair amount of floating of nurses to any and every unit, chances are you're going to stay within your specialty anyway.

I mean can you honestly picture "Nurse Ratched" being pulled to work in L&D?

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Specializes in Oncology.

I started out in BMT and four years later I'm still there. Am I pigeon holed? Yes. Do I care? No. I'm an awesome BMT nurse and I love my job. I do think I could get another nursing job and be no worse off than a new grad, but it would be a learning curve. I work at a job where things are expected to be done right and we're staffed to allow for that. A lot of other places around here staff ridiculously short and as a result, short cuts abound, so I do think I would struggle with that of I were to change jobs.

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Specializes in Med-Surg.
If people are 'stuck' in med/surg, they obviously don't want to leave for various reasons, or they would.

OP, if you have a desire to work psych and a job offer, go for it.

I knew from early on that I wanted to do critical care. It's just how I'm wired. In my area, there are multiple nursing schools, so the market is pretty saturated. I took the job I was offered: MS. I'm still here, 2 years later. I'm now a certified MS nurse and, while I feel like this job has taught me so much and could probably do anything I wanted in nursing because of it, I'm more than ready for something new. I definitely feel pigeon-holed. When I graduated, I couldn't get a job in critical care because I had no nursing experience. Now, I can't get a CC job because I have no experience in that area. It's so frustrating! I'm definitely stuck in MS and not because I want to be. I've been applying for transfers/new jobs for a year and nothing! So, I don't think it's fair to say people that are "stuck" in med/surg are so because the don't want to leave.

To the OP, take the psych offer! You know that's what you want to do! In the end, you'll be happier doing what you want to do versus what you think will be better in the long run.

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Take whatever job you want. I couldn't disagree MORE with the idea that working in (and gaining experience) in med-surg will "pigeon hole" you in the least. I've seen many nurses--myself included!--use their med-surg background to jump off into a wide variety of specialties. You'd be the exact opposite of "pigeon holed": you'd be getting some experience in everything, and using it to get wherever you'd want to be. Just because an individual nurse here and there can't find employment outside of their current unit doesn't damn the lot. Lots DO get where they want to be, trust me.

That said, while I DO think such a background benefits everyone and anyone (could learning MORE skills really ever be a bad thing??), I don't think it's a hard-and-fast requirement anymore. If a job opens up for you that you want to take....take it.

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Specializes in CCRN, ALS, BLS, PALS.

I never went to med/surg, and as a matter of fact, Ive never even worked a single shift on the floor. I went straight into ICU. I learned alot and quick. I got lucky though, that hospital was really in need of people.

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Specializes in Pulmonary, Transplant, Travel RN.

In my experience, Pigeon-holed is just what you will be. Spent the first five years of my career in M/S and hated the last two years of it. I was trying to move up into more acute settings the whole time, but found it very difficult. This got worse as the economy tanked.

Problem is, once you have some experience in M/S Nursing under your belt, everyone will want to use you to fill holes in M/S positions. Your hospital will avoid allowing you to transfer. I talked to others about this and the advice I got was "Apply to outside hospitals. Then, you will either get hired by one of them or your current hospital will see you are going to leave and give up on trying to keep you in the M/S setting." Neither happened.

The problem was: There would be multiple applicants for the same ICU position. Even when I was going up against new grads, I was at a disadvantage. It is cheaper to place me on a M/S unit and give me minimal or no training, and then train the other person for M/S. Why place me in the ICU, where I need training, and also train someone else for the position I could fill without training. Its twice the cost.

I made it clear on applications that I was interested in ICU only and was not interviewing for M/S. Despite this, hospitals would play the "Donkey carrot" game with me, get me in the door with promises of being interviewed for the ICU, then offer me M/S positions. With some, it was so obvious from the start there wasn't even an opening in the ICU, I'd politely end the interview.

Thats the world of M/S nursing for you............so desperate for help they have to play games like this just to get someone in for the interview. Things might be different now with the job market being what it is but still.................

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med/surg SUCKS in my opinion. that's why so many new grads end up there. people are CONSTANTLY trying to get out so there are always positions open. managers will take whatever they can get to fill the positions because seasoned nurses don't want them!

med/surg will leave you jaded. my very first job as a student nurse was on a med/surg floor and i thought for the longest time (and my manager would drill into me) "it's like this everywhere!" it's NOT like med/surg everywhere......thank GOD!

if you can get offered a position in anywhere other than med/surg as a new grad....you better take it!

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Specializes in MICU - CCRN, IR, Vascular Surgery.
In my experience, Pigeon-holed is just what you will be. Spent the first five years of my career in M/S and hated the last two years of it. I was trying to move up into more acute settings the whole time, but found it very difficult. This got worse as the economy tanked.

Problem is, once you have some experience in M/S Nursing under your belt, everyone will want to use you to fill holes in M/S positions. Your hospital will avoid allowing you to transfer. I talked to others about this and the advice I got was "Apply to outside hospitals. Then, you will either get hired by one of them or your current hospital will see you are going to leave and give up on trying to keep you in the M/S setting." Neither happened.

The problem was: There would be multiple applicants for the same ICU position. Even when I was going up against new grads, I was at a disadvantage. It is cheaper to place me on a M/S unit and give me minimal or no training, and then train the other person for M/S. Why place me in the ICU, where I need training, and also train someone else for the position I could fill without training. Its twice the cost.

I made it clear on applications that I was interested in ICU only and was not interviewing for M/S. Despite this, hospitals would play the "Donkey carrot" game with me, get me in the door with promises of being interviewed for the ICU, then offer me M/S positions. With some, it was so obvious from the start there wasn't even an opening in the ICU, I'd politely end the interview.

Thats the world of M/S nursing for you............so desperate for help they have to play games like this just to get someone in for the interview. Things might be different now with the job market being what it is but still.................

This is *exactly* what I'm terrified of. I have 1 year of m/s now and I've wanted out since before I ever even started. Cardiac critical care is my goal, and I'm beginning to think that it's never going to happen because of starting in m/s. Now I basically have to re-plan my whole career goal :(

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In reading all these anti-med/surg posts, it's hard to believe anyone ever left that unit...even though I have known literally a dozen who HAVE, *I* went on as well, into specialties they preferred.

I wonder how many people reading these posts will believe that it simply isn't possible, that med-surg is some kind of dead end, when it actually has been a wonderful catalyst of experience for so many. I have known people to go to ICU, ER, oncology, ambulatory, home health. On and on.

It'd be a shame for people to disregard the experiences of people like me, in favor of "it just can't be done" posts like the others. I tend to believe life and experience is what you make it to be....period.

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Specializes in Psych ICU, addictions.

OP: the advantage of some time in med/surg are that it will help with getting a handle on treating medical issues as well as developing physical assessment skills.

Is it absolutely necessary to have m/s first in order to be successful in psych? IMO, no. You WILL learn time management, prioritization, delegation and other first-year skills in any specialty that you go into. You can keep your medical knowledge up on the side through CEUs, courses, etc...and you will need to, since psych patients don't check their medical issues at the door when they check in.

As far as m/s--or any specialty--pigeonholing you, IMO you're only pigeonholed if you let yourself be. It may be hard to transition specialities, especially in this job market, but it's not impossible. You will learn valuable skills in m/s or psych that can be used to help you transition.

If your heart lies in psych and you have a chance to go into it, go for it! Why kill time in a specialty you don't want to be in?

Best of luck whatever you decide!

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