Need some advice from experienced nurses.

[ItsYourJourney]

Hello all!

I am graduating in May and I am not sure what to do. I entered nursing specifically to become a mental health RN, but I am not sure whether or not I should jump into it.

I have a lot of people in my ear telling me that I should go into med-surg first before I jump into psych. Most people say that it would make me a better clinician.

I guess my question is, are the skills that I would acquire on a med-surg floor very applicable to the skills I would need on a mental health unit?

And, if you are a mental health nurse, do you think that one would need med-surg experience to be a great clinician in a mental health environment?

Thank you in advance!

[Cat365]

If you want psych go for it. Med-surg gives you a basis for the medical end of things and some of your psych patients will also have medical diagnosis depending on where you practice. However if you want a specialty and can get into it right away go for it. The medical skills can be learned elsewhere and depending on where you practice they may not be very necessary anyway.

In the words of another nurse who told me to try for ER right out of school. You can always go to Med surg because they are always hiring. The specialty may not be. Also it seems to me that even med surg is getting a bit specialized at larger hospitals.

[martymoose, BSN, RN]

Go straight to psych. A fellow student with me went straight into it, no problems. Different skillset.

Not that m/s is wrong, but I'd say if you can get into the psych, then go for the psych/mental health.

And thank you .From what I see in general medicine, mental health is very needed.

[dream'n, BSN, RN]

I had many years of nursing experience, including Med/Surg before starting psychiatric nursing. My previous experience made my transition to psychiatric nursing much easier. For example, there are many psychiatric patients that will attention seek, manipulate, or as part of their mental disease process, present to nursing with medical complaints. It is important for the nurse to have experience and strong assessment skills to make appropriate decisions. Without this knowledge, a nurse would be sending patients to the ER almost continuously and feeding into some of the patients psychiatric conditions.

As a psych RN, resources may be somewhat scarce and at times, you may be working without any other nursing or medical staff present. Therefore, autonomy and confidence are also important qualities to have. I personally think that some medical experience would be of benefit to a new psych nurse.

[Natasha A., CNA, LVN]

I was a mental health worker formally known as a CNA for 6 years before becoming a LVN and the skills I used mostly were crisis intervention, management assaultive behavior (MAB) skills and deescalation techniques. You will also use a lot of communication techniques to help with patients wanting to AMA.

[Meriwhen, ASN, BSN, MSN, RN]

Having prior med-surg experience definitely couldn't hurt and does have benefits. However, it is no way required to be a successful psych nurse. Psych nursing utilizes a different skill set, that is all. Not a superior or inferior skill set, just a different one. Therapeutic communication and medications are your two major nursing interventions in psych.

Depending on the type of facility/unit you're working, the medical acuity level of patients will generally be lower than that of your typical med-surg floor. Seriously medically ill patients are transferred to medical units (ICU, tele, etc.) and will usually be followed by psych while they are there, then return once stabilized. Psych-med units and geropsych are where you'll find your most medically acute patients. Of course, your lower medical acuity patients will still have chronic medical problems (HTN, DM, etc.) that need to be addressed. But if you're willing to put the effort into it, you will be able to pick up a lot of that knowledge as you go long.

Having prior medical nursing experience doesn't mean that it will be easy-peasy to transfer into psych or to be successful at it. There's more than a few threads in the Psych Nursing forum about experienced nurses lamenting how hard it is to break into psych. And I've seen experienced nurses new to psych be driven to tears because psych wasn't what they thought it would be.

And last, if you know you don't ever want to do med-surg, then why torment yourself for a year doing it? BTW, med-surg is a specialty in it's own right--many often forget that.

So if your dream is to go into psych and the opportunity presents itself, IMO, grab it. If you decide to try something else first, that's cool too.

Best of luck whatever you decide.

[BSNbeauty, BSN, RN]

Go for psych! I don't believe all nurses should start on medsurg. Been a nurse for 8 years and never stepped on a medsurg unit. I've done may other specialities and found my niche in post partum. Been a PP nurse for 4 years and love it!

[Nature_walker, ASN, BSN, RN]

I graduated last May and started on a psych floor. I love it. I have no desire to go to a med/surg floor. If you are interested in psych and there is an opening, I say go for it.

[ItsYourJourney]

Thank you all so much for replying. It can be difficult making a decision regarding specialty as a new grad. I am pretty sure that I will take a job in mental health floor if I am afforded the opportunity. I just want to make sure that my lack of med-surg experience will not be a hindrance to me providing quality care to my future pts in a mental health setting.

Thanks again for all of your replies. This group is has been such a great help to me.

[RNOTODAY, BSN, RN]

The old " you need a year of med surg afterschool" does NOT apply anymore, it's outdated info... I , before even sitting for Nclex , had three jobs lined up.. Neonatal ICU, Cardiothoracic ICU, and Trauma ICU.. I made the decision before I entered nursing school that I was never going to be a bedside floor nurse, and I never was... my first job, I picked Neonatal ICU... then mY REAL position opened up-- the OPERATING ROOM, I'll never work anywhere else !!!

sooo, if you know you have no interest in Med surg? Don't bother wasting your time!!go into psych, like you want to!!!

[ItsYourJourney]

The old " you need a year of med surg afterschool" does NOT apply anymore, it's outdated info... I , before even sitting for Nclex , had three jobs lined up.. Neonatal ICU, Cardiothoracic ICU, and Trauma ICU.. I made the decision before I entered nursing school that I was never going to be a bedside floor nurse, and I never was... my first job, I picked Neonatal ICU... then mY REAL position opened up-- the OPERATING ROOM, I'll never work anywhere else !!!

sooo, if you know you have no interest in Med surg? Don't bother wasting your time!!go into psych, like you want to!!!

Wow, straight into the ICU?! That's awesome! Thank you for the feedback. I am just gonna go for it. My mind was made up before nursing school began and it was reaffirmed during clinical. I feel a lot better about forgoing med surg before entering psych.

[Meriwhen, ASN, BSN, MSN, RN]

The old " you need a year of med surg afterschool" does NOT apply anymore, it's outdated info...

Another thing about the "year of med/surg first..." experience: people may tell you that it will help you in changing specialties or returning to med/surg later. The reality is that it will only help if you make a switch fairly soon, as in a couple of years. Because after a certain point, many employers will no longer consider that initial year of med-surg as being current enough. There's too many medical advances going on.

For example, one of my employers--a major healthcare player out here in the Western US--considers experience for ANY specialty relevant only if it is within the last three years. So with them, that year of med-surg (or whatever) from 10 or even 5 years ago may or may not count for anything in your application.

Just another think for the OP to ponder.