ICU to Psychiatric Nursing

TheMoonisMyLantern, ADN, LPN, RN · Jun 21, 2019

I worked med/surg and PCU for 7 years prior to getting into psych and do not regret the change. I always enjoyed working with psychiatric patients prior to switching over and since they were always my favorite patients it just made sense to switch. I think the hardest thing that nurses with a medical background have to learn when becoming a psych nurse is that in most cases physical problems are no longer the primary concern of the treating team instead it is the psychiatric problems that take priority. It may seem like common sense but it is a difficult frame of mind to get out of. That being said medical emergencies do happen and require quick recognition and intervention because more likely than not you're not going to have the resources you'd have on a medical unit. Having a medical background will certainly help you when these instances come up.

I find that psychiatric nursing is usually less physically strenuous but more mentally taxing. You are constantly thinking, observing, planning, assessing, not only your patients but also the milieu. A lot of people think that since you are sitting down a lot as a psych nurse that you're not doing anything but this is incredibly untrue. On the medical side of things nurses follow a lot of algorithms and protocols for responding to various issues, in psychiatry there's not a one size fits all approach so being able to think outside the box frequently through out your shift is required.

Violence can occur in any setting in healthcare, psych however does tend to see more of that depending on the type of psych unit you work on. What's more our patients are physically healthy and can really do some damage it's not uncommon where I'm at to get in report that the patient is 6'3 fresh out of jail, multiple assault and battery, acutely psychotic and was tazed 3 times prior to arrival, that being said, our restraints both physical and chemical tend to be more effective in my opinion because our patients are healthy enough that they can tolerate multiple drugs being thrown at them to calm them down.

There are a lot of good reasons for getting into psych nursing, and there are some bad ones as well. I see frequently nurses who come to us looking for something "easy" and indeed if you're not spending time in the milieu with the patients and working with them and doing the job correctly it can seem easy. But if you love taking care of psychiatric patients now then I think you'll love it even more as psych nurse.

If you decide to go the psych NP route, please get experience as an inpatient psych nurse first, psych on a medical unit and psych on a psychiatric unit are treated very differently.