Moving from Med-Surg to Pscy

Specialties Psychiatric


  • Specializes in Psych, med surg.

Hi all,

I have a year of experience on a very busy med-surg floor, but this has never been a good fit for me. I've always been drawn to mental health, and loved both my psych nursing class and my psych rotation at a VA hospital on a long-term locked ward.

I have just accepted a position on an in-patient 16 bed psych unit. This unit has 2-3 day average stay with patients who are fairly stable, primarily depressed. Patients who are unable to agree not to harm themselves or who are actively psychotic are sent to another unit. I will be working evening shift. I am very excited about this new job and think I will be much happier here.

I am looking for any words of advice or things to keep in mind in my new field. When I mention to most of my current co-workers that I'm moving into mental health, they groan and tell me not to do it.



11 Posts

Actually, I'm in the same boat as you. Just a week ago started in psych. nursing after one year in med/surg/telemetry nursing. So far it seems I'm going to like this very much. As far as what other people say, don't worry about it so much. they groan, I think, because we all remember the altered mental status patients we had in MS nursing, and how difficult they can be to care for. BUT....a lot of these were UTI's, etc. I'm playing on the bet that there will always be jobs in this field because unique individuals do it. Ya know.....


660 Posts

Specializes in ER.

I'm not a psychiatric nurse but I will chime in. I am an ER nurse so I deal with psychiatric patients on a regular basis. I think the other nurses groan when you say you are moving to psych because they are uncomfortable with the specialty. Med/surg gives you a broad area of skills so moving to ICU, ER, tele, OB- whatever- you can still use your hands on nursing skills like IV's, foleys, etc. In psychiatric nursing you still use some of your skills but it's more off a hands off type of thing. Psych nurses have to be able to calm patients by talking to them. It is a really different skill set than you have in med/surg. Not saying psych or med/surg is better than another, just different. And differences are a good thing! Don't let anyone put you down for being a certain type of nurse. There is an area for everyone and god bless the psych nurses!


162 Posts

I agree with you, one should not allow the naysayers to discourage or direct your career path. I have been apsychiatric nurse for more than 20 years, I have managed to remain excited and supportive and knowledgeable of the best practices in mental health. I am dismayed when I hear or read that other nurse specialties are not aware of how important it is to be able to care for the total patient and that behind or in front of each pateint's complaint the is an emotional/mental component and that to minimize the disruotion for the unit and the patient it is imperative that the nurse has the skill set to engage and diffuse so that the best level of care is provided. We are all just an emotional stressor away from a mental health admission for ouself or familky member.

To provide care and safety for yourself, coilleagues and patients it is important that you are always in a defensive mode, evaluating and assessing the patient and environment, seeking every opportunity to minimize the negatives. It is critical that a real relationship is developed with the patients and that egos are left at the door. If it is apparent that your interaction is escalating the behavior, move away and allow someone else to intervene. No shame and before bringing in security do everything you can to resolve the issues (win/win).It is a dignity issue, the psychiatric symptoms are at center before medication is on board to stablize, the individual is out of control but inside is observing behavior that he/she can't control, if possible perserve dignity.

Be real, if you make a promise keep it, maintain boundaries, there is power in being distant but approachable, caring but objective.

Gooid luck and welcome. Sorry I blabbered on!! Nanacarol


116 Posts

Specializes in Medical-Surgical/Oncology.

Hey, sounds like what I want to do. I am a new nurse on a busy med-surg floor. I am also thinking about going

into psych. Just part-time to see if I will like it. Maybe take a class on psych and medications. Let me know how things

work out. Are you in CA?


86 Posts

Specializes in Psych, med surg.

Nope, Des Moines, Iowa. I'm moving from a full-time med-surg to part time psych until something full time opens up. Thankfully, I've been working part time in another, non-medical field and they're letting me go full time for a bit. I'm so looking forward to the new job! Just five days left on my current floor.

Orca, ADN, ASN, RN

2,066 Posts

Specializes in Hospice, corrections, psychiatry, rehab, LTC.

You have avoided one of the pitfalls of mental health nursing by getting a year of med-surg experience first. I didn't have that (I went straight from nursing school onto an adult/CD unit) and when my hospital closed virtually no one would hire me.

Mental health can be very rewarding - and your unit sounds like a good one to work on. Depressed patients tend to be pretty calm and you shouldn't have too many incidents (keep an eye out for suicidal behavior, though). My unit took pretty much everything - detoxes, psychotic patients and some court commitments. The depressed patients were my favorites (although I had a fondness for schizophrenics as well).

Good luck on the specialty change.

I'm a new grad on a med-surg unit. Psych nursing is where I wanted to be staright out of nursing school but every place I interviewed with wanted 1 year of med-surg experience first. So now I'm on the med-surg unit waiting till my year goes by to pursue my passion. So to all the psych nurses out there how can I stay abreast of what's going on in this specialty until I can transfer to a psych unit?

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