Hello! I am a recent grad (BSN) and am currently applying for jobs and peparing for NCLEX. I have always been interested in psych and am consiering psych nursing, however I have heard from soome that I should get med-surge experience first! I need opinions/advice PLEASE!!!! I really have a huge interest and a lot of compassion for psych patients, but am afraid of entering this field and not beingmarketable if I want something else later and am also afaid of wasting my time in a position I might not really be happy with like med-surge....
suggestions please...
Has anyone out their done psych nursing throughout their whole career? Should I get some med-surge experience?
Your patient is floridly psychotic with extremely delayed responses. He's got the word salad, flight of ideas, tangential, etc. He was dropped off by someone who doesn't want him around. He's paranoid and responding aggressively. He looks sick! NOW: do your H&P.
You have a paranoid patient who looks like a body builder. 300lb of muscle. He does NOT want to take his involuntary medications. You do not have time to do the paperwork associated with holding him down to administer. Can you get the medication in him.
Can you tell the difference between compulsive polydipsia and a diabetic going acidotic?
Can you train minimum wage staff in patient care? Can you build them into a proactive team?
Can you tell the difference between a 'heart attack' or 'seizure' in a drug seeking patient who has been fooling ERs for 20 years and the real thing? Without the benefit of history?
A piece of advice from one who did it - don't go straight into mental health without polishing your technical skills. I took a job in mental health right out of school. Five years in I worked for an employer who closed the facility out from under us. I went from fully employed to on unemployment compensation for three months - at a time when local hospitals were running full-page ads in the Sunday paper begging for help. I couldn't buy an interview because mental health was all I had done and, in the eyes of most, all I could ever do. There is an unfortunate stigma that goes with psychiatric nursing, one that almost cost me my career at one point.[/quote']
Very true!!! I've heard this story tooooo many times!! I float to our behavioral health center on my off days because I have a psychology background & nurses who have been there for 10-15 years ask ME, a new fairly nurse, medical questions about their patients because they simply don't know what they are looking at or what's the best course of action. Another friend I work with at behavioral health has been a psych nurse for 23 years & can't even get a transfer position to a med/surg floor with in the same hospital system because even a new grad is going to be a little more 'qualified' because they're coming into it w/ current knowledge.
Please, please, please get at least a year of med/surg under your belt before specializing in psych.
I started out in psych. I have no regrets. If you know you're going to hate med surg, my opinion is don't waste your time. Yes, a year of med surg won't hurt, but the arguements of keeping up your skills.......meh. I think you would be looking at the same difficulties if you DoD a year of lex surg and then jumped to psychfor a few years. Your med surg knowledge is only as current as the last time you worked in it iykym.
I have been a psych nurse for over 25 years with absolutely no regrets. I went into psych straight out of school. In fact I finished my senior preceptorship on Thursday and started full-time on that unit the following Tuesday.
In nursing, as in anything, if you can find something you are passionate in you should do it. Life is way too short to do something because other people tell you you should.
I personally found med-surg nursing very frustrating. I wanted to talk to patients, to spend time with them. There just wasn't the time in med-surg to nurse the way I wanted to. In psych, I found my niche. There are enough physical-medical things to appeal to the side of me that wanted the "task-y" stuff, but I also had time - in fact it is my job - to talk to people!
I started on Geriatric psychiatry and Neuropsychiatry units where there was a fair amount of basic physical care required. I got to hone my assessment skills and practice good nursing care. At the same time I was starting to develop my psych nursing skills - communication techniques, crisis intervention skills, therapeutic use of self, etc.
Over the years I have changed specialty areas frequently (always in psych, though). I have worked in forensics, mood disorders, schizophrenia, both with inpatients and outpatients. I also worked as a study co-ordinator for drug study research. I currently work as a nurse educator doing staff development. (Teaching is my other passion, so I am incredibly lucky!)
If you feel drawn to a career in psych - mental health, then go for it!! My faculty advisor (who was not a psych nurse btw) told me in my final year that the technical skills / technology can be learned or re-learned at any time - the skills you learn in psych nursing are invaluable and will always be relevant wherever you go in nursing or in life. I have never forgotten that and I have found it to be true.
I have been a psych nurse for over 25 years with absolutely no regrets. I went into psych straight out of school. In fact I finished my senior preceptorship on Thursday and started full-time on that unit the following Tuesday.
