how much orientation for new grads in psych?

TitaniaSidhe · Mar 2, 2005

I went right from school(BSN) to acute psych & have remained there ever since. Personally I wouldn't recommend it that way, but it was how I did it. You may be better off working at least 1 year in med-surg for the experience & medical skills. Keep in mind you can practice psych anywhere you may work...

elkpark · Mar 2, 2005

The length and depth of orientation you may get will depend entirely upon the individual organization, and is something you need to discuss in detail during the job interview(s) process and take into consideration when deciding on a position.

celle507 · Mar 2, 2005

Thanks for the replies - I very much appreciate them. Titania, can I ask what your experience as a new grad in psych was like and why you would not recommend starting out in psych?

I know that new grad orientations in hospitals take about 3 months (which I would want anyway just to feel comfortable) but I was hoping that orientations for psych nursing positions might be a bit shorter since the care is not as acute and my goal is psych nursing anyway. The reason I am asking is because I am starting a full-time MPH program in September so I only have a month and a half to orient to a new position/career. Do you think it would be possible for a new grad to feel comfortable in one and a half months in psych nursing?

elkpark · Mar 3, 2005

Do you think it would be possible for a new grad to feel comfortable in one and a half months in psych nursing?

I can't imagine a new grad "feeling comfortable" in one and a half months ANYWHERE in nursing, but others may have different opinions. And I'm curious by what you mean by "the care is not as acute" in psych settings -- psych patients have very serious, acute psychiatric problems or they wouldn't be admitted (esp. these days ... :rolleyes: ), and often have concurrent significant medical problems as well. The days of psych nurses sitting around, playing bridge with the clients all day are long gone (I was actually around for the tail end of those days (big sigh) ...), and strong med-surg skills are a necessity.

There are other threads here that have discussed starting right out in psych vs. the traditional recommendation that one get a year or two of med-surg experience before going into psych -- you may want to search and review them. Some organizations will not hire new grads into psych (or other specialty areas), some will. Depends on how desperate they are for nurses, among other considerations.

TitaniaSidhe · Mar 3, 2005

Very valid points elkpark, but alas they are DESPERATE for nurses everywhere.

What was it like for me starting right off in acute psych...way back when...lol. First let me say I started & still do work in a large institution, a VA hospital. You could perhaps equate this to a state hospital type setting as opposed to a community hospital psych unit. We had many chronic, severe, forensic, violent patients. I was fortunate to have had a very good nursing education in the college I attended. I was also fortunate that even though I was in a BSN program & had less clinical time in comparison to a diploma program, I did get to have many more clinical experiences than I ever expected to. I also had the privilege of working in social services in the community at a center city drop in shelter for the homeless while I was attending college. This experience was invaluable as I worked with the mentally ill & substance abusers as well as the police & various agencies. Let's just say I saw A LOT working there. Coming into my interview at the VA fresh out of college & still just a graduate nurse (nope didn't yet know if I passed the boards yet) the nurse recruiter after speaking to me at length hired me on the spot & in a sense threw me to the lions...lol. I have said this in previous posts but I think that the most valuable quality a psych nurse can possess is common sense & intiuition coupled with a good nursing skill foundation. For you to assume that a brief orientation is all that would be required b/c you don't have the medical acuity of other areas is just naive. In psych the acuity is of a different nature but no less acute...also just b/c they are mentally ill doesn't mean they don't also have medical issues/problems. You still need to know your stuff perhaps even moreso b/c they may not be capable of telling you their medical history if they are so psychotic, do you see where I am going? Then of course you have the situations that arise which are unique to psych such a NMS, lithium toxicity, TDS, occasionally brain tumors, head trauma. Yes we do work on psych & yes even moreso now than ever as insurance will not pay for "frivilous" admissions. *sigh* Length of stay grows shorter & shorter while the paperwork gets longer & longer but that is another ***** all together. BTW speaking of paperwork, please realise the lengo & assessments are completely different than what you are used to doing on a medical floor & you will need time to become familiar with the terms & their meanings as well as their manifestations in actual patients. Do I think a month & a half is a long enough orientation for acute psych, nope I don't. Maybe an open unit where the patients have full privileges but well even there you will be expected to design & conduct groups as well as do the charting. There is also the fact that you have to become familiar with the various meds we give which are different that those on a medical unit...I dunno, for me it was exciting in the beginning but scary as well. In the first several months of my employ there I was assaulted for the first time. I was so gung ho & had the I can change the world attitude I was not really listening very well to the advise from the older more experienced nurses & NAs. It is always the last one you would expect to smack you that does it to....lol. I put myself in a situation where I was alone with the patient, even though I had been told never to do this, & he punched me in the face/head 4X before anyone could intervene. Needless to say I learned very quickly to pay attention to the pearls of wisdom which were being so graciously imparted upon me from the more experienced staff...lol. Ah yes humility is a wonderful thing. Psych can be scary, exciting, overwhelming, deeply saddening & joyful. It is I suppose like anything in life, it is what you make of it. I mentioned the getting some med/surg experience simply b/c it is something I wish I had done myself.

I don't know exactly if I answered your question, perhaps not the way you wished I might have. I simply typed what came to mind as I sat here & I certainly hope it helped. I wish you luck in whatever you may do but please, never think that we in psych sit around doing any less than any other speciality area. What we do is simply quite unique to us much in the way Maternity or Peds are realms onto themselves. Do you see?

