Graduate in May need advice as to where I should start.

[19Kristin]

I graduate with my BSN in May, I have been an LPN for 9 years and my experience includes inpatient psychiatric nursing for a few years and I have worked at an outpatient addiction clinic for 5 years. I'm a pretty strong student, 3.9 GPA but I am also well aware that this doesn't translate to being a good nurse in practice.

I'm currently wrapping up my med surg 2 rotation then I will begin my transitions. I chose inpatient psych for transitions because honestly its my comfort zone. I'm scared of medical nursing. The nurses on med surg I have been working with have all told me I do fine and I am right where I should be. The last two days both nurses I worked with complimented me on how well I did. But inside I feel extremely scared and I am well aware I have soo much to learn. There is a part of me that wants to do IMCU or even ICU because I do love to learn about and experience that kind of nursing but then there is this huge overshadowing fear of incompetence in myself and an inability to actually succeed. I feel like on my own I wouldn't be able to handle the work.

There are times on med surg where we will have 5 patients, 1 aide for 20 patients, an admit, a discharge, patients needing things, meds due, new orders etc all at once and I think to myself yeah I would just flounder doing this on my own. So I want to run to psych where I don't know if it is what I want to do forever but it is where I know im comfortable because thats where my experience is and I feel less likely to harm someone or make an error that would harm someone there. However, I can remember feeling overwhelmed and scared when I first started psych too. I remember the first few weeks there I went home crying to my mom telling her I can't do it and I ended up really liking my job and feeling confident in my position.

Is this normal to feel this apprehensive though? What do you suggest I try to go for upon graduation? The hospital has an opening on IMCU, ICU and Psych and new grads are welcome to apply to them all. I just have no idea what I should do. I'm very conflicted.

[brownbook]

I love psych and psych nurses...however my gut says you should give med/surg a try. If it doesn't work out I would think you could get a job in a psych unit.

A nurse is delusional if during school or as a new nurse on a med/surg type unit, or even a psych unit, she isn't scared, overwhelmed, etc. Think of your "fears" as being a realistic assessment of what is happening. Try to take your "fear" down a notch or two and tell yourself you are just being careful, cautious, watching out for the "what ifs".

I don't trust a new nurse, or doctor, or even a nurse or doctor with many years of experience, who isn't cognizant of, careful, watching out for the what could go wrong and do I have what I may need to handle it.

[Ruby Vee, BSN]

14 hours ago, 19Kristin said:

I graduate with my BSN in May, I have been an LPN for 9 years and my experience includes inpatient psychiatric nursing for a few years and I have worked at an outpatient addiction clinic for 5 years.

I chose inpatient psych for transitions because honestly its my comfort zone. I'm scared of medical nursing. The nurses on med surg I have been working with have all told me I do fine and I am right where I should be. The last two days both nurses I worked with complimented me on how well I did. But inside I feel extremely scared and I am well aware I have soo much to learn. There is a part of me that wants to do IMCU or even ICU because I do love to learn about and experience that kind of nursing but then there is this huge overshadowing fear of incompetence in myself and an inability to actually succeed. I feel like on my own I wouldn't be able to handle the work.

Is this normal to feel this apprehensive though? What do you suggest I try to go for upon graduation? The hospital has an opening on IMCU, ICU and Psych and new grads are welcome to apply to them all. I just have no idea what I should do. I'm very conflicted.

It is absolutely normal to feel apprehensive. That normal apprehension is what keeps new grads from killing their patients. Seriously. There is nothing that scares the experienced nurse more than a new grad who *isn't* apprehensive. If you're not scared, then you don't have a clear idea of how much you don't know -- I won't trust you as far as I could throw you. If you are scared, and I know that you'll come to me with questions, I'll let you have a bit more freedom. Not enough to actually cause harm to anyone, but enough that you won't hate me because I'm always breathing down your neck.

If you were sure that you wanted to do psych forever, perhaps I'd give you different advice, but you're not. So I'm going to urge you to do Med/Surg. Or IMC. Not ICU, because at present it might be TOO overwhelming, but this is a fabulous time for you to get more Med/Surg under your belt. In fact, if there are Med/Surg openings for new grads, I'd urge you to consider that.

New grads -- the good ones, anyway, are scared. They cry on their way to work and on their way home from work and sometimes in the bathrooms AT work. (The men, too, at least a few that I know of personally.) They question their sanity at going into nursing, and they are sure they're going to kill someone. It takes about a year to go through that abjectly miserable new grad stage, but as a new grad is the very best way to go through that stage. This is the best time to try Med/Surg or General Medical or General Surgical or IMC or any other medical or surgical floor or IMC. Even if you work there a year after your orientation (and you should work at least that long before making a decision) you will learn many valuable things that you can use forever in your career as a psych nurse. Because psych patients have physical ailments, too.

One more thing -- your Med/Surg or IMC colleagues will love you for your psych experience. Our patients have psych issues, too, and we haven't the faintest idea what to do with them! One other thing -- I wish you luck with your next job. Keep us posted.

[Sour Lemon]

If you're not sure, med/surg is a great place to start. I wanted psych right out of school, but I'm glad I didn't get it. Med/surg made me a lot more versatile and I feel like I could transition to most other areas with minimal stress.

[traumaRUs, MSN, APRN]

Moved to First Year after Licensure forum.

[raemcclain]

Yes - to the 'graduate in May'. It is very normal to feel anxious about entering the med-surg world. You really LEARN the first year on the job. After that, you know what you can do and feel more secure. You will always learn on any job - even bad ones! I swore I would never do trachs, but wound up on a unit that had a trach unit with it. I despised it until I learned how to do it, then I loved the challenge of helping someone breathe! It also is 'great to have on a resume'. Don't ever sell yourself short of any skill. It takes time but all skills are needed to be a good nurse and you sound like you want to be one! Good luck!

[TriciaJ, RN]

I worked as a Registered Psychiatric Nurse before I went back to become an RN. Then I went back to psych for a number of years, because like you, I felt intimidated at the thought of doing anything else.

However, I have since done med-surg, got over being intimidated, got a job with a good orientation and did very well. So it can be done. The advice to do med-surg first has a lot of merit, but if you're conscientious and able to move outside your comfort zone when the time is right, you can do it however you like.