In nursing, as in anything, if you can find something you are passionate in you should do it. Life is way too short to do something because other people tell you you should.
I personally found med-surg nursing very frustrating. I wanted to talk to patients, to spend time with them. There just wasn't the time in med-surg to nurse the way I wanted to. In psych, I found my niche. There are enough physical-medical things to appeal to the side of me that wanted the "task-y" stuff, but I also had time - in fact it is my job - to talk to people!
I started on Geriatric psychiatry and Neuropsychiatry units where there was a fair amount of basic physical care required. I got to hone my assessment skills and practice good nursing care. At the same time I was starting to develop my psych nursing skills - communication techniques, crisis intervention skills, therapeutic use of self, etc.
Over the years I have changed specialty areas frequently (always in psych, though). I have worked in forensics, mood disorders, schizophrenia, both with inpatients and outpatients. I also worked as a study co-ordinator for drug study research. I currently work as a nurse educator doing staff development. (Teaching is my other passion, so I am incredibly lucky!)
If you feel drawn to a career in psych - mental health, then go for it!! My faculty advisor (who was not a psych nurse btw) told me in my final year that the technical skills / technology can be learned or re-learned at any time - the skills you learn in psych nursing are invaluable and will always be relevant wherever you go in nursing or in life. I have never forgotten that and I have found it to be true.
Best of luck to you!
Thank you for the advise! I've also been told technical skills can be taught as well. I'm just trying to find myself and my niche and its been super frustrating... I've got about 6 months exp and I have some not great experiences... Some days I question if I've even made the right choice with nursing... I didn't like med surg, I would like to keep my skills up so I'm trying to get a prn position. I worry so much about it I'm trying myself crazy, maybe I need inpatient therapy lol.
I am in a similar boat and I plan on jumping right into psych! It's the only rotation during school that I actually really liked and I was miserable on med surg floors so why am I even going to bother? I want to be happy where I work and not suffer through a year of something that doesn't make me happy just so I can eventually move on and see what psych is about. I think it may be more difficult to get back into med surg after being a psych nurse but not impossible and things can be relearned. However if I go into med surg first,, I know I will be regretting that decision until I've had a chance to see how I liked psych.
Specializes in Hospice, corrections, psychiatry, rehab, LTC.
So what did you do? Where are you at now? To be honest with you, working on a medical floor doesn't interest me.
I love psych.. Interested in correctional & forensics.
I am a DON in a correctional facility.
I worked in a free-standing mental health facility. Our parent company closed the facility. Since we were the largest mental health service provider in our area, there were not enough available psychiatric nursing jobs in our area to absorb all of us. Because I had no medical nursing experience apart from nursing school clinicals, I couldn't buy an interview. I drew unemployment for 90 days (with five years experience as an RN, almost all of it supervisory). I went from making $20 per hour to less than $300 per week. I finally caught on with a rehabilitation facility and did rehab nursing (physical rehab) for a while, then I went back into mental health before taking some per diem hours at a prison that led to a full-time position and eventually to upper management.
If all of your experience is in mental health, there is a general perception that you cannot do anything else. Many employers are unwilling to take you on if you cannot find a mental health job. It's better not to paint yourself into a corner, because you never know what lies ahead. Nurses who are skilled in med-surg, critical care or emergency medicine don't face this issue because their technical skills are easily marketable. Fair or not, being skilled in saving lives without medical procedures isn't held in the same esteem by prospective employers.
K.P.A.
205 Posts
Your patient is floridly psychotic with extremely delayed responses. He's got the word salad, flight of ideas, tangential, etc. He was dropped off by someone who doesn't want him around. He's paranoid and responding aggressively. He looks sick! NOW: do your H&P.
You have a paranoid patient who looks like a body builder. 300lb of muscle. He does NOT want to take his involuntary medications. You do not have time to do the paperwork associated with holding him down to administer. Can you get the medication in him.
Can you tell the difference between compulsive polydipsia and a diabetic going acidotic?
Can you train minimum wage staff in patient care? Can you build them into a proactive team?
Can you tell the difference between a 'heart attack' or 'seizure' in a drug seeking patient who has been fooling ERs for 20 years and the real thing? Without the benefit of history?
Psych takes some skill...