Psych RN2 · Mar 12, 2005

Thanks for the replies - I very much appreciate them. Titania, can I ask what your experience as a new grad in psych was like and why you would not recommend starting out in psych?
I know that new grad orientations in hospitals take about 3 months (which I would want anyway just to feel comfortable) but I was hoping that orientations for psych nursing positions might be a bit shorter since the care is not as acute and my goal is psych nursing anyway. The reason I am asking is because I am starting a full-time MPH program in September so I only have a month and a half to orient to a new position/career. Do you think it would be possible for a new grad to feel comfortable in one and a half months in psych nursing?

I have worked in pscyh for 16 years. I accepted a full-time position directly out of RN school. I eventually took a part-time position in a medical facility for experience. Although working in med surg may have helped some, you really have the basics from school. Your best bet is to jump right in. Make sure the facility you work for starts you on one unit and you stay there until you are comfortable. Many psych hospitals treat adults, adolescents and preadolescents. It is important to feel comfortable with one specific age group before conquering another. The treatment is quite different. One month is okay for one unit. I am a supervisor and have hired many new nurses. The ones with ambition, determination and self assurance always do well. If this is your goal stick to it. I have found it takes a special individual to do psych nursing. Not all nurses enjoy this field, that's why there are so many of us and we are highly recognized due to our ability to specialize in different areas. It sounds as if this is your calling. Stick to it:)

blue chips · Mar 12, 2005

Hi,
I am going to graduate from this July from an RN program and I am interested in working in psych nursing.
I am just wondering, how long are orientations for new grads? Is it easy to find a job as a new grad in psych?
Thanks!!

6 weeks. :)

2ootsRN · Mar 12, 2005

Hi,
I am going to graduate from this July from an RN program and I am interested in working in psych nursing.
I am just wondering, how long are orientations for new grads? Is it easy to find a job as a new grad in psych?
Thanks!!

Hello Celle507, I've read your question as well as the replies you received. i have to say that I go along with elkpark and TitaniaSidhe's replies esp. Titania...'s. I too have been in nursing too long to even begin to think about it. I also started my nursing career on a Med/Surg unit and even though I also believe that this is the best way for nurses to start out, I also have to say, "times have changed" and we see new grads starting their 'Nursing Journey' right where they desire to work. I work in a Community Based Psych. Unit. and where I work, the turn over is very minimal. On our unit we have three RN's who are relatively "new" to Psych Nursing. One has been an RN for several years and opted to work in psych and two RN's are fresh out of school-took their boards passed and are working their first ever job as a Psych. RN. I also know that 'Nurses can eat their young' as the expression goes. Do I think this is right-heck no!!!! but it still happens. Fortunately for the new Psych. nurses on our unit, the majority of us feel as I do (but we do have one or two 'old time' nurses that are Passive Aggressive and who can get out of hand given the opportunity) anyway the new nurses on our unit were preceptored with an older experienced Psych. Nurse: meaning they worked the same shifts, had the same days off as their preceptor nurse. Management as well has kept close contact with the new nurses and with the rest of staff and thus far, these two new to nursing RN's are working out okay. They had approx. two months preceptorship and they are still 'learning' the ropes but you know what, so are we as everyday can be a learning experience for all of us new and old to nursing alike. I started out in nursing in 1962 and I love it more today then when I first went in. I enjoy working with the new RN's as well as the experienced nurses but this is me and that's my attitude about nursing as I refuse to 'eat my young in nursing'. Our new RN's also were oriented to the Med/Surg unit of our hospital. I have to say that I also work with an RN who is Mastered Prepared who literally 'falls apart' if she has to 'float' over to the Med/Surg unit when our unit has low census (doesn't happen too much anymore but none the less) as she doesn't have "Med/Surg" skills and becomes very intimidated if she has to go there as she doesn't know what to do, doesn't feel she knows how to assess a Med/Surg pt. and panics as she is out of her element. I have to say that I really believe how 'well' a new grad will do on a Psych Unit depends on the integrity of the unit as a whole and on the new grad her/himself. Like the other feedback you received, doon't think for one minute that 'Psych Nursing is a breeze' because it isn't. People can and do get hurt there secondary to the type of pts on their unit. I have a girlfriend who is out on workmens comp. who probably won't be back to work. She's been a nurse as the saying goes, 'forever' and got injured on the job from a quote unquote, 'Little old Lady'. Two other associates got thrown into the wall as well as got bunched with a fist and 'karated' in the process-why, because one of our so called experienced nurses turned her back and let an acute care pt. get through the door into the nurses station. So Psych Nursing can be dangerous too. I guess you always need to remember to keep your guard up. So before you take a job as a new RN in Psych or any nursing field, check out the 'water' see how the staff is see what you feel during the interview process, the tour of the unit etc. and one last comment. May your journey into the field of nursing be forever fullfilling and rewqrding to you as it is and has been to me. Welcome aboard. 2oots aka 'Sarge' and old but young at heart nurse:) :Melody:

CharlieRN · Mar 12, 2005

I'm of the opinion that a 6months to a year of med/surg hell is a good background for any sort of speciality nursing. ICU or ER experience is also great.

Remember when you are part of the "psych treatment team" they will be looking to you to have the generalized knowledge of medicine. You will be the one they ask about the patient's new rash. It is you who will comb the lice out of hair, and tell all the other spcailists that they have to go home and treat themselves and their families with "Kewl". Oh, the joys of one to one patient contact!