gn to be--really like psych!

Thunderwolf, MSN, RN · Oct 16, 2005

I am sure you will hear both sides on this topic...which is good. However, I am one who believes that having some prior or concurrent experience in Medical Nursing or Med-Surg Nursing only benefits your mental health patient more. Many, and I mean many, MH patients have concurrent/underlying physical health problems that need to addressed either FIRST or at the same time. This is especially true if the MH is dual diagnosed with both a MH disorder AND a substance abuse problem. Heroin or IV drug users are typically at very high risk for Hep C and endocarditis. Alcoholics are more prone to malabsorption problems, seizures (if detoxing), pancreatitis, liver disorders, and electrolyte imbalances. If an Alcoholic comes in for detox who also has essential hypertension, knowing how to differentiate and intervene appropriately...is it the alcohol withdrawal or the hypertension? Around 50% of folks with Schizophrenia and Bipolar disorder abuse substances, 80% of Antisocial Personality disorders, and at least 30% of depressed and anxiety ridden disordered folks. Certain meds affect cardiac conductivity. Folks on Geodon need to have an EKG in their work up due to it elevating QT intervals. Patients on Lithium need to have their labs monitored related to kidney functioning. You need to know that some certain pain meds are not to be given with certain Psych meds...such as Demerol and MAOI antidepressants. Folks with asthma who are going through Opiate withdrawal need to be monitored closely for worsening of their asthma. Many MH patients may have diabetic related issues that have gone untreated and may have sky high sugars. Knowing how to assess, differentiate, and intervene appropriately with seizure disorders is also important...for example, a grand mal vs a pseudoseizure. Bed sores are an issue for patients who are bedridden...especially the Geriatric MH patient. There are many issues and reasons why a background in Medical/Med-Surg has alot of merit. You will be a more rounded psych nurse IMHO. Psych nurses who do not have this background may disagree, however. But, much of what I just listed above is from the exposure you get from other areas of nursing...that are not psych related. I guess the question is...what do you think?

This topic has been on the board before. You may want to do a search.

I wish you the best.

tineann · Oct 20, 2005

I tend to agree with Thunderwolf. I had 2 1/2 years of med/surg prior to transfering to psych 8 years ago and I am really glad I have that experience under my belt. I am finding that our patients very often have medical issues that need to be addressed and it is so helpful to have some clinical experience with these medical issues. However, my closest collegue went right into psych from school and I don't think she regrets her decision. I will say that I usually end up dealing with the more medically compromised patients though - partly because I have more of a background and largely because I feel more confidant in this area. Confidance is a biggy - it is nice to feel able to deal with a variety of different situations with some level of competance.

SFCardiacRN · Oct 20, 2005

If you want to go into psych, that is what you should do. Find a new grad program. Remember, they are not "I've been a med-surg nurse for 2 years and now want to be a psych nurse" program. They are called 'NEW GRAD" program and that is what they mean.