new grad seeks advice

[GLW]

I just graduated from an ADN program in mid December. I have received 2 job offers. One offer is for a psych position. I am interested in psych and also have a bachelor degree in psych. I went into nursing thinking that I would end up there. I also received an offer from a telemetry unit. I enjoyed my rotation in telemetry during school and would be interested in pursuing that type of position too. My concern is about my future. I have been told that it is better to take a medical floor position as a new grad and then specialize in a field of interest later. My question is, if I start in psych will it be more difficult to switch to a medical floor in the future if I decide to change fields. Any advice on this topic would be greatly appreciated.

[GLW]

BABS - what is a med/psych floor and where would I find it? I've never heard of a floor like that - at least aound my area.

[GLW]

Tim - I don't know if you're still out there, but, I was wondering if you could tell me a little about Gerontological nursing and about your title of GNP. Sounds intersting.

[Tim-GNP]

GLW- glad you asked! A Gerontological Nurse Practitioner belongs to a group of nurses referred to as "Advanced Practice Registered Nurses." APRN's are Registered Nurses who are prepared at the Master's level. If thy are going to be a Gerontological APRN, then their MSN must be in Gerontological Nursing [if they want to be eligible for ANCC [American Nurses Credentialing Center] accreditation, anyway]. APRN's practice within the scope of practice defined by their state's nurse practice act. There are two types of APRN's that specialize in Gerontology. There are the Gerontological Nurse Practitioners and the Gerontological Clinical Nurse Specialists. The major difference is that Nurse Practitioners [NP's] usually have prescriptive authority [depending upon state practice acts] and Clinical Nurse Specialists [CNS's] don't. Having said that, some state's grant prescriptive authority to Clinical Nurse Specialists.

There are many types of NP's and CNS's. They could specialize in famly health, maternal health, womens health, acute care, psychiatric health, and so forth...

Regardless of the title, however, Gerontological APRN's must demonstrate a serious committment to obtaining knowledge of the older adult population. The A.N.A. defines it best as: It involves assessing health and functional status of aging adults, planning and providing appropriate nursing and other health care servies, and evaluting the effectiveness of such care. Emphasis is placed on maximizing functional ability in ADLs, promoting, maintaining, and restoring health, including mental health; preventing and minimizing the disabilities of acute and chronic illness ; and maintaining life in dignity and comfort until death.

I love being a GNP. It is fun and rewarding. I hope I have answered your questions.

[puzzler]

GLW

Just have to add my 2 cents worth. First congratulations on becoming a nurse.

I have been a nurse for 24 years. I have worked med/surg, psych (5 yrs), Labor & Delivery (12) years, and a very short stent in Long Term Care.

I firmly believe that all nurses should have at least one year med/surg experience. Regardless of what specialty area you go into the patients can have all the same physical problems as a med/surg patient.

A med/surg floor is the best place in the world to learn organizational skills, efficiency of time management, and setting priorities.

I have worked with nurses in each area that did not have the benefit of a med/surg background and somewhere along the line it was very apparent.

Ex: The pregnant patient that presented in respiratory acidosis; the psych patient that had an MI.

When I worked psych (in the 70's) our facility did have a medical unit. That was a very interesting and challeging unit. I do not know if there are any facilities like that any more. I do know that the one I worked at is no longer in use.

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Sheryl

If you enjoy word puzzles come visit me at www.CrosswordsForNurses.com

[Redeye]

It is so true what you said "You have to wake up and go to that job everyday no one else." I am having increasing difficulty with every day I work, waking up and going to "that job". A med-surg job that I took to make myself feel better about my nursing skills.

[shannab]

GLW

I'm a little late, but that I'd go ahead and offer what little info I have....

My husband and a close friend graduated from a 2 yr program in nursing and then immediately went into psych positions. Both had backgrounds in psych, so it was in their "comfort zone."

After 3-4 years, my friend wanted to change specialies. Mental burnout. He lived in Alaska at the time and he had difficulty getting a position.

My husband has remained in psych, and says that even if he wanted to change, he'd be scared to do it because he feels like he has forgotten way to much to work on a med/surg floor ---given it would be his first time. I think if he'd done at least 1 yr of med/surg he would feel more capable of doing it. He too is a bit burnout, but doesn't feel like he should make a switch at this point.

Good luck to you and congratulations!